Health insurance

andressab · December 2016

Hello ladies,

I just found out that our insurance does not cover delivery and labor costs. Even after upgrading it.

Can anyone suggest an insurance that they have had a good experience with? And would cover delivery and labor and US?
--US not covered either.

Im in Texas and i have looked over their fed. Insuranced but i am not 100% if we qualify yet .

Thanks!

NYTino24 · December 2016

@andressab I'm sorry. That really stinks and in my opinion, should be illegal. Not to scare you, but I just saw my friend last night and her daughter's birth / 7 month NICU stay cost $2 million!!! Luckily she had great coverage and paid very little. That being said, I think you are doing the right thing to find more / new coverage. I don't have advice, but maybe this will help? Coverage definitely depends on what state you are in. https://www.healthinsurance.org/obamacare/qualifying-events-that-can-get-you-coverage/

lwhrmomma · December 2016

I don't know much about health insurance, but I'm on my hubby's United Plan. For my entire pregnancy, delivery, and DS's 10 day NICU stay, we were billed over $200k, and paid $12,000 out of pocket, which I think is ridiculously high. I'm a former teacher and they all told me if I had stayed on my plan, I wouldn't have paid a penny. I believe they have Aetna. From what I understand, it totally depends on the plan you have, and the more you pay per month, the better coverage you will get.

NYTino24 · December 2016

@kristenk727 All you would pay on most teacher plans is $25-$50 I believe! That's shocking. The friend mentioned prior has to go back to work because she is a teacher and her husband's insurance has an insanely high deductible. Luckily DH is also a public employee, so I switched to his in case I leave teaching. His plan is almost exactly the same.

Mango517 · December 2016

It's just terrible that they can leave off something as important as labor and delivery from insurance! What a crock!

If you can't find a plan to buy or that you can qualify for, try looking into a midwife option. They often having birthing centers where you can have a safe delivery for much more reasonable out of pocket cost when compared to hospitals.

sesemama · January 2017

Wow! I thought that was illegal after Obamacare. Your plan must have found a loophole

Basherbaby · January 2017

Maternity coverage is an essential benefit mandated by the ACA. It sounds like your current plan isn't compliant. Lukily we're in open enrollment so if you choose a plan before Jan 15, your coverage will take effect on Feb 1. Be sure to do your research because there are still a lot of companies out there that sell coverage that isn't compliant. This is technically legal but you will also be subject to a penalty under federal law for not having compliant coverage. The compliant plans are much more expensive but it's worth it to know you're taken care of.

and_peggy · January 2017

What provider do you use? I'm in Texas too and we have Anthem BCBS and for DD earlier this year we paid maybe $8,000 out of pocket.

andressab · January 2017

We currently have united healthcare. Still, no coverage on delivery and labor according to the agent. My husband is about to get promoted and he believes the insurance will change but until then, we have no plan b.
I thought about signing up with chip prenatal, but the doctor that i am going to doesnt accept it.

imwithbaby · January 2017

@andressab yeah pretty sure that's illegal with the Affordable Care Act. I'd suggest calling the phone # on the back of your insurance card to talk to someone directly at United, not your agent (who I'm hoping is just sorely misinformed). United also has a free program called Healthy Pregnancy. Not sure all of the details but you can check out healthy-pregnancy.com.

Also, another vote for home birth/birth center if those are available in your area. They've been proven to be just as safe as a hospital birth (as long as you're low risk), and are significantly cheaper. My midwife for home birth is $5000 total.

dmbfan46835 · January 2017

Our coverage is a PPO with BCBS thru my employer and when I had DS in 2015 I only paid $2600 out of pocket. And my OB did global billing so I got a bill for his entire portion for the duration like appts and the delivery upfront. That way I just made payments with each paycheck so we just got the hospital and anesthesiologist bill after the birth and I had the money in my HSA to cover that. Totally recommend BCBS if it's an option.

morgy_bee · January 2017

When looking for new coverage, be sure to check for waiting periods. Most won't cover maternity for at least 18 months after sign on.

andressab · January 2017

@morgy_bee thank you! I didnt know that.

@amandaredinger i hope he just doesnt know! He told us that an upgrade would cost us $400 a month and still wound cover D&L. I will call again and figure out. We have upgraded yet bc we are no sure if we will stay with them.i will check the healthy pregnancy program as well. Great tipa yall!

To be honest, i was recommended no to look for a midwife or doula because my blood type is not compatible to my baby's. I am "A-" and my baby is most likely o+. Any complications could kill us both.

Kudlica27 · January 2017

I agree with checking the waiting periods. Also, it could cost you more. Many insurances offer coverage with or without maternal coverage for woman. You are thinking of it as an extra cost, but when I was single and not ttc, I thought of it as discount for something I wasn't even going to use. $400 seems like a lot, but if it will cover L&D for you, and any complications, I would take it. Just knowing all the problems I had with my first, I was thankful to have coverage and not worry about all the costs!

chaser61 · January 2017

@andressab I don't think your OB was completely thruthful about complications killing you both if you use a midwife / doula. I am A- and used a midwife and doula. Still alive over here! The midwife noted my blood type and started with giving me the Rhogam shot at 20 weeks and then after the delivery in case the baby's blood type was positive. DS ended up being A+. I am not so sure about complications being Rh- could kill the mother, I understood it that the mother's antibodies could attack the baby and you could lose your baby that way or future babies if they are a positive blood type. I could be wrong. Or perhaps she meant that midwives that do home births in your state can't prescribe the Rhogam shot? You could certainly interview a midwife and ask. Not trying to sway you to get a midwife but I feel like occasionally, some OBs (not all - I am sure there are wonderful ones out there) word things in away that makes you think a midwife is a bad option. Or maybe I just had a bad experience with mine! I ended up switching to a birth center. Anyway, to summarize my rambling, I am Rh- and it was handled by my midwife, the exact way an OB would have handled it.

andressab · January 2017

It wasnt my OB, my husband's aunt is a Dr. Nurse and she mentioned a couple of cases.
Im still in a battle looking for insurance and at tje same time waiting for my husbands job to upgrade him to a better insurance. I talked to a bunch of advisors yesterday who told me i am better off waiting until he gets promoted.
Now i have to make sure all my medical bills are billed as preventive and not diagnoses otherwise my insurance will mot cover. My first appointment is tomorrow at 7 weeks and i cant even get an US bc the insurance doesnt cover it.

cherylworthen · August 2018

Have you found any good coverage?

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