Options for women who are pregnant and uninsured and who fall in the in between category of not qualifying for government funded health care, but also can’t afford private health care.
I feel this is one of biggest issues in modern day healthcare: The fact that there is basically no way you can get affordable private healthcare that includes maternity. I’m serious, start researching it yourself and you will be extremely frustrated!
I should probably mention that, no I’m not pregnant and yes I do have insurance, but not too long ago I was in this situation.
Due to a series of unfortunate events, I found myself 3 months pregnant with no insurance, there was a major lapse in coverage (though I thought I was covered) and so the whole, “pregnancy can’t be considered a pre-existing condition” thing totally went through a loop hole.
We looked into almost every option and talked with a bazillion other people, but could find absolutely no solution. Either the waiting periods were so long I wouldn’t be pregnant when it was off, or the monthly premiums were so high that I could not feasibly afford to pay it (around $1000 a month).
I am what the industry has coined, a Mom in the Middle. I don’t make enough to pay for outrageous private healthcare, but I also make too much to qualify for any federally or state funded insurance.
So recently I decided to do a little research on it to see if times had changed and if any progress has been made to help the Moms in the Middle. I should have known better because it hasn’t.
So what are some options for moms in the middle? Unfortunately, none are ideal.
If you own your own business there is an association for the self employed called National Association for the Self Employed (NASE). You have to pay a sign up fee of $75 for the year then you are part or a “corporation” so you are offered health benefits like if you were employed. They do have a maternity rider because since they aren’t a huge corporation ie- Starbucks they don’t have the cost for maternity spread out to all employees (even males) so that the cost is lower. The rider is something like $300-400 extra per month for 12 months and then they will pay 60% of cost up to $3000. If you pay the extra $300-400 premiums for 24 months, they will cover 80% up to $7000. Obviously, this is NOT a good deal.
Only like one or two companies offer this. I saw that Humana offered a maternity optional coverage, which was an extra $150 a month (in addition the $250 premium for Lyric and I). Then there was a $5000 deductible. Then after you paid the deductible, for the first 2 years, they would cover up to $2500 worth of pregnancy related expenses, then 3 years they would cover $5000 and then after 4 years of paying this extra premium they would pay up to $7500 of maternity related expenses (which is the max).
Well I had a baby in a hospital with an epidural, and my delivery fees alone (not including the doctor) were $10,000. It would never be worth it.
Women who live in Texas and who can’t qualify for Medicare might be able to qualify for CHIP. They just started a program for maternity. It doesn’t give a whole lot of financial wiggle room (especially if you are a 2 income family), but it’s a sliding scale based on how big your family is. It might work for you, click here to find out the income guidelines. I think a family of 4 (they count your pregnancy- so if you just have 1 child, but you are pregnant, they count you as a family of 4) you can make up to $42,000 a year. If you can qualify, you pay like $50 every 6 months and they cover all your expenses. The only drawback is if you have a preferred doctor, they may not take CHIP, but heck, if you can qualify and aren’t insured, I would make that sacrifice, or at least pay your doctor out of pocket. The most expensive part of pregnancy is the hospital/delivery anyways.
If you are a Stay at Home Mom look into getting a part time job at a large corporation. Here are a list of places that offer great benefits to part time employees. Places like Starbucks and Fed Ex will let you work just 20 hours a week and have a wide variety of hours to accommodate almost any schedule. It wouldn’t be ideal, but hey, you can do anything for a short period of time right? Especially if it will save you thousands of dollars.
As long as you are with a company employing at least 15 individuals, this coverage can be carried up to 18 months after you left your company. Essentially, you would be covered under your previous employers coverage but paying your portion PLUS the portion your company was paying. This would also protect you from falling under any pre-existing clauses as you would have continued your healthcare coverage, therefore eliminating the 63 day clause (however, if you let the COBRA coverage lapse more than 63 days the the pre-existing clause comes back into play). As you can see, this once again is VERY expensive. If I paid the full healthcare bill for Lyric and I that my company pays, it would cost me almost $1000 a month. Ick!
This would be good if you were already pregnant, had a major lapse in coverage, are working part time and your company doesn’t offer insurance or you have a pre-existing condition of some sort. It’s a little on the expensive side, but not as bad as the private healthcare. It’s still has a high deductible and only covers I think 80% of the cost.
No new mom likes to hear this option as they immediately envision some overweight woman with long hair tied back into a braid wearing pioneer style clothes putting a leather strap in your mouth and telling you to push that baby out. No pain meds? However, childbirth doesn’t have to be straight out of an old western. More and more women are choosing natural childbirth at either their home or a birthing center. The midwifes are all certified and very experienced. Obviously the drawback is no pain meds and doctors/surgeons in the room if there is an emergency, but they give you different coping mechanisms that you don’t get to use in the hospital and should all be experienced enough to know when an emergency is presenting itself. I personally haven’t done it, but know many women who have. The bright side? The cost of this is between $2000-4000. More than half of what you would pay at the hospital and most will work with you as far as payment plans go.
I personally never used this, and had done some research on it. I’ve found that you either love it or you hate it. Basically you pay a monthly fee to this company and they TRY to negotiate better rates. I found that I could do this on my own, without having to pay the $50 fee, but some people find it easier to just let someone else. I can see both sides. All the research I’ve done on it, just seems to result in people saying it’s not really worth the $50 a month.
So how can we change this? Some people say we need Universal Healthcare like in Europe. I’m a bit more for what Hilary is vying for. That would be to keep private healthcare intact for those who want it, but then open up the insurance that federal employees have and then use a sliding/affordable monthly premium based on how much money you make. No pre-exisiting condition crap, it would meet you where you are and your premium works with your current lifestyle.
Unfortunately, I’m not sure, even if Hillary gets elected, if any of this will change. I’m not sure if it should, since it could most likely bankrupt our nation trying to pay for it all… but the bottom line is the healthcare situation for uninsured mothers are ridiculous.
Hundreds and thousands of women are pregnant right now and are in that “Mom in the Middle” category and they have no hope. It’s not so much the fear that their normal delivery will cost too much, it’s the fear of the unknown. What if they have to do an emergency c-section? What if the baby is born prematurely, what if the baby has an unknown condition and needs to go in the NICU for a few weeks? We are talking about 40-100k for complicated childbirth. Talk about a hefty bill!