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Pregnant and Uninsured?

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.

  1. NASE

    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.

  2. Private Healthcare with a Maternity Rider

    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.

  3. CHIP

    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.

  4. Part-Time Job

    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.

  5. COBRA

    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!

  6. State Insurance Pool in Texas

    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. 

  7. Birthing Center

    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.

  8. Maternity Card

    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!

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  1. This is an excellent article, and I\’m glad someone is tackling this subject.

    One thing though… On the State Insurance Pool in Texas, it says that pregnancy is considered a pre-existing condition and excludes the candidate from coverage. Unless I\’m reading this wrong, this plan is of no help to anyone already pregnant without insurance.

  2. Oh, thank u for this article…you’re right, it doesnt help a whole lot but does give some insight on the situation. I’m a stay at home mom, my husband through with his current job, and waiting for a TX license for his new job (which may take between 2-4 wks)-and even after he gets it, will take 30 days for the insurance to kick in. So what’s the worst part of the whole deal-i’m 26 wks pregnant!! Cobra is probably our only option-but will cost a minimum of 1,200 per month! yikes!!

  3. I am about to be right there in the middle. I lost my job when I was 5 months pregnant and my insurance is going to expire soon. I have found that no one really wants to hire someone who is pregnant and so close to the end of the 9 months, so I cannot find a job that would cover childcare for our first child and also pay for insurance. We do not make enough to qualify for government programs and I cannot get covered on an individual policy. If I got on my husband’s insurance, it would take out more than he gets paid. We are looking at options, but nothing is seeming plausible.

  4. IF YOU ARE FIRED OR DRIVEN OUT (I.E. YOU DIDN’T MAKE THE DESCISION TO RESIGN ON YOUR OWN), THEN CONTACT THE EEOC. EMPLOYERS CAN’T DISCRMINIATE AGAINST PREGNANT WOMEN — IT’S ILLEGAL AND THE EEOC IS A FEDERAL AGENCY THAT WILL INVESTIGATE. IF THEY AGREE WITH YOU (THAT YOU WERE WRONGFULLY TERMINATED), THE COMPANY MAY HAVE TO PAY YOU LOST WAGES, PAY FOR YOUR INSURANCE, PRENATAL CARE, LABOR/DELIVERY AND/OR OTHER FINANCIAL REIMBURSEMENT AND DAMAGES.

  5. Why are you screaming at us? That is considered bad manners.

  6. I am so glad you wrote this article. I am currently in this situation. I am uninsured due to a pre-existing condition. “Ovarian cysts” was my pre-existing condition. SMH. Well, I’m pregnant now and uninsured. I make too much for medi-caid, but there’s no way I can afford the 11,000 that the hospital wants me to pay in 6 months to treat me throughout my pregnancy. My first visit would be $1500. I am now 13 weeks pregnant and haven’t seen a doctor yet. I’m 35, Rh negative. I’m worried about Down-syndrome being pregnant at my age. This article was very helpful. I have been so stressed out. To all of you teabaggers out there who fought so hard so that working Americans like me can’t get medical care because of a pre-existing condition….kiss my ass. I hate you heartless people.

  7. I am so glad you wrote this article. I am currently in this situation. I am uninsured due to a pre-existing condition. \”Ovarian cysts\” was my pre-existing condition. SMH. Well, I\’m pregnant now and uninsured. I make too much for medi-caid, but there\’s no way I can afford the 11,000 that the hospital wants me to pay in 6 months to treat me throughout my pregnancy. My first visit would be $1500. I am now 13 weeks pregnant and haven\’t seen a doctor yet. I\’m 35, Rh negative. I\’m worried about Down-syndrome being pregnant at my age. This article was very helpful. I have been so stressed out. To all of you teabaggers out there who fought so hard so that working Americans like me can\’t get medical care because of a pre-existing condition….kiss my ass. I hate you heartless people.

  8. I am so glad you wrote this article. I am currently in this situation. I am uninsured due to a pre-existing condition. \\\”Ovarian cysts\\\” was my pre-existing condition. SMH. Well, I\\\’m pregnant now and uninsured. I make too much for medi-caid, but there\\\’s no way I can afford the 11,000 that the hospital wants me to pay in 6 months to treat me throughout my pregnancy. My first visit would be $1500. I am now 13 weeks pregnant and haven\\\’t seen a doctor yet. I\\\’m 35, Rh negative. I\\\’m worried about Down-syndrome being pregnant at my age. This article was very helpful. I have been so stressed out. To all of you teabaggers out there who fought so hard so that working Americans like me can\\\’t get medical care because of a pre-existing condition….kiss my ass. I hate you heartless people.

  9. How crazy is it that I’m considering asking my employeer to LOWER my hourly rate so that I can qualify for Medicaid and SAVE money!!! Talk about a flawed system! I’m 16 weeks, single, and just changed jobs to move closer to family. New job does not offer insurance and paying for insurance would be fine if I could find one that covered pre-natal and delivery! *Sigh*

  10. I am 5 bmonths pregnant and Uninsured. I applied at the Health Department for a supplemental Program to cover me for 45 days, until I got to Department of Human Services for an appt to e if I qualified for state insurance. Soooo….I applied and they have up to 45 days to give you an answer if you qualify. They did hold out until that 45th day only to tell me I didn’t qualify. I missed 2 Genetic Testing appts while these jerks already knew they would deny me. I am 35 y/o 2 children healthy, no problems. I was soooo furious because they prob knew that my income was too much but yet they waited to tell me I was unelgible. When I spoke to the lady at Human Services I asked her if she or Tenncare thought it was ok for a woman to go without PreNatal Care…duh no.. I also told her that if there was something genetically wrong with my baby guess what…that child would be on state covered insurance for the rest of its life. God Forbid. I pay out of pocket for my Prenatal visits, it’s the responsible thing to do as a parent. It is just so frustrating because I do work full time and pay into this system so in a time of need why can’t I get help. Please watch the movie SICKO by Michael Moore it puts our American System to SHAME. Is it time to move?

    I am a nurse, my company does not provide any Health Insurance. I got pregnant about 2 wks before my husband got laid off.
    If you have any suggestion please Email me @ DSGURL1225@aol.com

  11. P.S. to above posting United Healthcare (supplemental program through Health Dept) did not “Cover”me for 45 days I just got a bill for $500.00 for prenatal exam and labs. If I quit my job I could get covered…

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