No Well Baby Coverage in Our Insurance

Updated on January 17, 2009
C.L. asks from Chicago, IL
18 answers

We had our first baby about 4 months ago and I quickly realized that our health insurance through my husband's work offers no well baby or immunization coverage. We have quickly racked up over $1,000 in expenses. There is no upgrade available to the insurance plan and no open enrollement that would help us change it.

Does anyone know how/if the state's program works and does it operate as a supplement to current insurance? Is it income restricted and do only some providers accept it? Also, I have heard of a vacine program in IL but I can't find anything on it. Does anyone out there have experience with this?

All help and advice is greatly appreciated. We currently go to the Northwestern Children's Practice and really like our Doctor.

1 mom found this helpful

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J.L.

answers from Chicago on

My kids have all kids because of the same reason. If you do qualify, they ask if you have any bills in the last 3 months that you have had. So, they CAN backdate. I know this because I had some of my medical bills backdated from the state. Email me if you have any other questions.

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Z.

answers from Chicago on

http://www.cityofchicago.org:80/city/webportal/portalCont...

Long link, I know. It goes straight to the webpage that lists the different clinic locations where you can get free vaccinations for your child. I had a plan that only covered up to 500$ in well care visits and this was used up with the first round of vaccinations for my child. We visited the clinic the remainder of the year and got the shots for free. It would still be smart to take your child to the pediatrician for their scheduled check-ups, but refrain from getting the vaccinations from the ped office. This makes up a huge amt of their bill. We also use the same ped office and I think the office visit comes to about 100$ each time.
With going to the free clinic, make sure you set aside enough time as there are several families who wait outside in line before the door even opens for the day. The money saved is worth it to me though.

1 mom found this helpful
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A.T.

answers from Chicago on

Your local health department should have days where children can get immunizations that are less expensive. The state's program does not supplement insurance (you can't have that and insurance). Only some providers accept it and its not that great and everything that has happened with the govenor, who knows how long the program will be around.

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J.H.

answers from Chicago on

My coverage only coverd $500 in well baby care. So, I used to go to the pediatrician, as usual for check ups. But, I would go to my village for immunizations. That first year is hard because the baby goes all the time! Depending upon where you live, call your village. I live in Schaumburg and Schaumburg/Hoffman Estates would have their immunization clinics together. You had to fill out papers and wait a little each time. The cost was $5 per immunization. But, the money I saved was definitely worth it! Also, tell your pediatrician that you do not have well baby coverage and would they accept a lower fee for the exam. Overwhelmingly, they do!! Good luck. - J.

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T.C.

answers from Chicago on

When my kids were little and we didn't have well baby care, the doctor's office had a sign that talked about the state's vaccination program. Maybe you can call your doctor's office and ask about it. I didn't have to fill out another form, qualify or anything. The doctors knew we didn't have the coverage and it was done. The nurses told me that the state provides a batch of vaccinations and the nurses had to use those vaccinations from that box (not their own supplies) - that was the only difference I found. Good luck!

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K.S.

answers from Chicago on

I know there is somewhere you can go to get vaccines for very cheep (I think less than $10). When my first was born, my husband's insurance did not cover vaccines. We live in Cook County, and there where several locations that we were able to go to get the vaccines. Call you County office, they should have the info.

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M.M.

answers from Chicago on

We did our vaccines through the county because they were much cheaper. The nurse at our peds office said their vaccine stuff was newer and fresher than what they keep at the Dr. office. Check with your county health dept.

M.

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J.K.

answers from Chicago on

Dear Kathy -

I'm so glad to hear that we're not the only family that's had to deal with this! We have an 11 month old, and we ran out of well baby coverage when she was about 6 months old despite having "good" insurance (BC/BS PPO). We were also slapped with a huge bill that my husband managed to negotiate down to $700. We also go to a Northwestern children's practice, and we talked with our doctor about it.

She told us that she has patients who have our same problem with insurance who go to the Chicago Public Health Clinic on Wilson for all of their vaccinations. (It's on Wilson off of the lake. You can take the Wilson exit off of Lake Shore Drive). I had some reservations about trying it because I had never gone to a public health clinic before. I was concerned about the competency of the staff, and I didn't know what to expect of the other patients seeking care. Basically, I had a lot of stereotypes that turned out to be unfounded.

There were others "like me" and the patients who were not "like me" were either very friendly or indifferent. No one was loud, or inappropriate or smelly; there were people of every race, educational level, and socioeconomic status just like me, trying to get their health needs met for themselves and their family. It actually made me feel really good about America to know that my family was not left without options.

The medical care was good. Both of the nurses were meticulous and careful with the vaccines, and the vaccines were free of the dangerous additives that are of so much concern to so many parents. They wrote everything down on a record which they gave to me, including specific dates for follow up visits.

I have been there three times now, and only once has the service been really slow. Get there early so that you can get a place in the lot. I always get there at 8 am regarless of whether they open at 8 or 10, which they do on alternating days.

We save A TON of money by going there, so we're planning to get all of our baby's vaccinations there from now on. THE VACCINATIONS ARE FREE! They ask for insurance information for their records, but it doesn't matter if you have it or not.

GOOD LUCK!!!

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A.B.

answers from Chicago on

Good Morning -
I am single mother of a 1 year and I have had the same problem with my insurance not having Well Care. I did apply for All Kids and the case got denied since I currently have medical insurance. All Kids is not based on your income. My doctor's office does have the vacine program. I was eligible for the program once they starting received denial letters from my insurance for the well care visits and shots. How it works at my doctors office is I only have to pay $16 for every shot visit (no matter is she gets 1 or 3 shots). And the bad part is that I have to pay for the office visit which is $150.00 each time.

I hope this helps, please let me know if you have any other questions. A.

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C.Z.

answers from Chicago on

Hi C.- I know exeactly what you are going thru. My kids went to that same office as well. We did like the docs there but they told us either we treat them under their care only or go somewhere else. With my first child went just sucked it up and paid out of our pockets for doc visit, shots and etc. After #2 came we saw them for 4 months. After having hospital bills and baby visits we couldnt' keep up with the bills. they threatend to not see my son unless we paid in full or the told us to go somewhere else. I did and I found a great all women ped's practice in Countryside. They actully recommened us going somewhere else for the immunizations so we could save the money. I took my son to St. Xavier College at 103rd and Pulaski at the Nursing building. They only have certain days of the week, but you only pay $10.00 per family for as many shots and kids you have. It' goes to the university. that saved us a TON of money doing that. When we saw the previous docs one visit alone was anywhere from $300 -$500 which adds up fast. Try calling the nursing school there to get the schedule. The nurses were very nice and you also don't have to wait in a long line. Good luck I hope you can find it and save some money for your family!!

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S.E.

answers from Chicago on

Insurance is so frustrating! We pay over $1,000 a month out of pocket for insurance that, like yours, does not cover basic things. A whole other story...BUT, for you, I would suggest asking your pediatrician for options. Ours in Evanston recommended the Evanston Health Center which provides very low cost immunizations for "under-insured" patients like ourselves. The same nurses from Evanston Hospital work there, and it's the same quality service and products. If your doctor isn't aware of what's out there, check with your city/town. Evanston recently stopped the immunization program - which is just terrible for people who really can't afford shots elsewhere, but that's a different story - so a local hospital, St. Francis, is picking up the slack. You should be able to find someplace that will offer immunization at a fair price for those whose insurance will not cover them.

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G.H.

answers from Chicago on

State programs are generally for the indigent or poverty level families. They're not usually a "help pay off bills" program. Sorry to say but what I did when I had to get the kids in for shots was I took them to a clinic for them. The price savings was incredible (about 1/3 of the drs. office price). I also had all their sport psysicals and going back to school checkups done at the clinic. Sorry I can't help with dental which is so important but Sears dental is much cheaper than the normal dentist. Good luck mom. I've been where you're at.

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C.D.

answers from Chicago on

I have the same problem. Along with having no maternity coverage throughout my pregnancy, it made things very difficult. I spoke with my doctor, and she recommended getting vaccinations at the Board of Health. They are free if you don't have insurance coverage. It takes a LONG time (I mean, really long - 3 hours for us the last time I went to get my son's flu and Hep B) but with the cost of vaccinations at the doctor's, it came out to saving about $90 an hour, which I can live with.

I still go to my doctor's for checkups, and just have vaccinations at the Board of Health. I believe, though, they also do checkups at BoH. Talk with your doctor and give the BoH a call.

--C.

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L.

answers from Chicago on

Hi!
Did you talk to your ped. office about it? Our rooms have a sign saying you can apply for some type of help through the state, but you have to do it BEFORE the shots are given and we can inquire in the office. This may help for next time!

L.

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K.B.

answers from Chicago on

Call your local township, county, village, or elementary school nurse and ask for information about the public health clinics for free immunizations. These clinics provide free immunizations for all kids. Our kids are older now, but I always used the public health clinics for immunizations when they were little. I had to wait in line, but who cares? It saved us a ton of money, because our insurance didn't cover well baby or well child at all. There was a family in there with quadruplets...think of how much money they saved by using these public health clinics! There was no income requirement. The county has to provide this as a free service, because the law requires kids to have these immunizations for school enrollment. Go for it!

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M.B.

answers from Chicago on

My husbands insurance is the same way. They'll pay if you child is sick but not on the healthy visits. It gets very expensive those first few years. The doc apts, we just paid but we did got to a clinic for the vacines. You pay $5 a shot. Big difference than the hundreds you pay in office. We went to the Hoffman Estates childrens clinic, it is the first monday of the month. Check out their website and you can get more info especially if you aren't out in the NW suburbs. It is a hassle, one more thing to do with the kids and can be a long wait but if you get their early its not to bad and the money saved is well worth it! Good Luck!

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J.L.

answers from Chicago on

Many pediatricians participate in the VFC (Vaccine's for Chidren) program. You can call your pediatrician and ask them if they participate. We did this when we had a similar issue and vaccine's were significantly cheaper. You just have to be sure that you remind them every visit that you don't have vaccination coverage and you want your shots thru VFC.

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G.P.

answers from Chicago on

Check with your local department of health and see if they have immunization clinics. They are not only for those with little or no income as they usually can get medicaid and they cover immunizations. The program is for everyone and since the government is pro vaccinations they offer them to every one at a cost $10 - $15 dollars each, don't quote me though. $40- $60 is still a lot but far better than hundreds of dollars.

We had the same problem w/ our insurance $250 wellcare max and fortunately we were able to choose another insurance plan my husbands company offers that covers 100% wellness for everyone.

I hope this info helped. Take care.

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