Pregnant with No Maternity Coverage

Pregnancy medicaid AND look into a Midwife who does birthing center births or home births. MUCH cheaper and the rates for unnecessary interventions is very low which means your risk of a cesarean is very low too.

I do medical billing for midwives...If you can prove you weren't pregnant until after the insurance started it may be covered. Check with them, you would have to send a letter from your doctor with the estimated due date and estimated date of conception and your last menstrual period date. Thats why they do the 12 month waiting period, to protect them from paying for a pre-existing condition. Plus if you did have prior insurance coverage and can get proof of credible coverage from them, they will waive your waiting periods.

Otherwise they should cover all your prenatal care still, just not the delivery. If youre a good candidate, I'd look into doing a birth center or home birth with a midwife, costs will be much lower and many take payments. Or you can prepay with a credit card or check/cash and get a discount.

And yes look into Medicaid coverage for pregnancy! There are income guidelines but you never know!

"This was a surprise because we weren't planning on trying for several more months." Birth control?!?!?
Just sayin....

Medicaid--- this is why we pay taxes, well in part, so good moms can have good prenatal care and raise our future leaders.

There's nothing to be ashamed of , it's there for situations like this.

start making arrangements with your OB/GYN and the hospital. Let them know that your private insurance does not cover maternity at this time and need to make payment arrangements.

Most hospitals and OB/GYNs will give you a cash discount as well as payment plans.

Congratulations and good luck!

I will echo the Medicaid advice, I qualified for Medicaid with my first 2 babies and I still saw the same OB (first baby) or midwife (second baby) that I would have with insurance, there was no difference in the level of care that I received. With my second and third babies I saw a Certified Nurse Midwife who delivered in the hospital, I preferred that by far to lay midwives and I wanted to give birth in a hospital with an NICU just in case (my first baby had to be whisked off to the NICU so I was very grateful it was there, she had Group B Strep disease). The point being that you can still have the benefits of care from a midwife (more personal, kinder, doesn’t talk down to you, stays with you throughout your labor instead of just for the pushing part, fewer invasive interventions during labor, safer track record than OB’s, and yes, cheaper too) and still have a hospital birth with doctors on staff just in case of emergencies. Someone also mentioned Planned Parenthood, they do also offer prenatal care, and there are probably other places you could go for free or very cheap care, but I am not sure of the quality of care because I have never experienced it. Best of luck to you and your new baby!

Pay out-of-pocket but talk with the billing department. You can negotiate their fees- ask about paying the "insurance rate" for services. Also find out which procedures are not really essential!

For what it's worth I do have coverage but apparently my carrier feels that the 20 week ultrasound is not clinically necessary and they denied the claim. Needless to say, if my OBGYN thinks I am paying $700 to find out that we are having a girl, they are seriously mistaken
I will be calling tomorrow to discuss this and see if I can pay the insurance rate ($300). We will see!

Good luck!

I vote for a midwife...way cheaper! :-)

medicaid. it cant hurt to try. "most" OB offices will work with you on the financials if you are up front with them. there are also free clinics that will do your prenatal care, though it may be very minimal. I would apply for medicaid to see if they will even approve you. Good luck, CONGRATULATIONS and God Bless!!

eta: It is against the law to consider pregnancy a "pre-existing condition", it is a federal law.

I didn't think that insurances could deny maternity coverage. Maternity is NOT a preexisting condition if that is what they are saying.

Not sure if you are still looking for advice but we were in the same situation a few months ago. I am 18 weeks pregnant and we have private health insurance without any maternity coverage. I had my first two babies in the hospital with an epidural (we had insurance then) but I knew there had to be a better option than paying $10,000 out of pocket (Utah). Someone mentioned a midwife to me which I had previously thought was for hippies and those who like pain. But I set off on my research. I first watched "The business of being born" documentary which got me thinking. Then a quick trip to the library to check out almost 10 books on the subject. I feel really good about our decision to have my baby with a midwife in a birthing center. The $1500 price tag helps too. So to make a long story short If having this baby naturally might be an option start your research. Good luck!

I would seriously consider having a midwife and deliver at home. If you try to have a hospital birth with no insurance, you'll never get out of debt.

You have 9 months to $ave, I guess.

Apply for medicaid. If you don't qualify, do one of two things. One- Talk to your OB about a cash pay discount/payment plan. This is what we did with one of my kids and he was "paid off" before he was born :) Two-if you can't come to a payment agreement with your current OB, ask him/her if there are any area clinics that charge a flat rate for everything (usually a little higher for a c-section). There is a clinic at one of my area hospitals that charges around $2500 for all prenatal care/delivery/etc. There is also a midwife group locally that charges about the same. Usually, you can pay monthly and have it all paid for by the time baby arrives. If for some reason none of that works out for you, you will go into debt, BUT, with medical debt, as long as you pay SOMETHING/month to show that you are making an effort, it will not be reported to the credit bureaus.

Are you sure maternity isn't covered I have never heard of a "waiting period" for maternity coverage.I would call your insurance carrier to verify this information yes there is waiting periods for pre-exisiting conditions but maternity I have never heard of that being a claus in private healthcare

Depending on the state there is a state plan, here in Colorado its called "covercolorado.org", there are also prenatal care programs through planned parenthood etc
. If you have benefits coming up for open enrollment and you or your partners job, you can apply for that in open enrollment. If you "loose" your individual coverage, in Colorado you have the right to go back on your group health due to Federal HIPPA loss of coverage law.
Also, most hospitals in Colorado allow you to pre-negotiate a care plan and price if you start making the monthly payments prior to the delivery to help people in this situation.
All complications (not regular care) in Colorado would still be covered on the individual pan.

Will your infant be covered from birth or will you have the option to cover him from birth? If not and/or you have any complications or he has any health issues, this could completely bankrupt you. If you (hopefully) have an uneventful pregnancy and delivery, I assume you would pay out of pocket.

Um I am here to say you can call your insurance, but you will not be covered. Same thing happened to us. They do have a wait period on maternity when new- Some are 6 months and others are a year.
This of course applies to private insurace- we own our own biz! Made us wish we were back in the rat race for sure.
Colorsdo now MAKES insurance companies give maternity- but that law hit AFTER our 2nd was born. So NOW I get to pay higher rates for maternity coverage (even though hubby got fixed) but back when I needed it, I couldn't get it.
Bottom line is that you might want to look into a birthing center. Yes that will mean no drugs, but that doesn't have to be a bad thing. I encourage you to explore it all. I second the movie "the biz of being born".... interesting for sure. Also look up "doula" and see what they can do. They can't take away your pain, but they will help you through it.
Good luck!

We didn't have medical insurance when we had our two sons. We paid on a monthly payment plan. There's lots of good advice from the other Mom's here.

Congrats! Worrisome..but still a great early Christmas present, eh?