Maternity insurance WWYD?

[pitterwoo]

I can't get hired at my job which has excellent health benefits (hiring freeze) so I've been a contractor forever. My H has his own business. We are so ready now to start our family but haven't because of the health insurance issue.

Does anyone know about getting a maternity rider? My insurance company doesn't offer it.

Paying out of pocket is too risky I guess? We could afford a pretty normal delivery, but not NICU or something extreme. I've heard of pre-paying the hospital a negotiated rate ahead of time. Anyone know about doing that?

I really don't want to leave my job because it's a unique niche, but I guess I could if it's the only way for us to have a baby.

WWYD in this situation?

[vanillacourage]

So do you not have any health insurance at all right now?

[ijack]

Most of the time maternity riders cost about the same as they pay out. Does your insurance offer coverage for pregnancy complications? When I had independent coverage it did - which meant pre-natal visits weren't covered, but had I been admitted for pre-e, abruption, any other pregnancy complication, they would cover that. Also, NICU wouldn't be covered under a maternity rider, it would be the child's own insurance. The company would have to insure them, though it might be pricey, and generally the state offers backup coverage for that.
Also, have you looked into your state's health plan (if it exists) to see if it covers maternity?

[bunch]

A friend of mine has no maternity. When she had her daughter, she had an emergency c, so it was covered because it was emergency surgery. Her daughter, who did have a short nicu stay, was covered under the regular policy.

Now she's pg again and is not suitable for a vbac. She called the hospital and pre negotiated everything. She was even willing to change drs and hospitals for a better price. Her c is going to come around 5k plus the cost of her prenatal visits.

She looked into maternity coverage, but it was something crazy like they only pay 10 percent the first year after her 10k deductible.

[pamela]

I'm thinking you're likely better off to save up and prepare to pay out of pocket. Like pp said, a lot of the complications are covered under your regular policy so be sure to check the details on that.

[pitterwoo]

Nov 27, 2012 12:01:32 GMT -5 vanillacourage said:

So do you not have any health insurance at all right now?

H and I have basic coverage that does not cover maternity.

I will have to see if it would cover complications or other things. I don't know.

[pitterwoo]

yes, I forgot to mention that I did look at the State health plan and it appears that the income limits are very low so we wouldn't qualify.

[ijack]

ours has low income limits too, but if you're not covered due to a pre-existing condition (like pregnancy) then you're eligible.

[pitterwoo]

Nov 27, 2012 12:13:42 GMT -5 ijack said:

ours has low income limits too, but if you're not covered due to a pre-existing condition (like pregnancy) then you're eligible.

oh! I did not realize this! I have a lot more to look into, obviously, but you are all making me feel like this isn't as hopeless as I feared.

[bunch]

Nov 27, 2012 12:16:05 GMT -5 pitterwoo said:

Nov 27, 2012 12:13:42 GMT -5 ijack said:

ours has low income limits too, but if you're not covered due to a pre-existing condition (like pregnancy) then you're eligible.

oh! I did not realize this! I have a lot more to look into, obviously, but you are all making me feel like this isn't as hopeless as I feared.

Definitely not. If my friend was having a vaginal delivery her oop would be less than mine. I know lots of Realtors who have kids wo maternity insurance.

[biscoffcookies]

Definitely ask about pre-paid deliveries. I'm aware of a hospital for example that will do an entire delivery and recovery for something really low -- I'm talking like $2,000 OOP -- if you don't have insurance and agree to deliver without an epidural (not because the hospital is a natural-birth advocate, but because the epidural is expensive and, I believe, adds potential complications/risks/follow up procedures for spinal headaches and whatnot).

Not to say that you should have to forego the epi if you want one, but there are probably some options out there that would help keep costs under control!

[frlcb]

We had a maternity rider and it had a 1 year wait to deliver, so if you wanted to get pregnant right away you would likely not be able to use it, so check on that.

[MadamePresident]

My homebirth with a midwife was $2,500. Depending on your birth desires, it can be a less expensive option.

[sjh722]

Talk to your insurance agent and the hospital. Friends of ours recently had a baby without maternity coverage. Basically, the insurance agent told them that they'd pay so much in vs what was covered that they would be better off to save that money and pay out of pocket for the delivery. For their policy, if she ended up with an emergency C-section, it became "surgical" and their regular insurance would cover it. Same for complications with the baby.

The hospital here also has a special program for people without insurance that has a pre-negoitated set rate and covers x, y, and z for a vaginal delivery. (And the OB bills one global fee for everything but lab work and ultrasounds, which is about $2400 for a vaginal delivery, and covers all office visits. I think they may have negotiated with them a bit also.)

[readyin07]

I think someone said that for most private insurance you have to cycle through one full year of paying (outrageous) monthly maternity premiums before you coverage kicks in. With what copays and whatnot are even WITH a private maternity policy, you could easily save and pay the same if you had a typical pregnancy and normal vaginal birth. But I would never do that. Just too many risks in my opinion. Maybe if your insurance definitely would coverage an emergency c/s and other procedures YOU might need then possibly maybe...but even then maybe not. As others said NICU would cover your child. I have a HDHP and one one hour trip to L&D for a stress test when I was a little nervous that baby wasn't moving as much cost us $500 OOP.

I am glad to hear the Affordable Healthcare Act is addressing some of these issues b/c the cost / availabilty of maternity insurance has been a HUGE issue of mine after watching friends have to pay shitloads of $$ to have a baby.

[pitterwoo]

Nov 27, 2012 15:02:31 GMT -5 MadamePresident said:

My homebirth with a midwife was $2,500. Depending on your birth desires, it can be a less expensive option.

This would be my preference actually. I would just be terrified if I felt like I couldn't afford to go to the hospital if that ended up being necessary.

[bunch]

Nov 27, 2012 15:47:22 GMT -5 pitterwoo said:

Nov 27, 2012 15:02:31 GMT -5 MadamePresident said:

My homebirth with a midwife was $2,500. Depending on your birth desires, it can be a less expensive option.

This would be my preference actually. I would just be terrified if I felt like I couldn't afford to go to the hospital if that ended up being necessary.

that's how my friend ended up with the emergency c. She ended up paying for the midwife and then still had to go to the hospital. I think not having maternity makes attempting a home birth a lot more financially risky.