High Risk Pregnancy with No Health Insurance

So you just found out that for whatever reason, you have a high risk pregnancy and you have no health insurance. The first thing you should do is look in to getting state insurance. Even if you have already tried, please read what I have to say because you may yet find out that you qualify for something or more then they gave you. I was very blessed with my pregnancy in that I had no complications that came up. I did however discover that the path to getting health insurance from your state is a lot more complicated then the workers that “help” you to get this insurance would make it seem. After the birth of my son (at home) I had post labor hemorrhaging. My midwife took care of it but I did have to go to the hospital to get a blood test done to see if I needed a blood transfusion. It turned out that I did not but what I did get was a nice bill from the hospital for $3300 for the room I stayed in for 2 hours (I should have gotten a lot better service for that price, can you say penthouse?) and a blood test. I also got a phone call from this wonderful lady that worked with the hospital that showed me how to qualify for state insurance to pay for my bill. I live in Washington State so I do not know the universality of my advice but I think that everyone should at least take a look at it.

1. After you have applied to get the state insurance and they deny you or give you a “spend down” pick up the phone and give who ever is in charge of your case a call. Ask them questions! If you were denied, ask by how much, ask if they do spend down amounts (it is like a deductible), ask if you can reapply if your income changes, ask anything that you can think of! I did not do this and paid the price. I was put on a spend down of $4500. This would be nothing for a typical hospital birth but it was a lot of money for me. If you have a high risk pregnancy you really need some insurance so ask. The workers may or may not just tell you these rules. I know the guy I worked with did not tell me anything I did not ask about.
2. Once you have the insurance, it can not be taken away. My husband works a job that pays him by the hour. Some months he gets a lot, some months he gets a little, it just depends. I did not understand that if I could do without a little one month and qualify, that it would not be taken away from me the next month if he made more money. All I would have had to do is have my husband work no overtime one month and reapply. We would have been in and I would not have had to pay for anything else. So if you don’t qualify by just a bit, consider cutting your work hours a little for one month, then reapply.
3. Even if you have just had the baby or are close to having the baby apply or reapply. Don’t wait. In my state you only have 60 days to apply. If you are able to get the insurance for the month of the birth, even if it is past that month, the state will cover all charges that month. It is not like commercial health insurance, it is retro active to the time the coupon is for. Most of the charges you have will have come from the birth itself.
4. Even if you get a spend down reapply if there is any change in your income. Getting your spend down lowered will save you month so it is worth the trouble.
5. If all else fails and you have a big bill on your table call the hospital. My hospital had a woman that was in charge of getting pregnant women and children insurance though the state. It is so great having someone like that (that knows the system) on your side. They are there to help so let them do their job.

I hope this helps someone. Hopefully someday, all of my advice will be obsolete because no one will be without health insurance of some kind but until then good luck! If anyone else has tips (maybe from other state systems) I would love it if you would share them.

Pregnant with no Health Insurance

I have to say, it is really scary being pregnant with no health insurance. I was at my first job out of college and was going to get health insurance after 90 days when I found out I was pregnant. We did try so it was not a shock but it was a shock to lose my job a month later. As most people know, you can not just go out and buy health insurance when you are pregnant. It is considered a pre-existing condition and therefore you have to wait nine months to have it covered. I don’t know about you, but being as I am human, my pregnancy did not last more then nine months. I went though my entire pregnancy without health insurance but in the end, it turned out that I could have gotten state insurance at some point. So I will go over my advice for having to go though everything with no insurance. In a few weeks I will go over how to get state insurance and how to deal with a high risk pregnancy with no health insurance.

1. Midwife, midwife, midwife – These wonderful women are a life saver for those with no health insurance If you are having a normal or even slightly abnormal pregnancy, you need to pick up the phone book, look though the internet, ask your friends, or call your local birth center and find yourself a midwife. My midwife cost me $3000 for everything. This includes all appointments, the birth and well baby check ups. The only thing it does not include is lab tests because the lab will charge their own fee for that. Depending on where you live, midwife care will run you from $2000-$5000. An OB costs much more then that and they nickel and dime you for everything. My friend got charged $10 for every stick she had to pee on to see if there was protein in her urine (which they do at every appointment). For me that was included in my midwife’s fee. You will also get much more personal care from a midwife. All of my appointments were an hour long and I never had to wait more then 5 minutes. Midwives are used to seeing patients with no health insurance so they will set up a payment plan and some give cash pay discounts if you pay by a certain date. They will normally go anywhere to help you give birth, hospitals, birth centers or your home. I should note that you want to see a midwife with her own practice, not a group of midwives or midwives under an OB.

2. Do I really need that? – You need to always be asking that question of yourself. You are going to have to do your research and find out what tests you are going to do, and what you are going to skip. Ask yourself questions like “Do I really need to get a blood test to tell me that I am pregnant?” Remember, you can refuse anything and you have to pay for every test out of your own pocket. Most of the tests midwives give are very cheap ($20-$70) and most midwives will respect your wishes to do only what is necessary. My midwife knew I had to pay for everything so we would discuss it first and then I would decide if I wanted it done. Most OBs on the other hand, do not know what anything costs and will run as many tests as they can. They do not know you have no insurance and will not remember if you tell them. To give an example, I refused the blood test they do for downs syndrome and the other two diseases, but did get the glucose test done.

3. Ultrasounds – It seems like I hear so many woman that get these done all the time. I am sorry to break it to you but unless you want to spend a lot of money, I would recommend you skip all but the 20 week ultrasound. At 20 weeks, a good tech will be able to tell if anything is wrong. Some women go without them all together and that is fine too. Your midwife will listen to the baby’s heart beat with a Doppler and will measure your belly to see how big the baby is. From what I have seen, these measurement are often more accurate then ultrasounds anyways. You don’t really need an ultrasound unless your provider thinks there is something wrong. I did pony up the $150 to see my son at 20 weeks. My husband had heart problems as a baby so we wanted to get a good look at my son’s heart to see if it was normal. It was and we found it was a boy which was great too.

4. Stay Healthy – I know that we all want our babies to be healthy but it really is important to take good care of yourself especially when you don’t have insurance. The healthier you are, the fewer tests you have to do and the less likely you will have to get special (really expensive) care for you and your child. So get out and get some exercise and try to keep the sweets to a normal amount. I know you feel like a whale but it is so worth it. My midwife said that she would start to see problems for some women that gained more then 50 lbs. I gained exactly 50 lbs and was fine.

5. Consider a home birth or birth center – I know that is seems crazy but if you are having a normal healthy pregnancy, you really should consider one of these options. You home is completely free and a birth center (if you are lucky enough to have one around) is much cheaper then going to the hospital. I had a wonderful home birth and even if I have insurance next time I have a child, I am going to plan on another one. It was so wonderful to not have to travel while I was in labor and to only have people I knew and was comfortable with coming in and out of my room. I got to labor any way I wanted to with no IV or monitors. I pushed my son out in my own time with no one rushing me or threatening me with a C-section, vacuum, or anything else. If you do your research, you will find that homebirths with a good midwife for normal women are just as safe if not safer then hospital births. After the birth of my son I started to hemorrhage, my wonderful midwife took complete care of me. She had IV’s, pitocin, and other things that stopped the bleeding and stabilized me. Midwives are prepared for the most common sorts of complications. Birth centers are great too. They are set up like hotel rooms to birth in. They do have some medial equipment if you need it but it is no in sight.

I got though my entire pregnancy paying about $3500 for everything. It came out to be $3000 for the midwife and about $500 for tests and my one ultrasound. I think that is pretty good considering that the average healthy birth (not including pregnancy care or well baby care) cost about $12000 in a hospital. I hope that this helps someone. Please feel free to ask questions if you have them. I did a lot of research when I was pregnant so I might be able to help.