Yikes! Insurance Question....

[jasmine2312]

Hope this is the correct place to post this!

I have an individual health insurance plan (live in Ohio, USA) and after receiving an outrageously expensive bill from my OBgyn, I discovered - SURPRISE! My plan doesn't cover Maternity/Pregnancy. Yikes! i'm only about 6 and 1/2 weeks along (and this little bean was a surprise as well!)

Does anyone know if pregnancy counts as a pre-existing condition - since I am obviously going to have to get a new insurance plan? Will I be able to get coverage even though I am already pregnant? Also, pretty sure I can't lie and pretend I'm not pregnant and apply for a new plan WITH maternity coverage because there is already documented proof that I am currently "with child".

Tried researching this but everything online seemed very vague!

Any input would be very very much appreciated! I'm nervous.....

 

[FloridaGirl21]

Pregnancy, in Florida at least, is considered a preexisting condition. If you search the internet enough, you may be able to find an insurer to insure you, chances are their rates will be higher than normal and not give you as much coverage as you'd like (eg: higher deductibles/higher % of copay, etc).

If you can't afford to go that route, you could always apply for state assistance like medicaid, go through your local health department for care, or find a doctor that will let you pay as you go.

HTH & that you find a solution

 

[jasmine2312]

thank you so much! man.....pregnancy as a pre-existing condition? who knew!! thank you for taking the time to respond! i wrote down this info and have been looking into it! i really appreciate this!! congrats on your two little buns in the oven!!!! that is wonderful!!!!!!!!!!

 

[FloridaGirl21]

I know, it's pretty crazy. I work in insurance and sometimes don't understand how the health insurance side of it all works!

 

[jasmine2312]

haha well that makes me feel much more sane!! still trying to figure out what to do about the OUTRAGEOUS bill w/ the OBGYN that isnt covered. yikes. best of luck to you and hopefully your company gives you a wonderful and generous maternity leave to make up for all your hard work! good luck!

 

[Audraia]

I went through the same thing. Actually with the new laws pregnancy is no longer a pre-existing condition. HOWEVER, most all individual insurance plans requires you to have maternity coverage added for a year before conception, so you probably won't be able to get coverage unless your husband can add you to his policy and he has a GROUP policy, not an individual. My insurance was individual as well and doesn't cover maternity obviously.

Depending on your state laws/your income you might be able to get medicaid. Unfortunatly in WV I make WAY too much to receive any help, so I"m paying out of pocket for all my medical care. That bill you already have if you do wind up paying out of pocket, they will discount it for you if you talk to them, and you can make payments on it. Medical bills are a different kind of debt, as long as you're making payments it can't negatively effect your credit!

Hope this helps, I've already gone through all this stuff haha!

 

[jasmine2312]

thank you so much!! that was very informative!! i hear ya about the medicaid....so frustrating!! unfortunately i just found out i lost the little bean however d&c IS covered by insurance....how ironic!!

thank you! and happy and healthy 9 to ya!

 

[FloridaGirl21]

aww, so sorry hun

 

[jasmine2312]

Hi ladies!!! Just wanted to jump on here and thank you all for your info a few weeks ago! as u know i lost the little bean which was pretty sucky, however there was a silver lining....


My OBgyn was "annoyed" at the insurance company already billing me $3000 in only 6 weeks, but he understood my insurance did not cover maternity. So when the loss came, my Obgyn denoted on my chart that all the previous appointments and testing which were originally classified as "maternity" were now classified as "OBGYN general appointment" or "OBGYN follow-up".
He explained that since the pregnancy didn't advance to 12 weeks, it did not necessarily have to be classified as a "pregnancy" and could be instead classified as just a regular OBGYN situation/complication.

Sure enough, good ole Anthem Blue Cross Blue Shield sent me a nice little letter letting me know that my former $3000 bill was now covered by them and all I owed was $8.21 for some blood test. (I hadn't cried about the loss yet....but when I saw this I had a hot little tear run down my face! I called the OB office and I'm sure the receptionist thought I was a TOTAL nutjob because I was crying and kept telling her to "thank my dr" for me lol!)

PHEW! I certainly hope none of you ever have to go through a loss, but if (God forbid) you hear of someone in a similar situation to mine, it might be worth it to have them ask their OB if he/she could do the same.

 

[FloridaGirl21]

aww hun, so glad to hear about your OB helping you out and getting the $3k covered. I agree, losses are so hard, and I wish no one had to experience them I've had two and it makes being PAL so much harder FXed you get your forever baby soon

 

[jasmine2312]

aww hun, so glad to hear about your OB helping you out and getting the $3k covered. I agree, losses are so hard, and I wish no one had to experience them I've had two and it makes being PAL so much harder FXed you get your forever baby soon

thank you!! ugh yes this has been a rough few weeks but in some ways it just makes me realize how strong women are...women go through much much worse than i have and they keep on trucking!! incredible really....

sorry about your two losses but CONGRATULATIONS on that 12 week mark with TWO little babes! how WONDERFUL!!!!! Congrats squared!!! best of luck and hope you have a healthy and fun preg. through and through!!!