UPDATE — Insurance changes for Bees TTC in United States

posted 3 years ago in TTC
Post # 3
Member
4511 posts
Honey bee
  • Wedding: October 2011

I’m really interested in this topic. (I asked a couple questions about it awhile ago here and here.) To summarize: we actually do have insurance right now, but there is a decent chance we will have a period of no insurance, and we’re just worried that will coincide with the birth month if we get pregnant! (and for a variety of reasons I dont think any of the options like Cobra or govt-sponsored will work for us.) 

But if I’m understanding the healthcare changes, then it wont matter if we get pregnant right now… we will be forced to buy insurance AND maternity will be covered! (which will be a good thing.) That is good enough for me, but H doesn’t trust it, and I don’t know how reasonable it is to be concerned about things like if it will be challenged in court, or companies simply wont be able to financially comply, etc.

For us, it’s not necessarily the pregnancy itself which is worrisome – it’s mostly the fear of what if there are major complications. Like, a standard birth costing less than $10,000 is doable, but what if it’s like $70,000? You simply can’t plan for that…

Post # 4
Member
2740 posts
Sugar bee
  • Wedding: April 2010

I had health insurance through my employer but did not have maternity coverage when I got pregnant.  We were not TTC.  I could have added a maternity rider (at my expense) for around $250/month, but as we were not TTC I opted out.  Lo and behold I got pregnant unexpectedly, and of course it was too late to add the rider.

Luckily for us, I was able to be added to my husband’s policy that he has through his employer (a larger company) and which covered all my expenses even though I was already pregnant.

How could we have afforded it otherwise?  Honestly we couldn’t have and would have been royally screwed.  I’ve heard that some doctors will offer a reduced rate/flat fee for self-pay patients for prenatal care but then you still have to pay the hospital which can be a few thousand dollars even for an uncomplicated delivery and can go into the tens of thousands if you have complications or need a c-section.

Unless a person has lots of money to burn I can’t imagine TTC without maternity coverage in place.

Post # 7
Member
4511 posts
Honey bee
  • Wedding: October 2011

@MrsEdamame:  but why can’t you get pregnant now, then you’ll only be at most 6 months along in January, and then you can have the majority of expenses covered with your new plan that you buy Jan. 1? (Which is what I want to do, and am having a hard time seeing the flaw in that…)

Post # 10
Member
13168 posts
Honey Beekeeper
  • Wedding: July 2010

@MrsEdamame:  “We know SO many couples who have experienced unexpected pregnancies, and I can’t imagine the majority of them just happened to be paying for optional maternity riders they never intended to use (especially ones requiring a 12 or 18 month waiting period!).”

I think many policies that people get through the companies they work for already cover maternity.  I know that every work policy DH and I have had has already covered maternity and those that our friends have do to.  So in that situation, an unexpected pregnancy isn’t a big deal (at least, insurance wise).

Post # 11
Member
3360 posts
Sugar bee
  • Wedding: December 2011

@MrsEdamame:  Could you negotiate flat fees for those first few months of appointments with your doctor? My understanding is that those negotiated rates (which many doctors are willing to do) are nowhere close to insurance-covered rates (one of the reasons our system is broken – ugh). Once Jan. 1 passes, you could purchase a plan and the rest of your care would be covered (which would be the most expensive part, no?).  I would think that as long as you’re having an uncomplicated pregnancy (which, certainly, I know you can’t guarantee), your appointments over the first few months may not amount to much if you can emphasize that you’re paying out of pocket (rather than through insurance).

Post # 12
Member
3360 posts
Sugar bee
  • Wedding: December 2011

@MrsEdamame:  The other thing, which I know you don’t want to hear, is just wait 6 months.  I understand impatience, I’m ready to be pregnant, like, yesterday, but if you’re super concerned about the insurance aspect, 6 months isn’t that long to wait to have that piece of mind.

Post # 14
Member
10384 posts
Sugar Beekeeper
  • Wedding: September 2010

This happened to my friend. Once she realized everything involved cost-wise without insurance, she aborted. She just couldn’t see jeopardizing their entire financial existance and stability when they didn’t need to. They waited until they could get coverage and tried again, successfully.

Post # 15
Member
6644 posts
Bee Keeper
  • Wedding: June 2011

@MrsEdamame:  Perfectly honest I would wait til Jan 1, because things can and will change from now to then.  As I said in my previous thread I work in insurace and the procedures and polices we have to follow keep changing. I have so many cheat sheets at my desk right now for the upcoming reform its not funny. The keep changing how we have to input things to how the reform will work. 

Post # 16
Member
820 posts
Busy bee
  • Wedding: April 2013

@crayfish:  That’s awful. It’s really too bad when the system forces people who would otherwise be able to take care of their baby to abort. We should have options for expecting mothers, not just use it as another chance to stick it to people.

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