medicaid - for uninsured pregnancy

my2monkeyboys wrote: Just wondering, does anyone know if medicaid will cover a pregnancy if the woman is uninsured, regardless of the income levels? I've heard that some states have this, but I don't know if it is all of them and I can't figure out how to find it on the computer. I've searched ten different ways and it won't tell me what I want to know.
As to why I want to know this... we can add a maternity rider on our ins. for quite a bit more a month. However, we're not planning on trying to have one anytime soon, so we don't want to waste the money on a just-in-case situation. While I don't believe in intentionally getting pregnant and using medicaid just because you can, since we're practicing birth control, it'd be nice to know if we could use it just-in-case. KWIM?
Any help is appreciated!
Thanks!

MyLuvBugs replied: That's something to look into. We're currently on Cobra while DH looks for a new job, so that is something to look into right now for us.

C&K*s Mommie replied: I can only speak from the Medicaid in Florida. It is dependent on the income level, and other insurance can not be available for that PG woman- like her spouse or her rec'g it through work. Otherwise you would not qualify.

In my case, I was planning to quit my job because the conditions were not conducive to the health of our then unborn child. Insurance was not available through my then work, and BCBS would not alllow me to buy insurance through them (or any other carrier for that matter) since PG was considered a pre-existing condition. If I had not known I was PG (or maybe lied) I would be able to get BCBS insurance for a pretty penny every month.

So I had no choice but to apply for Medicaid to get the healthcare I needed for my PG. But at the time I applied my income was taken into account, and with my DH's income it put us slightly over the state limit for Medicaid. I planned to quit anyhow as I said, but I had to reapply after I actually quit.

They consider all in the households' income. The number of people in the house plus the unborn child is what would determine where you would fall into the income range. DH, me & the unborn child was 3 total-- we had to go under the the state max for 3 people in order to qualify.
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My suggestion is to check your local DCF office. They have all the information you would need. Sometimes the DCF office is combined with the local Health Dept. Check your blue pages in your phone book under County Departments for the number(s) to those offices.

And if you have access to other health insurance, by all means go with what you can with the other access. And pregnancy is considered (strange as it sounds) a pre-existing condition. Depending on any clauses in your insurance, you may not be covered if you get PG and try to obtain the insurance after the fact.

HTH's

Edward's Mommy replied:
Same with Colorado. Here in Colorado...I had to be on it because my job didn't offer health insurance, and so I tried to get myself and my DH on medicaid. At the time I made only $7 an hour and I almost didn't qualify because I made too much money. So I had to take my husband off.

MyLuvBugs replied: That's great information Nicole! Thanks!

Will they take you if your family has NO income? And do you know if they have to have a year contract with Medicaid or is it month to month with them? I tried finding information on their website, but it's like pulling teeth.

C&K*s Mommie replied: For our state (Florida) it is on a yearly basis, then you have to renew. Unless the income changes <<~~ then you notify them-- you have to reapply after one year. The process is easier when reapplying anyways. Depending on the state, since it is a state funded program- it would determine if you have to resubmit the info month to month and recieve a new card month to month. Does that make any sense? It all depends on your state.

If you have zero income (again for Florida) you are put into a different catergory and you are pushed to the front of the line so to speak. For us here in my town, anyone with no income at all have their paperwork expedited and you can recieve more benefits than just the Medicaid. If you qualify, you can receive cash assistance, emergency food stamps, maybe other things too. I just remember seeing those things on the form I filled out for Medicaid.

Your unborn child will be under your Medicaid for the first yr after birth, then they can get either 1) under a different program if your state has it (like for us we have KidCare/ HealthyKids/ & MediPass (i think that is what is called) or 2) but I am not sure of the circumstances of it-- maybe they will stay on Medicaid.

Also, I remember our instructor mentioning this, but Medicaid is no longer Medicaid for Florida. It is under Medicare or something like that. Anything beyond that I am not positive of.

Check the blue pages for your county though. Schedule an appointment to talk to someone. And if you want my SIL works for DCF in Tallahassee, I can ask her anything you would like to know about if you wish.

MyLuvBugs replied: Thanks Nicole! You're so helpful.

I've sent an email off to our Regional department of Medicaid, and I'll go in tomorrow to DCF and figure some stuff out. Now If I can just get my DH off his butt and find a job.

C&K*s Mommie replied: YW! Wish you the best of luck with it, there should be no problem with you getting it, and it is great that something is there for people that need it (like us )

BTW... I was on Medicaid for the the PG with both girls, and for that little bit of time given following the birth of our girls. So I hope any info I gave has not been outdated since the changes that our Gov (Bush) did with Medicaid. Everything above was from reading, and from my experiences several yrs ago.

GOOD LUCK!!! KUP!

CosmetologyMommy replied: here in IL not matter what if u are pregnant and have no insurance whatsoever u automatically get it.

Chiflata2003 replied: Here it goes by income. I had it when living in TX when pregnant with my daughter, but then again I was 18 (had her at 19) and didnt have a job. It got cut off after 3 months to give you enough time to go to your post pardum appointments and to also get on bc.

luvmykids replied: In NM it's based on income levels, but it does continue for bc after and for the child's first year, then you have to reapply.

My3LilMonkeys replied: in PA if you have no insurance available to you and are PG you can automatically be covered. Or at least you could 3 years ago - a lot of our laws have changed since then.

The coverage lasted until 3 months postpartum, and it also covered they baby for 3 months. After that you would have to be reevaluated and income was a factor.

Another thing I found was that as long as you have the medical card you are automatically eligible for the WIC program regardless of income also.

MommyToAshley replied: In Ohio, it is based on income levels. I am surprised to hear that it is different in other states... I thought medicade was a national program. Good luck, I hope you qualify in your state for insurance.

As far as insurance, I would not recommend maternity insurance if you are paying for it yourself. We are self-employed, and therefor self-insured and self-pay for our medical expenses. I looked into maternity insurance, and the cost would be about the same as if you were to pay the hospital bill. But, there are restrictions. If you get PG before a certain date, your PG insurance is null and void. If it takes you awhile to get PG, then you will end up paying more for insurance than you would if you had paid the hospital bill. Insurance companies charge an arm and leg for maternity insurance because they know you are planning/trying to get PG and it is an almost guarantee they will have to cover certain medical costs.... and they make sure they get every penny of it.

If you don't qualify for medicade, I would recommend putting the money you would pay towards maternity insurance into a savings account to pay your own medical expenses. However, you will need to have some kind of high risk insurance if you don't have it already... just in case there is some sort of complication and you or the baby are in the hospital longer then your high risk plan should take over for both of you. (I would double check with your agent that this is the case with your particular insurance plan).

HTH

3_call_me_mama replied: IN VT we have a program funded partly through medicade and partly through the state. it is for Pregnant women adn children. It can be your sole insurance (if you have no other and are PG you automatically are covered for prenatal and labor/delivery and then your child is covered. ) It is based on income mostly but the cut off for qualifying is quite high ($56K a year for a fmaily of 4~ you pay $70 a month). Also it can be a secondary insurance, say you have crappy coverage through your job or wherever, this will pick up the stuff the other doesn't. But you may pay liek $40 a month or so.
At least that is how it was when I was PG with Cameron adn kathleen

my2monkeyboys replied: The insurance we can get (husband is self-employed, we pay for it ourselves) is quite high, almost the same price of all the other insurance alone. And of course there is the 1-yr-wait. I am just scared of what would happen if I got pregnant and didn't qualify for medicaid, you know? What do you do then... will a doctor actually see you when you're having to make small monthly payments to cover the visits and stuff??? Or do you go to the local clinic, which maybe you have to qualify for that too?
Without mat coverage, the most we would have to pay is $5000 plus our hospitalization ded (which we have set high right now) that is $5000. So it would cost us $10,000. Our insurance has "pregnancy" listed as a $5000 event, so anything over that is covered by our med insurance, which is where our hospitilization ded would come in to play. I just know we couldn't come up with $10k in 7-9 months.
This is so bad... being self-employed and broke! lol

C&K*s Mommie replied: I was surprised about that too, DeeDee. It is a federally funded program to all 50states, with induvidual states supplementing with their own funds, but overall Medicaid itself is state-run. That is why Florida rolled Medicaid over into Medicare or something along those lines. I heard this, but I want to read up on it to know myself.

Also Medicaid is a health assistance program, not an insurance program. That is something that I did not know either. One of those things in the catergory of **learn something new everyday**