Pregnant and without Health Insurance?

Naturally, the ideal time to plan for maternity expenses is before you become pregnant. The whole concept of health insurance is to plan ahead, to have medical coverage for potential future events. Not that it is impossible to obtain health insurance for maternity expenses after you become pregnant, but it is much more difficult to get maternity health coverage once baby is on the way. Health insurance companies look at pregnancy as a "pre-existing condition." If a woman applies for health insurance that covers maternity after she becomes pregnant she will be using healthcare dollars, without having paid her share of premiums to cover the expense. That of course defeats the reason insurance works.

So, what do you do? There are several ways to obtain affordable health issuance coverage for delivery and maternity expenses:

First, check to see if you can obtain health insurance through your employer. Keep in mind that if you are working, not all companies provide health insurance, and even if they do, not all employee based group health insurance covers maternity expenses. The first step is to check with your benefits advisor at work if applicable, and see what your health insurance covers. If your plan doesn’t cover maternity or you don’t work for an employer with health insurance available, see what may be offered under your spouse's health insurance plan if available. Even if the specific pregnancy is not covered under your plan, illness or other complications resulting from the pregnancy or childbirth will normally be covered under your regular health insurance.

Second, if you are low income you may qualify for the Pregnancy Related Medical program in Washington State through Medicaid. This is a great program that covers the mother’s prenatal care, labor and delivery expenses, as well as the new baby’s expenses for a period after the birth. There is currently no waiting list for Pregnancy Related Medical as there is for the Washington State Basic Health program.

Finally, if insurance through your employer or your spouse is not an option and you do not qualify for Pregnancy Related Medical through Medicaid, your remaining option is to purchase a private health insurance policy through My Health Insurance of Washington. Of course, if you are buying a policy after you are already pregnant, that pregnancy may still not be covered (there are many ways to get around the preexisting condition however) but at least complications resulting from your pregnancy may be. Since average delivery expenses for a routine birth are around $10,000 (without complications!) it does make sense to pay for individual health insurance, even if the premiums may be several hundred dollars a month. While shopping for a private health insurance policy, keep in mind that most low-cost health insurance plans do not include maternity coverage so be very careful about what you buy. Sometimes buying a “cheap” policy to save a few dollars each month will cost you thousands if the pregnancy is not covered.

How do you figure all this out? Call me, I'd love to help!

www.myhealthinsurancewa.com 1-877-877-9545

Two days in the hospital is how much!!? I thought I had insurance!

Today I have been battling the great faceless Corporate Insurance Giant.

Here is the story. My Client, let’s call him Billy Bob, starts developing pain, real pain, the bend you over until a grown man cries pain. Now, a regular guy would have taken several hundred Advil chased with a beer. Not this guy, he’s intelligent, and decides to go to the Hospital Emergency Room. However, despite the searing pain, Billy Bob has the foresight to actually make sure the Hospital he goes to is in his Health Insurance Plan’s Network. Luckily, the insurance company website lists the Hospital as being In-Network! He goes to emergency, gets admitted immediately, and after two days of quality medical care, is discharged.

Billy Bob isn’t worried though, because the Hospital was in his network and therefore most bills should be covered or discounted, right? Then the bills start showing up, big bills, multiple bills, bills the size of small SUVs. Billy Bob is stunned, how could it have been so much? Remember when I said Billy Bob was pretty smart? Looking the bills over he discovers something no one usually would; the Hospital was indeed in his network, but many of the doctors (who belong to their own separate doctor networks) working at the Hospital were not! Thus he gets billed super high rates for out of network doctors at an in network hospital! Not just a few out of network doctors mind you, he was in for two whole days and thus he gets billed from multitudes of specialists all billing from their separate networks!

This is why there is so much anger focused on insurance companies. It’s not the level of care he received, it was excellent and he made a full recovery, but rather the coordination of benefits and billing issues that are dumbfounding.

Needless to say we are arguing that all his services should be covered at the less expensive in network coverage level. How will this turn out? My guess is the great Corporate Insurance Giant will throw us a bone on some charges. That would be nice, but it doesn’t solve the problem.

10 years, "just" over 1 TRILLION, only 30 Million more covered....

The first Health Care Reform Bill is now out of the House. What does it do?

1. Creates a new Government Sponsored Health Plan to compete with Private Insurance Plans.
2. Reduces the ranks of the uninsured by 30 Million.
3. Costs "just" over 1 TRILLION dollars over 10 years. (That's the House's own estimate)
4. Increases Taxes on the wealthy and medium-large businesses.
5. Will reduce the amount doctors receive for treating medicare/medicaid Patients.
6. Closes the "donught hole" in the Medicare prescription drug program. (Finally)


So, let's get this straight, it spends 1 TRILLION over 10 years to cover only 30 Million more People? If you do the math that's a terrible deal!

Once again it does not address the most pressing need, which is holding down the expense of medical care in our country. Just because you pay doctors less who see Medicare-Medicaid patients, that does not mean you have reduced the root cause of the expense crisis.

Our terrible wars in Iraq and Afghanistan will look like a trip to the "dollar store" compared with this plan's "Tiffany's" type shopping spree! If Obama wants to leave a lasting legacy, this will end up being the opposite of the reputation he desires.

I really hope our elected leadership takes a deep breath and a step back to consider the ramifications of this Plan before ramming it through like the Stimulus