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Old 07-05-2013, 07:56 AM   #1
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No maternity insurance? What about a possible NICU stay?

So, DH "lost" his job. He is still with the same company, but due to some CSI scores beyond his control, he's been downgraded to a different position that pays a LOT less. We haven't even enrolled for insurance in that company yet, but we can't stay with that current company at his current position and come close to making ends meet. We'll be okay because I have as much work as I want right now, so I can pick up some of the slack, and our car will (finally) be paid off next month, so there's that as well.

DH is exploring a few options, one of which is as a self-employed pest control provider. Someone at church does this right now, but needs rotator cuff surgery at some point and will be out for at least a few months, and would need someone to take care of his customers while he's out. DH is going to talk more with this person and explore options, like helping him out on DH's days off for a while, to learn some stuff, start taking the certification classes, help make sales calls, help do service calls, just basically work slowly into the business while still working at his current job.

But being self-employed, that means no group insurance and definitely no maternity coverage privately. We're currently on a short-term insurance plan, and I plan on talking to our agent soon and seeing what our options are for the long term if we go with the bug-killing option. A friend told me about a group plan through Costco (which is too much for us right now, so I'm hoping our agent can find us something more reasonable), and it says that Maternity is "not covered except for pregnancy complications." Other insurance plans I've looked at just say "not covered," period.

We are a homebirthing family and would pay for our midwife out of pocket like we did for our other two homebirths, but my concern is what would be to happen if we happened to have another NICU baby, or if I had to have another surgical birth. I don't know what's considered a "complication" or what would be covered. Our state does have pregnancy medicaid, which we would probably qualify for, but I started to try to do that with DS1 and the application process is long and painful and I'd be halfway through the pregnancy it seems before it's even done.

Anyone have any thoughts to share as I chew on this? In thinking about career options, this bug opportunity right now seems like it would be the best long-term option overall, but with my history, no maternity coverage scares me a little bit right now.

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Old 07-05-2013, 08:34 AM   #2
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mama. You should be able to buy maternity coverage but it will cost significantly more than a policy without it. Even as a small business/being self-employed, it should be an option. I would contact a local agent and find out what your options are. Re: cost, it is just expensive no matter what. We are small business owners and we pay around $1,000 a month to insure the 3 of us. But even when I worked FT and we got insurance through my employer, the price was over $700 a month and the coverage was pretty poor. I hope you guys can find something that works for your family!

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Old 07-05-2013, 08:45 AM   #3
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A NICU stay would be due to complications I would think, but thats usually billed as the baby, not the mother. The full cost of DD1s NICU stay for 6 weeks was $45000. We had insurance thank goodness. If you've had complications before I'd look into medicaid for you and the baby, personally.
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Old 07-05-2013, 08:57 AM   #4
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For pregnancy Medicaid in Texas, they now only have 3 weeks (I think) to either approve or deny you. The process isn't as bad as it use to be either as you can do it ALL online. I was on it for my last pregnancy and the only time I had to go into the local office was when they couldn't was when they couldn't read the scanned copies of DH's check stubs and to turn in paper work...both times it took less than 30 minutes.
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Old 07-05-2013, 04:47 PM   #5
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Re: No maternity insurance? What about a possible NICU stay?

If you were to purchase insurance privately, all of the plans say "no maternity coverage" because you have to purchase what is called a maternity "rider" on the policy. I couldn't find one online when I was purchasing mine and had to call and talk to the agent on the phone, then he emailed me the .pdf file with the information on the maternity riders.

It's best to have that in place before a pregnancy happens because then they can pull the "pre existing condition" waiting period crap, at least until the beginning of 2014, if you purchase the plan and rider after you've already found out you're pregnant. But, the pregnancy Medicaid sounds like it would still be worth the headache if worst comes to worst.
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Old 07-05-2013, 06:52 PM   #6
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Re: No maternity insurance? What about a possible NICU stay?

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Originally Posted by mibarra View Post
A NICU stay would be due to complications I would think, but thats usually billed as the baby, not the mother. The full cost of DD1s NICU stay for 6 weeks was $45000. We had insurance thank goodness. If you've had complications before I'd look into medicaid for you and the baby, personally.
Was that the after-insurance cost?

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For pregnancy Medicaid in Texas, they now only have 3 weeks (I think) to either approve or deny you. The process isn't as bad as it use to be either as you can do it ALL online. I was on it for my last pregnancy and the only time I had to go into the local office was when they couldn't was when they couldn't read the scanned copies of DH's check stubs and to turn in paper work...both times it took less than 30 minutes.
Oh, that's good. I tried to do it with DS1 and even just that short time ago, you had to go to DHHS in person. I think part of it might have been that she thought I was applying for regular Medicaid instead of pregnancy Medicaid, and that was a long and scary form as well.
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Old 07-05-2013, 06:52 PM   #7
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Re: No maternity insurance? What about a possible NICU stay?

But anyway. There was another old contact of DH's that I'd forgotten about - his old boss from the car dealership he used to work in car sales in. That boss (I'll call him S) is now at a different dealership, and said that dealership's looking for someone for the service department or parts. S is going to talk more to the appropriate people on Monday and give DH another call, and DH might go up there Monday if he doesn't get picked for jury duty, or Wednesday which is his next day off. That other dealership also has a CSI factor, but it's a locally-owned dealership instead of corporately-owned, so they don't have their hands tied with the numbers as much as the corporate dealership did. Could be interesting.
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Old 07-05-2013, 07:35 PM   #8
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Was that the after-insurance cost?
Oh no, before insurance. Eek. We paid a $350 hospital stay copay and a $150 deductible. She also spent a month on oxygen and 2 months on home health care after discharge. No out of pocket cost.
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Old 07-05-2013, 07:48 PM   #9
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Re: No maternity insurance? What about a possible NICU stay?

If it turns out to be a NICU stay or hospital birth ask for social services to pay you a visit while in hospital. They can help you through the application process. Until then, I don't think I would worry about it. If you cannot afford the expensive insurance then there is nothing you can do but hope for the best and cross that bridge when you come to it. It is actually pretty painless though when you get help. I was post surgical with my first child(a planned home birth gone wrong) when I received help filling out the forms. It wasn't bad at all. Much easier than going to the office to do it. Better attitude as well. At least in Illinois they will cover medical expenses 2 months prior to approval.


I don't want to scare you with the home birth transport. It was thanks to my midwife's vigilance that we both made it through with flying colors.
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Old 07-05-2013, 07:59 PM   #10
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Re: No maternity insurance? What about a possible NICU stay?

Not sure if this is what you are looking for but my friend uses this and it does cover maternity. It is a monthly premium and it is a cost share plan,but she loves it and they are covering her cost for her midwife. http://www.chministries.org/ Also like a pp said you can apply for medicaid after the baby is born in Texas. When dd was in the NICU that was one of the first things our case manager at the hospital addressed with us. We have Tricare so it wasn't necessary but they said that there are people in the hospital that could help us get medicaid straightened out if needed.
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