Pregnancy without insurance

I'm hoping people on FW can help with advice or at least direction on what to do. There was a thread on pregnancy without insurance and how hospital fees can be pre-negotiated. The thread was vague - can someone provide more insight?

My situation is this: My wife is 1 month pregnant and does not have insurance. She is not allowed to apply for government help and does not qualify for low-income (she is healthy but does not qualify for insurance due to questions about residency). My job does not provide insurance. What is the best way to minimize the cost of pregnancy? I do not even know where to begin. We are in Fairfax, VA

I did initial phone calls to an OB. They say we have to find a doctor and the costs are 3-4k. We also have to pay the hospital which is another cost (and greater). Estimates are 10k in all for normal delivery. How/who would I talk to in the hospital to negotiate the cost? What do I have to say/mention/ask for? How do I pre-negotiate complications?

Also are there alternatives in the area I can choose from? One idea is going abroad, but my wife is not allowed to leave the country without losing status.

Any suggestion is greatly appreciated

I assume you already checked to see if can you get insurance ---- like through the Kaiser individual and family plan?

also, do you have no insurance at work or is it only for you --- and you can pay to add your wife?

you should also look if you can stash $5000 away pre-tax if you are eligible for such a plan

I assume your wife is a foreigner? My wife is a permanent resident with conditional status, and in the application documentation, as well as at the interview, it says that receiving government assistance can disqualify the applicant. It is not clear to me what qualifies as government assistance. Clearly welfare checks are out, but I've heard of families getting WIC where one of the parents was a foreigner. The more relevant question is about medicaid. FICA taxes are taken out of my wife's paychecks, so I would think that that implies she would have some claim on Medicaid, but since IANAL I really don't know.

I know it doesn't do any good to close the barn door after the horses have escaped, but you should get at health insurance for yourself right away, and for your family as soon as the baby is born. It is so important to get health insurance (even high deductable insurance) for both yourself and your family. There are two very good reasons for this:

1) Protection against catastrophe or a chronic illness, which could make you uninsurable.

2) In my case, I had to sign an affidavit that I would financially sponsor my wife (as a condition for her visa). This makes me financially liable for her, and if my wife ever incurred medical debt, they could come after me for it.

In my case, I do not qualify for medical insurance from my employer, so I have private insurance, but my work did allow me to set up a Flexible Spending Account. My wife's insurance charges a $5000 maternity copay, so if/when my wife becomes pregnant, I plan to put that much into the account.

Also, if you are the primary income source in your household, you might want to consider term life insurance for yourself.

pjhartman said: Just have your wife pretend that she doesn't speak English.

(It's a joke, people; leave the rotten tomatoes in your salads.)

you mean like show up in a big city emergency room with no identification
fill out the intake form with an address in Guatemala City

pjhartman --- your not helping here

Why don't you call a local hospital (i.e. there labor and delivery department and/or social work) and ask them what available in the area in terms of women's clinics and the like. They might be able to point you to OB's who work with low income groups as well

OP, congrats on the news. Next time, will you think about all these questions before getting pregnant? The last thing you want right now is a pregnant wife stressed out over money issues.

I for one am getting fed up with the ever-rising pass-through costs to paying policyholders of subsidizing those who either can't or won't buy health insurance.

in all seriousness, if the pregnancy doesn't go well
costs could easily reach $100K

$50K for prelabor hosiptal care and a c-section for the wife
and $50K for time in the NICU if baby comes early

Firstly, we were told she had insurance but later found out she was rejected due to non-residency.

Because of her immigration status, even if we wanted, we cannot get government help, so please don't make this thread about subsidizing. Right now I am looking forward - it is too late to say plan ahead, etc... I am not looking for low income qualification or government help - so those are not options.

I am trying to find ways to minimize my cost as much as I can - please don't make this thread about government subsidy. I have already prepared with HSA but I fear that is not enough.

Again - she cannot get insurance (or else we would have bought her). My job does not provide insurance and I have to buy my own HDHP plan. If she leaves the country, she cannot re-enter.

Please don't turn this thread into war or debate.

alpharock said: Firstly, we were told she had insurance but later found out she was rejected due to non-residency.

Because of her immigration status, even if we wanted, we cannot get government help, so please don't make this thread about subsidizing. Right now I am looking forward - it is too late to say plan ahead, etc... I am not looking for low income qualification or government help - so those are not options.

I am trying to find ways to minimize my cost as much as I can - please don't make this thread about government subsidy. I have already prepared with HSA but I fear that is not enough.

Again - she cannot get insurance (or else we would have bought her). My job does not provide insurance and I have to buy my own HDHP plan. If she leaves the country, she cannot re-enter.

Please don't turn this thread into war or debate.

have you thought of finding another job that provides health insurance?

WalStMonky said: alpharock said: We are in Fairfax, VA

Consider moving to DC proper. They're a lot more liberal in the city. There are some very decent neighborhoods in far NE which are actually (relatively) affordable)

I for one am getting fed up with the ever-rising pass-through costs to paying policyholders of subsidizing those who either can't or won't buy health insurance.

Any constructive suggestions on how to remedy this or are you just whining? Ever notice how much a doctor charges vs what the insurance pays and they agree to take? Example: I had a lab test recently. List price $70. Blue Cross paid $12.43 and I paid $10. Reality is this bassackward system has the uninsured subsidizing the insured, not vice-versa. Heck, maybe the lady should just spring for for a few hundred bucks for an abortion to save you the thought that people are costing you money.

Protection's cheaper - or have the baby when you can afford it.

dudetheobscure said: Protection's cheaper - or have the baby when you can afford it.

I think it is clear that OP can afford the baby, and he will pay if he has to --- he is just looking for some help to avoid a major financial set back

The 50-100k figure is IF there are complications. Then bingo you have to pay for neonatal ICU, increased hospital days, etc.

vitbich said: I assume your wife is a foreigner? My wife is a permanent resident with conditional status, and in the application documentation, as well as at the interview, it says that receiving government assistance can disqualify the applicant. It is not clear to me what qualifies as government assistance. Clearly welfare checks are out, but I've heard of families getting WIC where one of the parents was a foreigner. The more relevant question is about medicaid. FICA taxes are taken out of my wife's paychecks, so I would think that that implies she would have some claim on Medicaid, but since IANAL I really don't know.

I know it doesn't do any good to close the barn door after the horses have escaped, but you should get at health insurance for yourself right away, and for your family as soon as the baby is born. It is so important to get health insurance (even high deductable insurance) for both yourself and your family. There are two very good reasons for this:

1) Protection against catastrophe or a chronic illness, which could make you uninsurable.

2) In my case, I had to sign an affidavit that I would financially sponsor my wife (as a condition for her visa). This makes me financially liable for her, and if my wife ever incurred medical debt, they could come after me for it.

Just for your information there is a number of Federal, State, and Local benefits which are not subject to reimbursement by you even under "strong" (I-864) affidavit of support. Follow this link and scroll down to "Benefits Not Subject To Reimbursement:"

http://www.law.cornell.edu/uscode/html/uscode08/usc_sec_08_00001183---a000-notes.html

If you read carefully and follow the appropriate links, you will find out that medical assistance in "emergency" situations is a "Benefit Not Subject To Reimbursement." Now, "emergency" here does not mean emergency in a normal sense. Most state medical assistance programs define "emergency condition" as a condition which if left untreated can result in death or serious disability. I do not know about Virginia, but it is very likely that a pregnancy will be covered under state emergency medical assistance program. Most states have pro-bono legal centers that help people with questions of eligibility for state medical assistance. Google is your friend.

<<If you read carefully and follow the appropriate links, you will find out that medical assistance in "emergency" situations is a "Benefit Not Subject To Reimbursement." Now, "emergency" here does not mean emergency in a normal sense. Most state medical assistance programs define "emergency condition" as a condition which if left untreated can result in death or serious disability. I do not know about Virginia, but it is very likely that a pregnancy will be covered under state emergency medical assistance program. Most states have pro-bono legal centers that help people with questions of eligibility for state medical assistance. Google is your friend.>>

I appreciate this passage - but like irates reader who label me as a person who "leaves others holding the bag"... they are wrong.

alpharock said: <<If you read carefully and follow the appropriate links, you will find out that medical assistance in "emergency" situations is a "Benefit Not Subject To Reimbursement." Now, "emergency" here does not mean emergency in a normal sense. Most state medical assistance programs define "emergency condition" as a condition which if left untreated can result in death or serious disability. I do not know about Virginia, but it is very likely that a pregnancy will be covered under state emergency medical assistance program. Most states have pro-bono legal centers that help people with questions of eligibility for state medical assistance. Google is your friend.>>

I appreciate this passage - but like irate reader who label me as "leave someone else holding the bag type"... they are wrong.

I am not sure I understood what you meant, but I do not think it would be smart to reject government (state or federal) assistance if you are eligible. If under existing law you qualify for that assistance then you should take it, because that is the whole purpose of those programs, so that uninsured people could get medical treatment they can't otherwise afford.

<<I suggest OP ask United Health Insurance for a quote, I think they may have plan(s) including maternity for pre-condition at a higher cost, which is still far better than pay $10+K without health insurance.>>

They will not cover if the person hasn't been in the country for 12 straight months.

or move to NYC and get one of the government sponsored health plans that are available to anyone without insurance. the cost is based on your income

Since she's only one month pregnant, I suggest getting an abortion. Then get some insurance if you still want to have a kid.

IVYtony said:
interesting thoughts.

another thought is canada. their healthcare is socialized. you won't be charged anything. if you can figure out when she's about to go into labor, drive into canada.

what if they live together but not married?