Sonntag, 29. August 2010

Single pregnant immigrant without health insurance in the USA.

Sounds scary!??? It sure is... BUT ONLY, if you're me and you base your decisions on the bigger picture.

Now before anyone thinks I'm stupid for deciding to start a family in the first place, knowing that I would probably have no health insurance covering maternity: We both were well aware of that and before the "We" picture collapsed, everything in regards to that was talked about and a plan established. Only problem: "We" is no longer existent, which makes it more complicated.

I believe it may be quite interesting for the 0.0001% of legal immigrants that will ever be in the same shoes to find out how the whole "pregnant - no insurance" thing works over here.

Looking at the market of individual health insurance, pregnancy is considered a pre-existing condition, so once you are pregnant, chances of getting a health insurance plan are veeeeery low. Even if looking for health insurance in that market BEFORE getting pregnant will prove challenging, as there's a lot of fine print and maternity is usually not covered. If you want it covered you start out paying a lot more each month, as pregnancy/maternity is quite expensive for an insurance provider. Just the plain natural labor and delivery without complications and interference in a US hospital bed is likely to cost $10.000,-. Caesarean sections will of course be more and every drug you need will push the bill higher.

Best situation to be in: Get great health insurance from your employer and your life will be much easier. In an employer based health plan, pregnancy can not be labeled a pre-existing condition as there's some legal protection going back to the 70's for that. But not everybody is that lucky!

So let's be the one not having insurance coverage like me. What are the options?

The answer is simple. Not many!

Option 1: You're very fortunate and qualify for federal Medicaid support.
Problems: Medicaid for pregnant women is income based and even if you qualify due to your income... You have to be a US-citizen or a permanent resident of the USA for at least 5 years to qualify, although in some sources it says as greencard holder being pregnant you are exempt from the 5-year bar. All I know is, I was denied :(

Option 2: Pay cash!!! Whoop! As cash is still loved by doctors and hospitals, you will be able to negotiate and get better rates than an insurance provider. You may "only" pay 50% for example of what an insurance would be charged. However, that would still be a lot if you don't belong to the rich and famous.

I was "lucky" enough to have noticed a highway billboard in my first months over here that advertised for a birth center. It is an alternative to hospital care and usually the cheaper option. In my case I found a birth center run by an OB/GYN and a midwife (vs. others where there are only midwifes) and although I'm still having to pay for my care in cash, the package including prenatal care, labor and delivery and postnatal care, will "only" cost me around $4.200,-, IF everything goes without complications. In addition to that, I'm looking at a completely natural birth. Drugs for pain relief? No such option!

May sound scary for many again, but since my birth center has an OB/GYN licensed to operate in the local hospitals, I'm on the safer side. In case of complications he will deliver my baby out of a hospital without additional charge. I would only have extra costs for taking up room and equipment in the hospital then, but that is where Emergency Medicaid for pregnant women could kick in and that is something I would be eligible for.

Now as I ended up on my own, I'm paying everything by myself, which is tough. Quite obvious if you don't make the super big bucks and all of a sudden find yourself with a $740.- extra bill each month on top of your regular bills. But what doesn't kill me, makes me stronger! :)

By the way, there would be an option 3, as some of you may question how illegal aliens get their pregnancy health care. Yes, I could just go to the hospital and demand prenatal care which they couldn't deny me. My problem with that: Within the last 18 months I established quite a nice credit score. Getting care from a hospital and just not paying my bills (like a lot of uninsured citizens and legal as well as illegal aliens do) does therefore not work for me. I rather work my pregnant butt off and pay cash for my medical care, than ruining my credit by not paying those hospital bills and having debt collectors chasing me. I may need my good credit for something once baby girl gets here.

Well, long enough post about that topic! Cross your fingers for me as there is still a lot to figure out in regards to my near future.

1 Kommentar:

  1. Toi, toi, toi weiterhin. Alles Gute fuer Dich und Baby E. Druecke ganz fest die Daumen, dass alles "normal" verlaeuft. Halt die Ohren steif. Du schaffst das.
    Ganz viel gutes Karma aus L.A.