My sister can be so stupid...

C

cheltzey

New member
So my sister and her husband have been trying to have a baby for over a year. Finally she calls and announces she's pregnant! YAY!!! But then...THEY HAVE NO INSURANCE!!! :confused: What were they thinking???!!! It's not like this was an accident. They've been wanting this for a long time. She did have insurance through her work, but she quit her job a few months ago because she decided she didn't like it. Then they DELIBERATELY chose not to get private insurance. Now she can't get insurance coverage for it since her pregnancy is now a pre-existing condition. Her husband is going to school and he's only a tutor, so he can't get coverage through his work. They will also probably not qualify for Medicaid since they have too many assets. And even though they made the conscious decision not to get the insurance, she has the nerve to call up my mom and tell her that they might need financial help. Um...maybe they should have thought about that before? Seriously. I can't believe we were raised in the same family sometimes. :cursing: What if something goes wrong with this pregnancy? It could wind up costing them a fortune and could really affect their credit.
 
man. this is no bueno. what can you do. nothing. just sit back and watch em make mistakes. story of my friggin life.
 
WOW. Childbirth and pregnancy are the most costly thing a young woman has in terms of medical expenses(aside from major illnesses, of course). Maybe there is a plan that does not have a pre-existing condition clause? When I changed insurance one time, that was the case--and I was 9 months pregnant at the time.

It is so hard to see someone make these kinds of mistakes. I hope it all works out ok.
 
CA Dreamer said:
WOW. Childbirth and pregnancy are the most costly thing a young woman has in terms of medical expenses(aside from major illnesses, of course).
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Where she lives, the average cost of having a baby is $6000...if nothing goes wrong. And I can tell you, they definitely don't have $6000, let alone more if something does happen.
 
If they don't figure out something by the time she gives birth, maybe they can work out a payment plan or something with the hospital. And, hopefully, she will have a totally uneventful pregnancy and smooth delivery.

And, (((hugs))) to you for having to take on the extra worry and aggravation!
 
Gosh, that IS rough. :( Maybe she can do a home birth and hope for the best. Or probably your mom will help her out and she won't even learn anything from this experience.
 
Does new mexico have anything like TN does...they have Tenncare and give it to women who don't have healthcare coverage...I had to use it since we had left our jobs down in louisiana to evacuate hurricane katrina..when i got up here i had no health insurance because they hadn't kicked in yet at work..and I kinda found out as Katrina came ashore that I was pregnant not sick with the flu (yea it sounds stupid..but with my medical condition i wasn't susposed to be able to have children.) Needless to say...I had my daughter...she was a good healthy baby but I used Tenncare and had a wonderful delivery its when i started almost bleeding to death after I had her was the problem...Blood transfusions and all...it ran close to 25 grand after they were done with surgery etc..If i have another child IF i mean IF which is doubtful i have to be on special pills the doctor told me. After Tenncare we got onto hubbys private insurance...that sure taught us a lesson :( Maybe she can check with the health department..just my .02 cents :)
 
qualifying for medicaid is alot easier to do then any other type of benefits. I had to use medicaid when I was diagnosed with kidney stones and ended up in the hospital with a severe kidney infection and even though we owned our own home and had no debt we still qualified because I was considered medically needy. Im sure having a baby would be considered being medically needy also and I believe medicaid is a federal program not state run so it should be that way across the entire US. Hope they find a way to make it all work out ok and congrats on the new baby coming into your family
 
Oh man! I totally feel ya on the stupid sister thing though. Mine is 40 years old, unemployed, not even pretending to be looking for a job, and just moved back in with my mom. She sleeps all day and plays on facebook all night. :blink::cursing: sigh.
 
I think there are grants and the likes for Pregnant women, and the new baby once it arrives.
Or at least special rules for Medicaid.
She should look into it, honestly.
 
wow that really is irresponsible of them. unfortunately, if your mom does help, she won't learn anything and will keep going back to Mom for help.
 
My hubby owns his own business and I am a SAHM. We are on private insurance which does not cover maternity costs. Most doctors and hospitals will work out cash pre-payment plans that are at significant discount to what would be charged if insured. For example, at the hospital I just delivered at last week, if you pre-pay for a vag. delivery, it's $2500. If you leave the hospital after delivery and have not paid, it's automatically upped to $5000. So it "pays" to pay ahead. My doctor's office does this as well. And I heard that the anesthesia does it also, though I neglected to check into it before I had Sadie. However, when I had Claire, they only made me pay 50% if I paid it cash within 30 days.

My insurance agent said that I could get a maternity rider for my insurance policy, but that she had never sold one because they were not worth buying. Her assurance to me was that baby would be covered no matter what the second s/he was born.

Said all that to say, it's not the end of the world. She does need to get some private insurance for herself though, even though it probably would not cover maternity. It would cover other stuff that she may need, plus will cover baby the second the baby is born, no matter when (even if preemie).
 
oh that stinks. I have a friend who didn't purposely get pregnant and has no maternity insurance. She did the prepayment thing. She's due in april but everything for the doctor and hospital had to be paid the beginning of the month and it's supposed to cover EVERYTHING, except for complications (which her medical insurance is supposed to cover).

Oh, I have also heard that pregnancy isn't considered a pre-existed condition so much anymore.
 
this happened to me too, I had a pregnancy that was considered pre-existing and it ended up that even though we FAR exceeded medicaids normal requirements, it IS different for pregnancy/childbirth. They covered me 100% and she had medicaid for her whole first year (though we didn't need or use it cause our insurance covered her)
 
She should look into Medicaid as they may cover her. Or, like others said, she needs to check into prepaying her doctor and the hospital to at least get a reduced rate.

We have private insurance with a maternity rider, but honestly, the maternity coverage isn't much even though we have to pay $$$ to have it. Private insurance is sooo overpriced too.
 
Tell her to check into options, there should be lots of things she can do to help the costs. When I hear of these outrageous amounts paid for having a baby, I am quite thankfully for TriCare.
 
My mom works for a not for profit agency that provides health insurance for woman and children for don't qualify for medicaid (if that ends up being her case). Most states have a similar agency as part of it is federally funded. She definitely needs to look into Medicaid and if that doesn't work, this other option.
 
I totally just had to look this up because I thought that pregnancy couldn't be classified as a preexisting condition. Under a law known as HIPAA, the Health Insurance Portability and Accountability Act of 1996, health insurers cannot consider pregnancy a preexisting condition. However, HIPAA doesn't apply to someone who previously had no health coverage and this is her case.

As others have said, she should look into Medicaid or something. A normal pregnancy and birth can cost around $5,000 but should she need a c-section or something out of the norm, the costs could be $15,000 or more.
 
WOW, doesn't make you have much confidence in her future parenting abilities when she makes selfish decisions like that, HUH?! Certainly not what I would've done; but I am a planner!
 
No reason to worry! It is HIGHLY unlikely that she won't qualify for Medicaid. Most states, regardless of income, cannot deny you for Medicaid if you are pregnant and have no insurance. I am so happy for her that they were finally able to concieve and have the joy of a child in their life!
 
lovely1m said:
Tell her to check into options, there should be lots of things she can do to help the costs. When I hear of these outrageous amounts paid for having a baby, I am quite thankfully for TriCare.
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What you said!!!

We are in a different situation altogether. We have TriCare through the Army, and I am SO grateful for it. But...because we live in a rural area, we have TriCare standard and not prime...which means they don't cover us at 100%.

That being said, because David is only an E-2, we make little enough to ALSO qualify for Medicaid as a secondary insurance.

I'm grateful for both and not embarrassed to be covered by the State for our secondary insurance!
 
Thank you guys SOOOO much for your advice! I called my mom and told her all these suggestions (I don't think I'm actually supposed to know that my sister doesn't have insurance, so I couldn't call her directly!). I know I definitely made my mom feel better, and she's going to be giving my sister a call right away. If she failed to plan before, she should at least do so now!
 
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