What Happens If You Lose Your Insurance While You're Pregnant? It Can Be A Scary Time
Pregnancy and childbirth are daunting enough without considering just how much they cost. The idea that you might be without health insurance during this time is terrifying, and for many, the truth of their lives. What happens if you lose your insurance while pregnant? Is there a way to get interim coverage, or are you honestly just looking at a mountain of debt?
Disclaimer: if the American Health Care Act (ACHA), also known as "TrumpCare," passes, this will all change. In its current state, the ACHA does not cover maternity as a preexisting condition, nor does it cover birth control, or postpartum care. It also eliminates federal subsidies to non-profits like Planned Parenthood and other low-cost clinics that might also provide abortion services. Medicaid is also set to be severely slashed, taking millions of people out of eligibility. Something to keep in mind.
There are so many reasons mothers may lose health coverage while they're pregnant. They might be dependent upon their spouse's job for insurance, and their SO may lose that job or need to leave. They might not have re-joined the insurance pool during the enrollment period and then find themselves pregnant, they might be downsized, and even though it's illegal, CNN Money noted that women still get fired just for being pregnant more often than you'd like. It's all a part of the motherhood penalty that women pay purely for having a female reproductive system.
If you find yourself in this situation, you can either join the COBRA plan, which allows you to maintain that insurance for up to 36 months after leaving that job, but at a much higher rate, according to the U.S. Department of Labor, or you'll need do do what the maze that is Healthcare.gov advised in this situation. The law outlined stated that regardless of whether or not you plan on entering the healthcare marketplace, you're going to need to apply for Medicaid first. It doesn't matter if you'll qualify or not, it's just required. You can do this at Medicaid.gov, or you can seek a certified application counselor to assist you in the trek through, "why does the richest country in the world still have this mess" forest. You have to do this because it tells Uncle Sam that you are now eligible for what is called a "special enrollment period" (SEP). These are only available in very specific situations, pregnancy chief among them, and allow you to enter the healthcare marketplace outside of the typical enrollment period.
Once you do that, it will be determined whether or not you qualify for Medicaid. If you qualify for Medicaid, you will be advised by the Medicaid office as to which hospitals and providers are covered under the plan, and what your state determines are your healthcare rights under their plan. It should also be noted that women who qualify for Medicaid often also qualify for WIC and food stamps, which may help ameliorate some of the costs of pregnancy and postpartum.
If you fall outside the range of household income for Medicaid, you may enter an SEP and choose a new insurance based on income, tax credits, and affordability. Be sure to be mindful of deductibles, out-of-pocket costs to hospitals, what is listed under coverage, co-pays, and provisos. For example, you might sign up for an insurance that seems to be affordable on the surface, but that sticks you with a huge bill for everything from your ultrasound to your delivery. Buy the best you can afford, suggested budget juggernaut, NerdWallet, and there will be hopefully fewer surprises.
Once you get the coverage, find a provider who works with or has a financial insurance counselor on-site who can work with you on all the minutiae of the fine print of your new plan and what that means in terms of your budget and theirs. Many larger providers employ such a person just for this sort of case.
However, you may find that you cannot even afford the most basic package in the exchange, and that you don't qualify for Medicare. If that is the case, the March of Dimes has a list of resources for you. Prenatal care is amazingly important, and prohibitively expensive for some. Resources like Planned Parenthood are invaluable in these cases.
If you find yourself paying cash for prenatal and maternity care, know also that you can negotiate the costs associated with pregnancy and birth beforehand with the hospitals, and shop around for the best prices, NerdWallet mentioned. It seems strange, because how many moms actually go into an ultrasound and ask beforehand, "How much is this?" You might find that it varies widely from place to place.
Take a deep breath. Sit back. Ask for help, and if you need to crowd fund, do it. This is a very stressful situation, but hopefully, after a pile of paperwork, it's doable.