Health Insurance question...

[dallas_the_tiger]

My brother and his girlfriend think they might be expecting.. One problem: My brother has health insurance. Girlfriend does not.

She is probably at most one month preggo. Are the policies out there for her?

 

[BA93]

I imagine there are policies out there, but the premiums have to be through the roof.

 

[Bevoldemort]

The health insurance would probably be more expensive than the actual bill. Assuming it is obtainable at all, the only reason to get it would be to insure against complications to the health of girlfriend. They aren't going to fool anybody by acting like they don't know she is pregnant. Insurance companies can count.

There is a decent chance that the baby would be automatically insured by brother's policy. That wouldn't pay for the delivery as I understand it.

 

[RC Didnt Offer]

She needs to go to work for a company who insurance doesnt discriminate against pregnancy in that way. My wife has worked for several.

 

[Bevoldemort]

I'm not fond of insurance companies, but discriminating against people who already have a "condition" when they decide to insure against the chance of said condition is inherently reasonable. One wouldn't expect to be able to start paying premiums the day before the delivery and have the same benefits as someone who has been paying for a year in anticipation of starting a family any more than you would expect a carrier to pay for a burned house when the fire was already burning when you called to insure the house.

 

[BA93]

If the girlfriend doesn't have a job or is paid very low wages, then she might qualify for Medicaid. Then we all get to pick up the tab.

 

[suttree]

She obviously has a preexisting condition. Has she been to an OBGYN yet? I think the total expense for a pregnancy, assuming no surgery, is probably about $10k. Typically when you start a new job you are added to insurance without regard to a preexisting condition, but nobody is going to hire her when she is pregnant. Yes, it is discrimination, but they won't because she is automatically a risky employment decision.

My advice would be for her to try and see if she is eligible for Medicaid or Gold Card (I think this is the Texas county health plan). This information is available on the web.

Even if she just paid out of pocket to her OBGYN for her prenatal care, she could theoretically just show up to an emergency room when the time comes and she won't realistically have to pay anything (I think this is tantamount to stealing, but the exigencies of having a kid may outweigh this observation).

You could also ask the OBGYN to do the entire deal for a fixed fee. If they can bill medicaid you will probably be okay.

Just tell your bro to make sure she gets her prenatal vitamins and sees and OBGYN before week 12 to get a sonogram. Some decisions cease to exist if you wait to long (e.g. terminating a pregnancy if there are massive birth defects or the baby is not going to be viable).

Good luck, tough situation.

 

[forgotmyusername]

Pregnancy is not considered a pre-existing condition when you are eligible for a corporate health plan. So their best bet is to get married immediately, and then add her to his plan. They may have a waiting period but the pregnancy should then be covered.

She will not be able to find individual coverage that will cover the pregnancy. If you read the fine print, they all exclude maternity benefits. And like everyone else is saying, it will be difficult to find a job with benefits.

They may be able to get some sort of high deductible coverage for the baby after it is born. My nephew had some seven digit hospital bills after he was born for a heart defect. It would have bankrupted my brother's family had they not been covered.

 

[LittleHornChick]

I have to agree with the suggestion to get her covered right away should something go wrong; it could financially devastate them. Individual policies would probably be out of the question because either a) pre-existing or b) premiums too high. So, she'll either have to go through her employer (if they offer anything), his employer (if they get married), or get hired right away by an employer that has a group plan and wait the probationary time before the policy kicks in.

Even having a baby a few weeks early or a last minute C-section because delivery's not going as planned could suddenly spell financial disaster for your brother and his girlfriend. Good luck...my thoughts are with them and the baby.

 

[Longhorn91]

The wife and I are pregnant and I couldn't imagine going through all this without insurance. The girlfriend's only chance at insurance is through a group policy issued by an employer. Does she work at all? If not, she could get a job at a place like Starbucks. I've heard they offer health benefits to part-time employees.