My wife and I moved from Northern California to Oregon a few months ago.
When we lived in Northern California she got pregnant (2 years ago) and we didn’t have health insurance.
Kaiser Permanente offered a plan for $300 a month with no maternity costs even though she was pregnant. It was a GREAT plan. She had a C-Section and the birth only cost us $600.
Now she is 13 weeks pregnant again (even though we haven’t seen a doctor or taken a test, we just know).
The few insurance companies we’ve applied with said they won’t approve her insurance until a negative pregnancy test and won’t issue insurance if she’s pregnant.
Does anyone know how we can get affordable insurance (less than $350 a month) and approved in Oregon? Or are we out of luck?
Contact Public Health Services of Lane County. They provide low cost prenatal care:
-The main clinic is located at 135 E. 6th Avenue, in Eugene. You can call 541-682-4041 for information or there is a website: http://www.lanecounty.org/HHS_PubHlth/default.htm.
Which is great if you are low-income, but since the OP said they were willing to pay $350/mo for insurance, I’d wager they don’t. Worth checking out. Here’s the state’s website. Maybe they can refer you to some other options.
And prenatal care 't really the concern, is it? A C-section delivery is gonna cost upwards of $10k for an uninsured mom.
All true. But even prenatal care can be expensive if there are complications such as high blood pressure, diabetes etc which require frequent Ob visits.
Are you just looking for medical insurance to cover your wife for future incidents, or are you looking for insurance that will cover the costs of this pregnancy?
If it’s the latter, I’m not sure you understand how insurance works. That would be the same has having a wrecked car and then buying collision insurance for it and than making a claim to have it fixed. It doesn’t work that way.
(Here’s a good place to insert a comment about how you avoid these hassles in Canada with universal government coverage.)
I’m not surprised at the problem - I have trouble understanding how an insurance policy would be worded. How does one separate pregnancy-related from other coverage? If you slip and fall,we’ll pay for the cast on the leg but not the part where the doctor checks if the baby is OK? Certain medications and procedures are not a good idea during pegnancy? It just seems that in almost any situation, repercussions of any situation are very different and complicated as pregnancy advances?
Usually the insurance would pay for the entire visit in that situation. The doctor would bill an E/M code, the cost of casting supplies, and the service of putting on the cast. The first diagnosis would be “Fracture of—,”, and the second diagnosis would be “pregnant state, incidental”. E/M codes are based on the time spent with the patient and the complexity of the problem, the insurance company can’t make them seperate it out nor undercode so they would just pay it.
I’m not sure what would happen if the doctor also decided to, say do an ultrasound to check the baby. I’d speculate that they would pay it if the first diagnosis coded had to do with an accident, rather than the first diagnosis coded had to do with maternity. There is a lot of gray area, but a lot of black and white too. Prental visits, delivery, etc, would all be denied, enough savings that we offer a disount on policies without that coverage.
The OP referenced a “no maternity costs” policy. I asume this is what he is looking for.
I can see where a policy would say “we don’t pay for prenatal visits or delivery”. What I’m not clear on is why any policy would want to, or could possibly, write a coverage for non-maternity related medical issues. When someone is pregnant, it can impact or complicate many other conditions. I assume that is why the latest queries are met with “come back when you’r not pregnant”.
If you fell hard enough to break a leg, say down a flight of 10 stairs, the doctor probably should do more than set the leg and note on the chart “BTW, also pregnant”.
If he wanted to raise a stink, take the response - “we need to see a negative prgnancy test” sent to someone who told them she was pregnant - to a local vocal right-to-life group. “See, moneygrubbing health insurance companies are implying the fastest way to get covered is to have an abortion”.