Medical Insurance for Pregnancy & Childbirth
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Medical Insurance for Pregnancy & Childbirth
Pregnant without Insurance
I just found out that I no longer have health insurance through
my dad's policy. I'm 23 year olds, 4 months pregnant, and
uninsured. I've had 2 healthy pregnancies before, and I'm open a
home birth, but what if there is a complication that requires
hospitalization? Plus, even the midwives that I've talked charge
5 or 6 thousand dollars, which is more than I can afford . What
do people do in this situation? Where do uninsured moms deliver?
What happens if I incur a hospital bill that I can't pay?
pregnant and uninsured
Have you tried the Berkeley PRimary Access Clinic, off University Avenue (and 6th
St.?)? I think you can go to them - they have midwives who will care for you before
you deliver at Alta Bates. Maybe you can try Planned Parenthood too.
As for midwives charging 5 or 6 thousand dollars - I've not heard of any midwives in
the bay area charging that much (and I work with midwives) - the usual fee is from
$3500 to $4000.00. Still steep but maybe more affordable. Homebirth is a great
option and as safe as hospital birth but is ONLY an option if you are having a normal
pregnancy (not high risk). Good luck!
I have the similiar situation when my husband was a student.
With different parties referral, they recommended ''First Care''
Insurance. I was around 30 weeks when I submitted the
application, it approved. It really released our worriness and
financial burden. Good luck.
If you're pregnant and unemployed I'm pretty sure you qualify for
medi-cal. Apparently its very easy to qualify when you're
pregnant. And 11 years ago when I had my son I was able to find
a midwife who took medi-cal.
Women without insurance deliver at Highland, which has improved
some over the years. Lots of midwives there. You can look in to
MediCal, but they will want to know who supports you, what your
income is, what your expenses are, etc. You can also pay
privately for insurance. . . or make a payment plan with your
midwives and ask for the lowest slideing scale they can accept.
hearing your concern
In SF there is a program that would cover you and kids but I
don't know about the East Bay Call 415-777-9992 for info
check into medi-Cal - the benefits are good and immediate if you
are pregnant and qualify.
Try AIM: Access for Infant and Mothers they cover all your
pregancy medical expenses and then cover you post-pregnancy for
1-2 months and the baby for up to 2 years.
you may qualify for free or low cost health care:
there are programs that can help. i was pregnant with my first w/o
insurance too. have you looked into medical? if you qualify, it's free.
if you work, you may still qualify for AIM which you would have to pay
2% of your yearly salary. (that's what i had to do. both my husband and i
work...ended up being about $60 a month for 1 year and i had
absolutely wonderful care). We also qualified for WIC. It helps with basic
food every month (milk, cheese, eggs, cereal, juice, peanut butter). Look
into these ASAP.
Good luck and don't depair with a little effort you will be able to take
excellent care of yourself and your little ones!
Being pregnant without health insurance is a very stressful
thing. We went through this a few years ago (unplanned
pregancy while travelling) and didn't realize we couldn't get
insurance when we came back due to pregnancy being a pre-
existing condition. We did consider having the baby in
Thailand (excellent medical care and very reasonably priced).
But unless you are really adventurous, this probably isn't an
option for you.
So hopefully what we ended up doing will work for you. Please
check out a CA program called AIM (Access for Infants and
Mothers). You can read all about it on the Blue Cross website
http://www.bluecrossca.com/bcc_state/user_groups/visitors/aim/aim.htm and Google will give you a lot of hits too.
We were able to qualify for this program using my income only
(as reported separately to the IRS). Since I only worked a few
months that year, I had the 'right' amount of income to
qualify. You pay a small percentage of your income to enroll
and then everything is taken care of for you and your baby
during pregnancy and delivery (and for your babies first year
after delivery). This program was a lifesaver for us!
If you have any questions, I'd be happy to try and help.
People who cannot afford private insurance always have
insurance through the Medicaid program. In California it is
called Medi-Cal. I am assuming that you cannot afford insurance
and not that you have simply chosen not to get it.
The vast majority of people who are uninsured are in fact
eligible for MediCal or have made a choice to spend there dollars
on investments or other consumer items. If you are in category 1
then you need to contact the local county hospital or public health
service to find out how to apply for the MediCal benefits.
Hi, I had no insuranace when I got pregnant 14 years ago. At the time I was making
very little money and was eligible for Medi-Cal. I think the system has changed
since, where you can be eligible for coverage depending on how much income you
have. It's called something like Share-of-cost and/or Healthy Families. I would call
the nearest Medi-Cal office and ask them if you are eligible and how to apply. There
might even be a website. Google Medi-Cal. I found a midwife who accepted Medi-
Cal and gave birth at Alta Bates. Everything was covered. The pedicatrician was
covered, as well as the follow-up with the midwife. It was a real lifesaver. You might
go to Bananas on Claremont Ave. (just up from Telegraph) in Oakland and ask them
if they have any info about Medi-Cal, and also midwives and OBs who accept it, they
are a great resource. Good luck and happy birthing!
If you are in ''middle class income'', you can apply to AIM
program. It is called Access for Infant and Mother and provides
covers everything. It covers all the prenatal care, delivery
(no co-pay), and also covers baby up til he/she is two years
old. Your income has to be more than Medi-cal criteria and less
than certain amount. If your income is lower than AIM's program
requires you to be, you can apply to Medi-cal.
If you are unmarried to the father and aren't making enough
money on your own, you can apply for Medi-cal. They cover
everything. Even food stamps. They also offer WIC.
I used Medi-cal because we weren't married and I only
worked 3 days a week.
We delivered at SF General-- a fine delivery area, i might
add, and they have nurse mid-wives or doctors. We
delivered in the bathtub in water (first time in history at SFG
that anyone has done that!!), and you can write a disclaimer
requesting specific do's and don't practices (i.e. no meds,
all natural, freedom of movement, no male doctors, no
guests, special food, etc..).
If you want more info, email me and i can tell you how to
apply and some loops that help you get as much as you
There is a program in Oakland called IPOP (Improving Pregnancy
Outcomes Program). They should be able to give advice and know
who to contact.
Alameda County Healthy Start Improving Pregnancy Outcomes
Applicant Agency: Alameda County Health Care Services Agency
Address: Alameda County Public Health Department
1000 Broadway, Suite 500
Oakland, CA 94619
Phone Number: (510) 208-5980
Fax Number: (510) 267-3270
Have you applied for Medi-Cal? It sounds like you would
qualify, and they cover all the expenses including prenatal
care, delivery, and c-section if necessary. I don't know where
you live, but there is a really helpful woman at San Antonio
Clinic (on International Blvd in Oakland) that will fill out the
paperwork for you.
wishing you good luck
A couple years ago, I had a friend who had no health insurance but found
herself pregnant (she was working part-time and was a student). She went to
Planned Parenthood and got her medical care through them. She was happy
with her care. The only downside I recall is that she only got one ultrasound
done (but then I only had two prior to giving birth in December, and I have
health insurance). I would call them up or go to PlannedParenthood.org for
There's a state program called AIM (Aid for Infants and
Mothers) that may work for you. There are inclome restrictions
in order to qualify. 800-433-2611. Call them for specifics.
I am sure you will get many responses, but in any case..
All pregnant women in California are eligible for Medi-Cal. The website is
http://www.medi-cal.ca.gov/ or you can look for your local office in the phone
book under the dept. of human services. It can be demeaning to go through
the process of applying, but the coverage is good, and free! Medi-Cal will cover
your pre natal care in a hospital or birth center. I had my son in a birth center
in San Francisco called Sage Femme. naturally! And if you need insurance
for your children, your whole family may qualify. Feel free to email me with
more questions. Good luck!
Don't worry! One thing that our lovely country/state does provide is medical
coverage for pregnancy/childbirth. I was in your same situation not so long ago.
Medi-Cal is the way to go. Although it does take time and patience, I have
discovered that they will not reject you if you are pregnant. After all the paperwork was
done, I was able to have a midwife and deliver at Summit all for free!!! Many local midwives
accept Medi-Cal, I chose Debra Coleman (she was great). It seems weird, but I was
told that many women who have health insurance (maybe with high deductibles),
also apply and receive Medical for pregnancy. All I know is that I had a wonderful
experience with it, you just have to do the leg work. Good luck and congratulations.
Oh and by the way, your baby will also be on Medi-Cal for the first year, this has
been a wonderful help to me. I
Healthy mom, healthy baby
I'm currently 23 weeks pregnant and a stay at home mom. I had
COBRA coverage with Kaiser from my former employer that ended on
January 31st, 2004. My family and I applied for a Personal
Advantage Plan with Kaiser at the end of December and got
accepted before the end of the year for coverage effective Feb.
1st. At the time of the application and acceptance by Kaiser,
we didn't know I was expecting. I found out about my pregnancy
in the middle of January. Since I had Kaiser for about 10
years, it never crossed my mind that I would have a problem with
Well, after paying Kaiser insurance premiums for the past 4
months and receiving regular healthcare, we got a letter in the
mail informing me that my health insurance had been revoked as
of February 1st, because I misrepresented myself as I failed to
inform Kaiser about my pregnancy before the coverage for
Personal Advantage took effect. I never lied, I wasn't aware of
my pregnacy at the time I applied and at the time I was accepted
I'm now in the process of appealing to get reinstated, however,
it takes about a month for them to let me know. I can't
understand how they can just dump me if I was a member under a
different plan when I got pregnant.
I'm desperate, I don't know what to do. I've been told about
AIM (health coverage for pregnant women & newborns), but we
don't qualify, because our income is higher. Can anybody give
me any ideas? I do need to get some sort of coverage, if I have
complications or something goes wrong during the birth, we
couldn't afford to pay all the medical expenses on our own!
AIM is the only option I can recommend for a pregnent woman.
My first course of action would be to push back on Kaiser.
I applied for Kaiser in August after moving here. At first we
were rejected because my children had a mild history of RAD
(reactive airway disease - childhood asthma) and it was going
to take a month or more to appeal. I just kept calling customer
service and, while most of the people were surprisingly
knowledgeable and nice for a health insurance phone service,
every few calls I'd get on with someone who really cared and
would go the extra mile to help me. We ended up getting on
Kaiser a month earlier than we would have. I was always very
polite when I called and just tried to explain the situation
over and over again. I imagine you could find people
sympathetic to your situation as well. Email me if I can answer
Hi Martha, Contact Integral Health Insurance Services in
Walnut Creek I got my health insurance through them and they
were very helpful in answering questions about my health
insurance options. They are health insurance brokers so they
work with all of the carriers. 925-935-9775
Questions about Childbirth Coverage
I need to purchase health insurance for me and my child. I am
new to this country and don't know much about how to choose the
right one. I am also planning to get pregnant soon, so I need
one that covers maternity. Is it better to go with HMO or PPO?
I know most HMO covers maternity, but I'll have to pay 30%-50%
for PPO. I don't know how much it cost to have a baby here, so
could some one tell me which is better?
In my experience, an HMO is better than a PPO for pre- and post-
natal care - for example, my Blue Shield HMO didn't charge a co-
pay for prenatal and well-baby visits, and covered almost all of
our hospital expenses for the actual birth. Of course, there's
a higher monthly fee for this insurance, but my feeling was that
we still came out ahead. Whatever you choose, make darn sure
you get the insurance nailed down BEFORE you get pregnant - I
tried to switch carriers while pregnant, and I don't think there
is a single insurance company that will take you on after you
We are currently planning on getting pregnant before the end of this year. I
have Blue Cross PPO with a high deductible and it does cover maternity
although we would need to find 30% of the fee - which will probably be about
$10k with the deductible and the high probability I will need to schedule a C-
My question is this? Should I shop around now for another health insurance
policy and hope they cover more? I have heard sometimes they make you wait
a year until you will be covered. Or should I just bite the bullet and use my
Any advice is welcome.
I am a health insurance broker who helps individuals, families
and small businesses find health plans tailored to meet their
needs. I work like a real estate agent who helps families find
You need to shop for a plan before you get pregnant. No one
will cover you if you are pregnant. I think an HMO is a good
option for someone planning to have a baby. Most HMOs have no
deductibles and very small co-pays. You did not say what
coverage you have currently, but it's likely that that your
current doctor is also in the HMO network. Denise
If you can do it, I would recommend changing coverage. You just
never know what can happen and while 30% of 10,000 doesn't seem
like a tremendously huge expense, just keep in mind that 10K
represents your best case scenario. After a relatively normal
delivery with my first, I ended up with pre-eclampsia with my
second - a 3 week stay in the hospital for me and a 6 week stay
for my baby and a hospital bill in excess of $500,000.
Fortunately for me, my hmo covered all but my $250 co-pay and
more importantly we are healthy and happy now thanks to the
great care we recieved at Alta Bates.
Happy HMO Momma
hi, i don't know what the original question was but if you find
pregnant without insurance or with a high deductible an option is AIM
(Access for Infant and Mothers). It's a state sponsored program that
provides insurance for pregnant women who make too much to qualify
for free insurance but don't make enough to buy there own or if you
insurance and your deductible is higher than $500. It has been a
godsend. We were approved in 2 weeks and the coverage includes all
prenatal visits, the delivery, 6wks postpartum for me and 1yr of
care for the babe all for 2% of our yearly income. Then for an
$100 I can get another year of pediatric care. I live in Alameda county
and was able to get bluecross. I've received excellent care from my
nursemid! wife (deborah coleman) and will be delivering in Alta Bates
sometime in September 2004. It's worth investigating.
A question about insurance. Hypothetically, if a woman were
pregnant & left a job in the middle of a pregnancy & then got on
husband's insurance through a new job he is starting (after
pregnancy started) would the woman be covered? Do the rules
about ''preexisting conditions'' apply when the insurance is
through employment?? Am contemplating pregnancy but concerned as
I may leave my job (which presently supplies our health
insurance) and my husband starts a new job in a few months and
is not clear when his insurance will start & when I may leave my
Thank You for any information,
Tangled Up in Blue (Blue Cross That Is)
Regardless of any advice you get, you can only know for sure
what benefits you are entitled to under your husband's new
insurance by calling his new insurance company, or have someone
in HR at your husband's new company verify the benefits for
you. That said, I can tell you that my husband's insurance
(which covers me) was scheduled to change to a new carrier
within days of my due date; with our obvious concern, his
employer verified for us that I would be covered by the new
carrier--it didn't matter that I was pregnant prior to
obtaining the new coverage. Don't forget that when you leave
your job, you will be entitled to continue your existing
coverage under your employer's group plan (at your cost, but at
the same price your employer pays) under COBRA laws. You can
con! tinue your coverage in your employer's group plan for 18
mos. following your termination. So this would be a good way
to bridge the gap, should you leave your job before your
husband's new insurance kicks in, as you only need pay on a
monthly basis and can terminate the COBRA coverage when you
don't need it anymore.
Be careful. You may not be covered if you switch insurance
companies half-way through pregnancy. I can't speak for your
specific situation because I'm sure it depends on the new
insurance provider, but we had insurance at one point (I think
it was Blue Cross) which would not cover a birth that occurred
within 10 months of coverage beginning. Meaning that one had
to become pregnant AFTER coverage began for prenatal care and
the birth to be covered.
We had been getting along fine with my wife's OBGYN when we
received a letter from his office asking for the delivery fee
(or installments) halfway through her pregnancy. The letter had
an estimate of what we ought to owe after our insurance coverage
and promised to repay us any overpayment. I called our
insurance and was told that this is strictly not allowed for
networked doctors. I would hate to see an antagonistic
evolution in the relationship between ourselves and the man who
is supposed to deliver our child. Has anyone had any experience
with such an arrangement? Does anyone have any advice for
communicating with the doctor's office?
I had the exact same experience with my OB, but I didn't even think about
it and I paid it. Especially since they estimated that without insurance my
cost would have been around $2000 and they only wanted $200 from me.
It is not only legal but the standard of billing, because
doctors' ''allowable'' reimbursements have been diminished so
exceedingly while overhead and malpractice has increased, that
the patient pay, up-front, the discounted projected balance after
the calculated insurance payment, after the insurance company has
discounted the doctor's fee(s). An ob/gyn couldn't possibly
afford to open his/her doors without being paid part of his/her
fee before delivery. (malpractice, alone, in this area averages
between $600 and $1000 DAILY!) In fact, at Cedar-Sinai, in L.A.,
the prospective parents pay the entire fee up-front, and most OBs
there do not accept insurance, anymore, for deliveries; payment
is never delayed until half-way through the pregnancy.
You might want to speak to someone else, a supervisor, maybe, at
your insurance company.
Been on both sides
This sounds really strange. How can they possibly ask for a delivery fee
when they have no idea what will happen during delivery. Will mom end
up having an epideral or natural childbrith? What about the possibility of
a c-section or, though unlikely, not even making it to the hospital. Then
there are all the other costs to consider. Will mom need some stitches?
Will baby need to be suctioned? What about other medications that may
be involved. Labor is unpredictable so I can't imagine they can predict
the cost. Maybe, you can try to discuss this with someone other than the
doctor. Perhaps a secretary or billing person. Otherwise, maybe you can
just politely ask how they deal with the payment and unforseen
circumstances. Good Luck
I recently gave birth (a beautiful, healthy son), and I pre-paid
the delivery fee in installments to my doctor under his office's
mandatory payment plan. There were no problems with my
insurance company (Blue Cross Individual PPO), although the
company didn't count the payments toward my deductible until the
doctor submitted an insurance claim after the delivery. Since
my pregnancy deductible was so high ($3500), paying the
installments during the pregnancy spread out the ultimate cost
and reduced the amount that was due at one time after the
birth. My doctor was fabulous, and so was his staff. We didn't
attempt to negotiate the timing of the delivery payments, but
I'm sure his bookkeeper would have been willing to work with us
if we couldn't meet the standard payment plan. (We received the
paperwork for the payment plan after our initial visit with the
doctor; it seems strange that you weren't informed of your
doctor's prepayment requirement until midway through your
pregnancy.) Like your situation, the delivery fee that we paid
was one that was ''estimated'' by the doctor, based upon his
contracted rate with my insurance company and factoring in any
payments that I had already made toward my deductible. The
actual delivery fee ended up being $400 more than the estimated
amount due to additional insurance allowances. I was meticulous
with my records during my pregnancy, and kept track of the many
medical payments and insurance allowances through an Excel
spreadsheet and paper documentation. Everything worked out
perfectly in the end, and I didn't pay a penny more than I was
obligated to pay under my insurance contract.
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