A few months ago, my husband lost his job. Because of his employer’s timing, letting him go on the last day of the month, we were uninsured by the end of the day. In fact, when he got home from work that day, I hurried to our pharmacy but still had to pay out of pocket for a refill of one of my prescriptions.
Right there, in the Target pharmacy checkout, I found myself trying to keep it together while my anxiety level was quickly getting higher each second. While the pharmacist was apologizing, and insisting on running my insurance just one more time, I was running through all of the implications of being uninsured.
You see, not only did I need to get my kids insurance before one of them broke something or spiked a fever of 105 degrees, I also knew that my pregnancy would make everything significantly more difficult to sort out.
Since I work too, we are one of those families in a weird spot when it comes to getting government assistance. I knew that chances were high we wouldn’t qualify for Medicaid, but we also couldn’t afford the outrageous costs of COBRA offered through his previous employer. And, even with the introduction of the Affordable Care Act, finding insurance was nowhere near as simple as I expected.
Now I admit, my anxiety may have exacerbated the situation. I am a chronic avoider of things that overwhelm me. So, for a week, I shoved the task out of my mind and moved full speed ahead with the tasks I knew I could accomplish: I kept my house clean. I picked up more freelance work. I took care of my kids. But I didn’t start my search for insurance.
Finally, when one of my kids was being a typical toddler and sustained a minor injury, I knew I needed to stop dragging my feet. It was only a matter of time before we would need insurance, and I needed to make that happen.
It took more than two weeks of paperwork, scanning check stubs and wasting my life away listening to hold music, but I was finally able to secure insurance for all four members of my family. I was surprised to find that the whole process, although involved and fairly stressful, ended really well. We actually ended up with really great coverage.
Here is what I learned through the whole ordeal:
No matter your income, Medicaid should always be your first phone call. I assumed that, since I work and make an OK income, my family would not qualify for Medicaid. Well, I was partially right, but mostly wrong. What I didn’t know what that most states offer expanded Medicaid coverage to children and women with exceptional health needs like pregnancy or breast cancer. Because of this, the eligibility guidelines concerning income were much more flexible and, although my husband got a clear “no” when he applied for Medicaid, both my kids and I were approved for coverage.
Medicaid is totally awesome, but your provider might give you the boot. This is my third pregnancy, and I was seeing the provider who delivered my second child for prenatal care. Unfortunately, once I was insured again, I had to start the search for a new provider since mine doesn’t accept Medicaid. The good news: Using Medicaid has been pretty awesome so far. There has been no weirdness or substandard care from my new provider, something I was pretty concerned about after working in healthcare for a few years.
Insurance through the Affordable Care Act covers pregnancy, but you’ll be asked to jump through Medicaid hoops first. Unlike private insurance, insurance plans offered through the healthcare marketplace won’t give you any trouble if you are looking for coverage while you are already pregnant. However, you will be required to apply for Medicaid first before you opt into a plan on the healthcare marketplace, even if you are pretty sure you won’t qualify for Medicaid.
When I met with a Medicaid counselor at my new doctor’s office, I had a lot of concerns about losing my Medicaid if my husband found a new job or my income changed. As it turns out, as long as you have provided accurate financial records, once you are approved through Medicaid, you are covered through the duration of your pregnancy, even if your circumstances change. Additionally, once you give birth, your baby will have coverage through your state’s Children’s Health Insurance Program, or CHIP, for the first year of their life.
If you don’t qualify for Medicaid, find a provider with a financial counselor. If for some reason you don’t qualify for Medicaid, or you might deliver without any insurance coverage at all, consider looking for a new provider. In my experience, some hospitals seem better equipped to work with cash-paying patients. A great place to start is a hospital that typically accepts Medicaid or works with low-income populations. It isn’t uncommon for these hospitals to help you find other forms of financial assistance or help you minimize the cost of your delivery.
Most importantly, I learned how critical it is to keep taking care of my unborn child and myself during a stressful time of life. It can be easy to zone in on stressful life circumstances and stop caring for your health and getting enough rest. In the end, it was important to remember that, insured or uninsured, a healthy pregnancy and safe delivery were the most important goals during this season of my life.