NJ Family care...need advice!! (low income, health insurance, vacation home)

[chicken781]

How does it work if I need coverage for myself and my baby? I currently don't have coverage...my husband is self employeed and we didn't have it b/c of the high expense. I know there are income levels but does it just go by mine if only I'm applying for me and the baby or by the household income? Even so our household income qulifies us but it would only cover the baby.

I know at certain levels it doesn't cover the parents but when would it cover the baby? Do I have to wait till his birth or can I apply now to cover him.

Any info would be appreciated

[blackandproud]

Originally Posted by chicken781

How does it work if I need coverage for myself and my baby? I currently don't have coverage...my husband is self employeed and we didn't have it b/c of the high expense. I know there are income levels but does it just go by mine if only I'm applying for me and the baby or by the household income? Even so our household income qulifies us but it would only cover the baby.

I know at certain levels it doesn't cover the parents but when would it cover the baby? Do I have to wait till his birth or can I apply now to cover him.

Any info would be appreciated

Your married, so it will go by both your income. Don't try to circumvent the system, it will only come back to bite you in the end.

[chicken781]

I wasn't planning on doing that but I wanted to check as too how it worked. As far as coverage for an unborn child, how does that work as far as when do I apply?

[blackandproud]

Originally Posted by chicken781

I wasn't planning on doing that but I wanted to check as too how it worked. As far as coverage for an unborn child, how does that work as far as when do I apply?

You can apply now. Make sure you have all of your documentation. Depending on your husbands income, you may have a co-payment, but something is better than nothing.

[frugalmom]

From my own experience - NJ FamilyCare does NOT cover pregnant woman - once they got your application, they will transfer your case to the social service of your county to see if you qualify for Medicaid. That delays your application. (And then if you are not qualified for Medicaid, they will transfer your case back to NJ FamilyCare, which you are not qualified since you are pregnant...etc.) I suggest you directly apply for Medicaid in your county's social service office (if I were you that's what I would do). You can call the Social Service, ask them what documents they need (e.g. copies of birth certificate of you and your husband, social security cards...etc. they need a lot of stuff). They will also need proof of pregnancy, e.g. a prescription written by your OB saying that you are pregnant. Then go down to the social service office and submit your application in person.
While you are waiting for an answer, you will hear from both the social service and NJ FamilyCare - I know it's confusing (it's confusing to me too). But what you will have is what they call "straight Medicaid". Know that MANY doctors do not take straight Medicaid or NJ FamilyCare. After you are approved for Medicaid, they will enroll you for NJ FamilyCare. If you have some doctors, or places you like to do ultrasound, call them ahead and ask them if they would take it. There are several HMO companies you can choose within NJ FamilyCare. But NOT all of them would be accepted by doctors. For example, the ultrasound place told me that HealthNet is the only NJ FamilyCare plan they accept - although they accept regular BlueCross BlueShield, they don't accept the NJ FamilyCare's BCBS.
Those OB office in hospital is extremely crowded and busy. Also NJ FamilyCare's doctor choice is very limited. And the application process added a lot of stress to me during my pregnancy. But begger cannot be chooser. I was thankful to have that during my difficult time (thank Corzine).

For private insurance that covers pregnancy, the cheapest option is the BCBS EPO Plus, you can find details of it on ehealthinsurance.com. Although it's a guarantee acceptance plan, you must have prior continuous coverage, or else they don't cover pre-existing condition (which is your pregnancy). However if it were a group plan (e.g. offered by employer), pregnancy will not be classified as pre-existing condition as per federal regulation. (Source: Pregnancy complicates health insurance options )

Both PA and NY government plan has higher income limit for pregnant women. Bergen County also has higher income limit than the rest of NJ. If you are not qualified for Medicaid here, you may want to: 1. have your husband get a job (perhaps Starbucks?) or 2. going across the river. Good luck!

[familymom]

Just saw that they made it harder for parents to get coverage too. I could get coverage for my children but with my husbands salary we (the parents) don't qualify. They changed it as of March 2010. Once again the system was probably being abused and now everyone must pay the price. My girlfriends friend was self employed, no mortgage, vacation home in Florida and qualified for a low income because he could make the numbers work for him and his family. I believe a family of 6 must make under $40,000 a year to have the parents qualify now, use to be $60,000.