Self Employed Maternity Insurance Options in TX (Austin: obgyn, health insurance)

[ryetronics]

Hi everyone,

I am getting married next month and my fiance and I want to start having children soon thereafter. I am self employed business owner, and my wife-to-be is finishing school to become a teacher late next year.

We are finding it frustratingly difficult to find any realistic health insurance options that cover maternity for someone who's self employed like myself. Now before anyone suggests it, we already know we can wait until she has a job, which will probably have sufficient maternity insurance options, but unfortunately, we're not exactly spring chickens and time is of the essence biologically speaking.

The closest option we've found thus far is a policy with a $106 maternity rider, however that rider only covers a maximum of $2,500, which is ridiculous when an average hospital stay for delivery is upwards of $10,000 or more. We make too much money to get medicaid, but we lack the option of a group rate.

Now I have heard of certain insurance companies that will sell you a policy that covers the pregnancy, or at least delivery, and only have you out of pocket for around $1,800 to $3,000, but I have yet to talk to anyone that could offer that (if it really exists).

If anyone on this board knows of someone that has been in this situation, please share your story. The insurance business is not set up for hard-working self employed people like myself, and paying a hospital such a large sum in cash is not very realistic for our situation. Of course, the option of a birthing center/mid wife is much more affordable, but for obvious reasons, we'd rather have the option of having a baby in a hospital.

Also, does anyone know of a website/forum that focuses on this sort of thing for Texas residents? Searching online for such a thing brings up countless SPAM sites.

Thanks! Any advice or suggestions/stories will be much appreciated!

-andrew

[DrTex]

Here's where you can purchase the best maternity insurance plans (in Texas anyway): www.instexas.com

Choices are slim for those who don't have group insurance at work. We found a plan with unlimited maternity insurance coverage for my wife. Our cost was $53 monthly for the maternity insurance (plus the cost of regular health insurance coverage to go with the maternity coverage). I am self-employed and group insurance was not an option (in my situation).

Perhaps this will help others. We searched & searched. This was the best deal we found. Most of the websites we found were worthless. Most of the agents who called us (constantly) could not offer any maternity coverage. This coverage will pay 100% of our maternity costs, with a 30 day wait before conception can occur, and after a $5000 deductible. Considering the cost of hospitalizations, we considered this deductible to be OK. We paid over $15,000 for a 2-day hospitalization recently.

[loves2read]

my suggestion if you fiance is graduating next year and want to teach is not to be pregnant at the interview--don't think with the struggle most teachers go through to get hired that knowing you are going to be taking maternity leave soon would work in your favor
and teachers insurance is really the pits in most districts...

check out these web links to info on the insurance company providing the pregnancy ins
http://insurance.freeadvice.com/reviews/211/

http://www.usatoday.com/money/perfi/...-1a-usat_x.htm

http://www.thesqueakywheel.com/compl...laint20405.cfm

http://www.consumeraffairs.com/insurance/assurant.html

you might think there are some problems with something that seems to good to be true...especially if a doctor has to resort to this type of insurance

might I ask if you and your fiancee voted in any of the past presidential elections--did you vote for someone who was advocating affordable health care for all Americans?

[NOTAM]

if you live in Central Texas, the best individual plan is the Scott & White Health Plan. lots of options. fairly reasonable. excellent coverage. and of course, comprehensive health care services.

[ChristieP]

Originally Posted by loves2read

my suggestion if you fiance is graduating next year and want to teach is not to be pregnant at the interview--don't think with the struggle most teachers go through to get hired that knowing you are going to be taking maternity leave soon would work in your favor
and teachers insurance is really the pits in most districts...

I'm a Human Resources Manager and I can definitely say that visibly pregnant applicants are often looked down on simply because the employer knows they will be gone for 2-3 months fairly soon. I'm sure this would definitely be the case with a teacher!

Also, for your own sake, try to be at your employer for 1 year before you have to take your maternity leave so you'll qualify for FMLA. Honestly, if you don't qualify for it, they have every legal right to terminate your employment on your last day of work before your maternity leave and let you reapply for another position when you're ready to return to work. This will leave you responsible for paying outrageous COBRA insurance rates to cover your delivery!

[loves2read]

CHRISTIP
I did not know that about the FMLA--that is really good info to remember for younger people starting families...

Harris Hospital System used to have insurance plan like the Scott/White one sounds--but it was too costly and they quit offering it
now can't get it unless you work for them I think--you can access Harris Hospitals under other insurance plans...

[KantLockeMeIn]

Think about it from an insurance perspective as well. Would you sell a product to an individual for a small monthly fee that would incur a 10k or more cost to you, knowing that the chance of incurring that fee is great? That's why group insurance is much cheaper, given the ability for the plan to realize that it's distributing that risk of incurring cost across a large number of insured participants.

Have you spoken to any doctors and hospitals about paying cash upfront for delivery? I've heard of many people negotiating it up front, assuming no major complications, and it not costing more than $2,500. In that case, having some type of catastrophic insurance would make sense, but paying cash wouldn't be unreasonable.

Back to the group rate point... have you looked at small business asssociations that allow group membership for business owners? Collective bargaining and distribution of risk would be beneficial.

[loves2read]

any insurance co that did not structure its rates to make a profit would not be in business long enough to pay off claims--

the OP and fiancee might consider a mid-wife--my niece is one in the Austin area--well-trained, is liscensed--has delivered lots of babies in the years she has been doing this and has lower rates than an obgyn...

[francy_w]

Hi there. I'm new to this board and can't figure out how to see the entire thread!

I read your post and my husband & I are in the same boat. Self-employed and our private insurance doesn't even offer a maternity rider.

Have you been able to get any good info?

[ryetronics]

I had no idea this thread was being replied to until this morning!

After much searching and stress, we found our best option to actually be through the University of Texas school system. Since my fiance was still enrolled in her university when she became pregnant, we found that the student health insurance offered FULL maternity coverage with major medical for my wife. 80% coverage up to $10,000, then 100% for everything thereafter, and the option for us to visit any doctor we want. This, as many of you know, is unheard of unless you have a group plan through an employer.

Now I know this isn't an option for everyone in our position, but it has worked out for us thus far, and we are already 5 months into the pregnancy. If she were not in school, I think we would have been forced to just pay cash with the hospital and negotiate a price, which would have run us upwards of $13,000 all said and done I believe.

You can PM me if anyone has more specific questions, and I'll be happy to respond.