What is with North Carolina health insurance not covering maternity?!?!? (house, income)

[mommytwingle]

My family is trying to move to NC but cannot find health insurance that will cover my pregnancy. We are willing to pay the over $1000 a month for health insurance but the pregnancy is not covered. I can, however, get Medicaid since our family income is so low for a family of 6. Does this make sense when I'm willing to pay?!?!?!?!? If you think the US is not in a health care crisis, think again!

[DawnW]

Is this because they find it pre-existing?

I would never have dreamed of moving during a pregnancy. My insurance covered 100% of my maternity (not in NC) and I would not have given that up for anything during that time.

Dawn

[brokensky]

I have lived in another state and had insurance there and it was standard there, too, that if you didn't have insurance PRIOR to pregnancy - or picked up a policy AFTER pregnancy - then the policy did not cover the pregnancy. This may vary state-to-state, but I guess since I had seen that in two states, I assumed all policies were like that.

Apply for Medicaid. If your family can qualify - then that is what you should do. Just remember - qualifications for Medicaid may differ in NC from what your current state regs may be.

[JanuaryGirl]

Yes, it is my understanding that virtually all insurance companies will consider it a "pre-existing condition." I have actually known a couple women who conceived right about the same time they signed up for new insurance and had to go through all sorts of paperwork to try and establish when conception occurred.

Good luck to you, it's a really difficult situation!

[gkleoni1]

If you think about the reasoning it kind of makes sense. A person who did not have insurance before getting pregnant goes out and gets a policy. Even if they do pay $1,000 per month, the insurance company will only get between $7,000 - $8,000 back. Labor, delivery, office visit will most certainly come out to more than that. I think they have to assume if you did not may for insurance before you got pregnant will drop the policy after. I agree with Ani, go the Medicaid route if you qualify.

[brokensky]

Please, whatever you do . . . check out the Medicaid rules here very carefully and do not assume you qualify. Did you already drop your other insurance? I am assuming - it is not portable to another state?

I am confused as to how you can afford to pay $1000/mo for insurance and then still qualify for Medicaid here, so that is why I am emphasizing checking NC's rules out. Just don't want you to get caught up in a really bad situation!

[sophialee]

I have a friend who got Medicaid for Pregnant Women here and it was very easy. Just go down and fill out the paperwork. Bring your drivers license, birth certificate, and a couple bills w/ your name and address on them. I went w/ her and the whole process took about an hour tops.

[mommytwingle]

Originally Posted by gkleoni1

If you think about the reasoning it kind of makes sense. A person who did not have insurance before getting pregnant goes out and gets a policy. Even if they do pay $1,000 per month, the insurance company will only get between $7,000 - $8,000 back. Labor, delivery, office visit will most certainly come out to more than that. I think they have to assume if you did not may for insurance before you got pregnant will drop the policy after. I agree with Ani, go the Medicaid route if you qualify.

That's just it; we are currently insured and there will be no lapse in coverage. NC happens to be a HIPAA state which means they cannot exclude preexisting conditions; pregnancy is excluded. We were told by private insurers that we would qualify for Medicaid because, although my husband makes about $40K a year, we are a family of 6...without the baby. I looked into Inclusive Health whihc has a maternity rider, but I have to be a resident for 30 days before I can apply. I have looked into everything! As for not moving, sometimes life makes decisions for you. Our house is sold...and I am pregnant, hence the move.

[brokensky]

Originally Posted by mommytwingle

That's just it; we are currently insured and there will be no lapse in coverage. NC happens to be a HIPAA state which means they cannot exclude preexisting conditions; pregnancy is excluded. We were told by private insurers that we would qualify for Medicaid because, although my husband makes about $40K a year, we are a family of 6...without the baby. I looked into Inclusive Health whihc has a maternity rider, but I have to be a resident for 30 days before I can apply. I have looked into everything! As for not moving, sometimes life makes decisions for you. Our house is sold...and I am pregnant, hence the move.

So are you here now? You need to go get the paperwork for Medicaid and make sure you qualify - do NOT take anyone's word for it except someone from DSS.

Income is not the only determinant for whether or not you qualify for Medicaid - that is why I would not trust anyone's word on this except someone from DSS.

NC DMA: How to Apply for Medicaid

Locations & Contacts (http://www.charmeck.org/Departments/DSS/Services+for+Seniors+and+the+Disabled/Locations.htm - broken link)

[gkleoni1]

I found this link:

Individual Health Insurance Sold by Private Insurers | North Carolina