Seeking Advice on Pregnancy Without Insurance

Midwives are amazing! They are afforable and after having my first birthing center birth, I chose to have my second child with a midwife as well. My first was with the "Austin Area Birthing Center". My second was at the "Family Birthing Center" in New Braunfels.

I had a home birth, as well. I would suggest looking into it. It was an incredible experience and I felt that the care was far superior to when I had my first 2 with an ob/gyn.

I live in Texas and they offer CHIP for pregnant women. She should look into what is offered in the state she lives in.

I wanted to chime in for support of midwives! My first two were delivered at the hospital with an OB with no drugs, so I was confident that I wanted a midwife for my third birth (well, I wanted her for my second, but only found out the birthing center was in my town in my 8th month and didn't want to switch!). My husband's insurance coverage would have been fine with hospital and OB or birthing center and midwife. I chose midwife for the experience. The lower costs were a happy bonus, but not the reason we chose a birthing center.

I am very anti-intervention, so I support midwife assisted birth. Midwives are trained in NORMAL NATURAL deliveries. OBs are trained surgeons. They see problems when problems aren't always there. So a midwife birth is not a "risk", especially in a birthing center that can relocate to a hospital in case of complications. My midwife had some very impressive statistics. Midwives also know how to handle older mamas and overweight mamas, gestational diabetes, and pregnancy-induced hypertension. Interviewing midwives will help tell her what they are comfortable with.

My midwife told me that her "cash" cost is $5700 (I think) - far less than what one would pay an OB AND hospital. SInce my midwife owns the birthing center, there was only one bill, instead of separate ones.

I wish I could tell you about other programs and such, but I don't know about them. We chose a midwife for the natural birthing experience (where my son was born very peacefully in water!), not for low cost, but found that the costs associated were MUCH lower.

midwives are a God send. I think your on the right track with this.

I am 39 and just had a baby at a local birth center. It was a wonderful experience. We had to pay cash for the prenatal care and delivery. With the ultrasounds and lab work included it was $5700 total, about half the cost of a hospital birth. I was on a payment plan so that by the time I was in my 37th week I had the bill paid. Most birth centers will work with you on a plan that fits your situation.

A home birth is even less, about $2500-3500 with everything included. Again, midwives will usually work with you on a payment plan. Spread out over 9 months it makes it reasonable.

I had my first baby when I was 38 and my 2nd at 40. There were no problems. The physicians wanted to do a lot of prenatal screening, but we limited ourselves because they were unnecessary. She can negotiate with her doctor and hospital. By paying cash for the services, the doctor/hospital will actually make more money than going through an insurance company. So, they are willing to negotiate.

Just be sure (EVERY appointment) you tell them you are self pay - and pay for that day's lab work or ultrasounds etc. that very day (I got 30% off if I paid the day of.) You also have to tell your doctor up front (and every time they say they are going to do something) that you are paying out of pocket and would like to opt out of certain tests etc. Otherwise they'll just run every test and tons of ultrasounds to be safe. Also, other posters have mentioned the thousands of dollars for an epidural. Both with my fist delivery in Houston and my second here in Corpus, the epidural (IF PREPAID in advance) was only $680 (as long as it isn't for over three hours). One night hospital stay was $1,500 and the doctor's fees (labor and delivery and ALL prenatal vists) was only $1,785 if paid by the fifth month of pregnancy. So I think my second child in the hospital was less than some of the midwives fees mentioned. BUT if I had had a c-section, it would have been much more. You just have to be proactive and ask up front for the discounted fees and request discounts for paying early. When I first went to prepay my epidural in Houston, they acted so confused, like no one had ever done that before. I guess they'd rather just bill you after the fact for over a $1,000. I think also if you are honest with your doctor about being cost sensitive, they'll hopefully be understanding about which tests are really necessary. Also, with our second child born last week...she was born at 11pm and had to stay 24 hours. So we had to wait until 11pm to be dismissed from the hospital (but we had to be dismissed before 12 midnight, or we would have been charged for another night's stay at the hospital.) Luckily we told the nurses etc. our situation and they helped us check out between 11pm and midnight. (Which wasn't ideal, but much better than forking over a lot more money.) I know it is frustrating and expensive to pay for maternity care out of pocket, especially when you're already paying for health insurance that just doens't cover being pregnant.

Your friend is unnecessarily scared of being an "older" mom. I know this has been pushed to be younger and younger since I started having babies 11 yrs ago. I disagree with the poor practice of scare tactics and I don't agree that a 36yo is "older" and has passed the threshhold of usually healthy outcomes. They said the same thing a few years ago for age 40. You can spend time in the statistically insignificant difference you'll find in problems during pregnancy at this age, but it's more important to be healthy & in a safe lifestyle and environment at every age than the age of the mother, and this is corroborated by major research studies. I believe that most mainstream pregnancy books (the highly marketed, easy-to-find books in every bookstore) further intensify this fear of being too old to have a healthy baby.
Suggested reading: Pushed (Jennifer Block) or The Thinking Woman's Guide (Henci Goer) and Pub-med website for abstracts. Best wishes.

Goverment Funded Programs
Medicaid is a state run program that is federally funded. Medicaid provides medical assistance for low-income families and individuals. To locate an office near you go to Centers for Medicare & Medicaid Services.
You may find that there are other options, depending on your state, which provide additional programs for women who are pregnant such as Medi-cal from the state of California. You can check with your local department of health at Health Departments by State for information on local programs that may further assist you.

WIC is a federal agency that serves to safeguard the health of low-income women, infants and children under the age of 5. WIC provides nutritious foods to supplement diets, information on healthy eating, and referrals to health care. To get more information you can go to Women, Infants and Children.

Health Care Discount Programs
There are many alternatives to traditional health insurance and Medicaid. These alternatives offer a discount on your health care and may help you out. Make sure to check with your health care provider to find out what discount you would receive if you paid cash. Take monthly fees, deductibles and premiums into account. Here are a few examples of discount programs.

Maternity Advantage™ is a discount health program that can save you up to 60% on doctor’s visits, lab work, sonograms, your hospital stay, and much more. Maternity Advantage is not insurance but it works with a National Preferred Provider Maternity Network. For a low monthly fee, Maternity Advantage can provide you with a comprehensive maternity plan. You can receive these benefits even after you have found out that you are pregnant. You can request FREE information by filling out this form: Request Free Information. Or you can call them toll-free at (800) 450-0183.

AmeriPlan is a discount plan that is currently available in all states except Alaska. AmeriPlan saves people up to 50% and more on their health care services. Benefits include physician, hospital, and ancillary services (i.e., lab work, tests, x-rays). Since AmeriPlan is not insurance, all pre-existing conditions are covered (except orthodontic treatment in progress), there are no deductibles, no waiting periods, no claim forms, and no annual limits. For more information on this discount program you can go to AmeriPlan. Or you can call them toll-free at (800) 647-8421.

OTHER OPTIONS FOR MANAGING HEALTHCARE COSTS
Here are some additional ideas for helping you manage the costs related to prenatal care and birth:

If you are delivering at a hospital, you can contact the account office and talk to someone about setting up a payment plan or ask if they offer a sliding scale. Many hospitals do offer these, but they are not utilized because people do not know what is available to them.

If you are having an uncomplicated pregnancy you may want to consider giving birth at a birthing center. The estimated cost of a delivery and prenatal care at a birthing center is about $3,000 – $4,000. This is half of what it would be for a delivery at a hospital. Many birth centers also provide sliding scales, payment plans, and accept Medicaid.

If you are a single parent you can go to Single Parenting: Making It Work and Doing It Alone for other ideas on how to save a little extra money.

Remember to enjoy this time and don’t allow the financial burden to take away your excitement.

Hello. I just recently had my baby - I am 39, had individual insurance and found out during my pregnancy that it did not cover anything related to having a baby. Luckily, I found out about the Austin Area Birthing Center. They have a very reasonable rate for people who have no insurance - about $3,600 - which covers all of your visits, the birth, and 3 visits afterwawrds. And the midwives are superb! I would definintely recomend them without hesitation.

Birth center or home birth would be the best bet. Her age alone would not make her high risk (I know many women who have babies in their forties with midwives.) and she can always refuse tests and ultrasounds, they are not necessary.

A friend of mine called to the hospitals and the OB packages were over $3,000 for hospital delivery alone, this did not cover the testing and OB care, just delivery! So, she chose a homebirth for her second child and has now had three at home! I had my first at UTMB Galveston with their OB package. That year it was $1800 and it covered everything, I had no other charges although they tried to get me to pay for the baby care because she ended up in the NICU for two weeks. The next year the package was $3,000 and had more restrictions on coverage so I don't really know what it's like now (that was 6 years ago.)

Texas CHIPS does now have maternity coverage, but probably won't cover if she does have insurance. It's worth checking, though.

S.

B.,
Your girlfriend should very well be concerned with the added costs of being "older" and pregnant. I am 38 and just had my first baby. My OB suggested I see a specialist because of my "advanced" age - even though I am/was extremely healthy. If I was to do it again I would not have all the ultrasounds (except maybe the first one) and lab work associated with the pregnancy ~ I would go straight to the amniocentisis (sp?)done by the specialist. This would have saved me a ton of money as I too did not have any insurance thru' out my pregnancy. I only went to one appointment with the specialist as I felt I and baby were doing just fine and did not require any extra special care. My regular OB bill was $2100, all the ultrasounds and labwork were about another $700 and the specialist visit was $500. The hospital bill was $6700 and they offered a discount which brought it down to $2000 - but this had to be paid all at once in order to get the discount. The epidural cost $2600(way too much!!) Be sure and tell your girlfriend to trust her own instincts ~ if she feels some testing is necessary then go ahead with it, but try not to get scared into thinking that all the testing is absolutely necessary. Congrats to your friend ~ it's such an exciting time!!

If she is able to find a midwife that she feels comfortable with, she will truly be satisfied with her choice. Even though she is an "older mother" she may not necessarily need the additional care that she is thinking of. The quad screen is usually a normal test and based on that, they will tell her if she needs to go for further testing. Midwives are the ones trained best in how the mommy and baby are doing. Doctors just want to "treat the sickness".

If she decides that she HAS to have an OB/GYN, she should look into www.MaternityCard.com and see what they have to say. I do know that they have no midwives and they expect you to deliver in a hospital. As long as the pregnancy is going well and mommy and baby are doing fine, there is no reason she should have to have her baby there. If she is nervous about the "pain" factor, have her look into doulas to help prepair her for what she will be doing.

My insurance at work used to be horrible. So instead of choosing their insurance I went with an individual plan through BCBS.

I would suggest your friend look for an individual plan that covers prenatal and delivery and has no pre existing condistion for pregnancy. Check all the major plans, BCBS, Cigna, UHC, Aetna. I saw a commercial for a plan through Cinergy. The plans may have deductibles and then 80/20 % coverage but if she does the math she will still save money over paying totally out of pocket.

Going with a nurse midwife and a birthing center will also save money, but if she is high risk she may want to consider a hospital birth.

Good luck, I hope she find something!

She should really check into Medicaid. It's really important to have insurance of some sort when you are pregnant, and for the baby after it's born. I'm sure a midwife is an excellent option as well, although I don't have any experience in that, but if there are any complications then she still won't be covered and she will still have to pay everything out of pocket. I would just want the peace of mind that if something goes wrong that I would be covered.

I did not have insurance with my 3rd baby. I did 2 things that helped with cost. First of all, I went with a midwife and birthing center. The experience was amazing, and it cost $6000 from day one through delivery & postpartum care (including a home visit). I used Nativiti Birthing Center in The Woodlands. They were wonderful! If you end up being transferred to the hospital for delivery, you'll still have to pay the hospital fees. But birthing naturally generally minimizes the problems that would cause the need for further medical intervention, so they have a low hospital tranfer rate. $6000 isn't cheap, but it's cheaper than a any hospital delivery these days.

Another option is for her to check around for a Pregnancy Assistance Center. We have one in The Woodlands. It's called te PACN...Pregnancy Assistance Center North. I don't know exactly how they determine who qualifies for help. When I was pregnant that last time, I was bleeding a lot in the beginning. The quality of the birthing center's ultrasound wasn't good enough to find a heartbeat so early, and it was too early for dopler. So they recommended I go to PACN for an ultrasound, which they did for free. They primarily deal with unplanned pregnancies. I'm not sure exactly how they work. The ultrasound was my only interaction with them. But it would be a good place to check into, because even if they don't offer full obgyn services, I'm sure they would know how to go about it inexpensively.

I hope that helps!

C.

We did not have insurance with any of our children and paid cash years ago. BUT that was when the first one cost $500 for everything, the second was $880 and the last was $1,500 total in 1979.

My 33 yr old daughter is pregnant now, is high risk but has medical insurance. Her monthly doctor visits are almost $600 and she pays her $21 copay. Even without high risk pregnancy the normal ob-gyn visit is almost $400! Not sure what the hospital bill will be, but since it is a C-Sec, probably between $5k and $10k. Her co-insurance is 80% and her copay is 20%. Things happen and a complications can bankrupt a family without insurance. 8 years ago my 8 lb 8 oz strapping grandson was born and could not breathe. Thanks to insurance paying the $110,000 hospital bill, he is alive and healthly today.

Not sure there IS an affordable way to have a baby. Has she looked into birthing centers? I'd just pay the high deductible, because you "get" what you pay for. Much luck to your friend.

Hi- I am 37 and 5mo pregnant w/ my 2nd child. I recently found out that my current insurance does not cover maternity. My OB/GYN office notified me of this after talking to my insurance company. However since I have insurance (even though my insurance will not cover maternity, unless there is an emergency), they are going to give me a reduced rate for delivery (although it's only my OB/GYN's delivery fee. that doesnot include hospital fee or anesthesiologist fee).

If your friend wants to have an OB/GYN care and hospital delivery, she may want to talk to the doctor's office and hospital to ask for a discount (or negotiate a discounted rate) since she does have insurance (though her insurance doesn't cover prenatal and delivery).

I have not worked with mid-wives, so I cannot comment.

GOod luck to her. I am in the same boat. It surprises me that some insurance companies do not cover maternity, and how complicated things can get.

I had my first at the hospital and and then my second at Austin Area Birthing Center. It was the most amazing experience ever! I have not a single bad thing to say and we want 2 more and want to have both of them there as well. It is very affordable and you get waaaay better care than a hospital or doctor! She should check out their website. Good Luck to her!!!!

B.,

You are such a sweet friend. I am sorry your friend is being faced with such worry. Our healthcare system is in need of a major overhaul. I'm appalled to know that most insurance policies will cover abortion expenses but not maternity! However, with that being said, let your friend know that a lot of OB/Gyn's will negotiate their fees if you are a cash paying patient. They also have a pay-out plan that lets you make payments during the pregnancy. I know that you mean well, but because of her advanced maternal age, I would not recommend a midwife. I, too, am advanced maternal age and have gone through 2 pregnancies (singleton, and twin)that could have had bad outcomes if I'd been seeing someone who was less than qualified to recognize the problems sometimes associated with advanced maternal age pregnancies. Your friend is right to be concerned with the extra costs. I hate to recommend it, but maybe she needs to seek financial assistance through her community services. I know nothing about this but I'm sure she could call Community Services in her area to check her eligibility. I am not an advocate of Medicaid for people who are too lazy to work, but those who work hard sometimes need assistance and that's who I think it should be reserved for. I wish your friend a happy, healthy pregnancy.

Did you know Planned Parenthood can assist in delivery and prenatal care... I know, everyone wants to beat Planned Parenthood and think of it only as an abortion clinic. Not true. They provide a wide range of family services. Have your friend contact them and inquire about their pregnancy assistance. I believe they can assist in getting her discounted rates based income and need level.

From their website:
http://www.plannedparenthood.org/health-center/pregnancy-...
Planned Parenthood strives to make health care accessible and affordable. If you do not have insurance, staff at your local Planned Parenthood health center can talk with you about your payment options. In some states, you may qualify for a state-funded program or a lower fee scale.

It is not terrible to have a baby without insurance. I did it 8 years ago with my middle one. The key is to pre-pay for everything. The prenatal blood tests cost about $500 all together. She has the right to say no to any test. The ultra sounds are the expensive ones. Some Drs do one every visit (unnessary). She does not even ever have to have an ultrasound for a healthy baby.

The anesthesiologist will be expensive, if she wants meds. She just needs to ask herself if $1200 is worth no pain. She will have to go for the pre-baby consult. If there are any complications and she needs a c-section, that is not the time to be reviewing the risks and benefits of meds. They may ask for a deposit then, but if she does not use meds, she will get that money back.

The hospital will be around $2-3000 pre- pay. If you do not pre-pay, it is significantly more expensive. I suggest she do this at about 32 weeks incase the baby decides to come early (like mine did).

Her other option is a birthing center instead of a traditional Dr. and Hospital. I do not know how expensive they are, but they do their best to have as little medical intervention as possible, but have hospitals on call incase anything happens.

Just have her do some serious research on her options. A midwife may be the way to go, if she is comfortable with their philosophy.

Best of luck to her!!!

We switched to delivery at home with a midwife for our second child because our maternity rider didn't begin until November 1. Child was due October 23 and we weren't covered by new insurance. With our first child I didn't do pain meds. and didn't want them again, so was very comfortable with home birth. We did a sonogram at a recommended doctor, but she handled all prenatals, tests and postnatals as well as the birth (at the time) for around $1800. Now you can estimate around $3000(I think) to budget for this...we were estimating close to $10,000 about 12 years ago for a hospital birth, without epidural etc. so I'm sure its more now.

I personally don't think of 36 as being an older mother, since I had my 6th child at 39 (we are both perfectly healthy) and could potentially have more children until menopause. I don't believe there are more tests that are necessary and a midwife would be able to refer you to places that could take them if they become necessary...we didn't do an amnio and wouldn't even now.

We used June Lamphier for our most recent births and she was wonderful!

By the way, baby #2 came later than due date and was born at 2:15am on November 1, the insurance ended up paying the midwife a good percentage. :)

Happy midwife searching, its a wonderful way to give birth even if you can afford the hospital.

If she is not pregnant yet she can go to Scott and White to get insurance! If she is already pregnant she will be like I was and have to pay the "RETAIL" of prenatal care and delivery. All that and a C-section costs around $15,000 out of your own pocket 3yrs. ago! I told my Dr. up front that I was paying out of pocket and any test he did not feel we needed to do would be great! EX. if your friend will not abort even if the baby tests positive for Downs. then don't do that test! Also, if she pays upfront you can negotiate a discount. While in the hospital bring your own vitamins, ibuprofin, tylenol, etc. because they brought me 2 advil and they were $10.00 EA. Anytime the nurse comes in to bring you something to take (don't be afraid) "ASK HOW MUCH THAT IS"!! Also, because my Dr. knew I was paying out of pocket I asked to leave the hospital one day early....cost of the hospital room is $1,000 a day and your baby is $1,500 a day....just for the room! This does NOT include anything else! My Dr. was great and let me leave a day early!
Good luck to your friend and I hope this helps! I wish I had gone to Scott and White even though we already had crapy health insurance!

if she lives in oklahoma look up SoonerCare. otherwise known as Free Babies! ;)
be prepaired to prove income.

I did this ame thing in 2006 with my son. It is expensive, but you can do it. What we did was this. Go and meet with your baby dr. and talk with him about what it would cost if you paid him cash up front for all prenatal visits and tests. My Dr. (in South Texas) Charged me $2500 this included birth and visits at hospital! So I paid that and everytime I had to go to him regarding baby problems, I was covered. They also checked pp every time you went in and they did that in the office and any labwork they could do in office was covered. I did have to pay for any labs that had to go out, but my chart was labeled cash pay, so I would pay cash same day for labs and get 20% discount, then i would file on insurance and some was covered and then got amount lowered due to network and then would have a little credit for next lab work. Then I went to the hosiptal and talked with their billing office and asked them how much for if I paid cash prior to a normal vag birth with epidural. They gave me a price of $1850 for a 2 day stay and I could pay this when I checked in, but not after check in. They expalined that the anethesiologist would charge seperate. Talked with them and due to the nature of the procedure, couldn't give me a prepay amount, but their bill after was about $900 and I ended up having a c-section. I then just made a monthly pmt to a little baby envelope for the birth. I think it was like $215 a month. As for the Dr. amount, I wrote a credit card check that gave like 6mths - a year with interest and made as big a pmt. to it as I could. So when the interest kicked in the balance would be small. So, I was in the hole about $5250. Now at the end, I was 2 weeks over due date and they had me go to hospital and weekly take a test that monitored baby and could look for contractions etc.. that cost me $600 a pop!! Now, during labor, baby heart rate dropped and we had to do an emergency c-section, so then my insurance did cover care required due to problems with baby and so the anesthesiologist's bill ended up being covered by insurance and the extended stay in hopsital was covered too. Most insurance's cover the infant for 30 days as long as you notify insurance of the impending birth and they have you fill out a form for the baby to add it to the policy. Luckily my son's circumcision was covered as well. So, all in all my out of pocket was about $6000. I pretty much paid this out in about 17 months and that is about $350 a month with no interest. Just remember though during this same time you are buying this for the baby and after birth, you are buying diapers and formula, which ended up being about $100 extra a week just that! So if you can't swing it, then I would hold off and save for a year then go for it. Just negotiate with your medical facilities you can get a big discount. Best of Luck. Oh and if you check on the insurance policy to add pregnancy coverage, then you end up paying about $500 a month for the rider and in a years time you have pretty much paid for the birth anyway.

would she qualify for medicade or wic for any of it

Hi, U should have your friend look into medicaid,medicare or chips she is a pregnant women and she needs that coverage one of those three providers should be able to asst. her its ok that she has a lob and insurance.
Hope this will help best wishes to you and your friend :)

I had my second child without insurance due to my husband's change of jobs. There was a lapse in insurance and I just happened to get pregnant during that time. We worried about the same thing. Our state (Texas) has Medicaid that it offered but I didn't think we would qualify because of our income. We by no means were wealthy but was above what their criteria would have been, so I thought. We paid cash for much of our prenatal care. Then we thought... give it a shot. The worst they can do is say no... right? Well, we found out that the criteria if you are pregnant is much different than that of just basic medicaid. We also found out that they had many different programs as well that I had never heard of. We ended up getting all of the papers finalized 4 days before I went into labor... and the entire labor and delivery was paid for. Not only that but they back dated many of the prenatal bills that I was still trying to pay off. I used Medicaid for that time period only. They also cover 6 weeks post-delivery on both you and your child. And if the child needs it, they automatically cover them for the next year. I was able to still use my same hospital and same obgyn. I got excellent care And you can qualify, even if you have insurance with no maternity coverage. After the baby was born, I removed myself from Medicaid and finalized my primary insurance which I have been on since. I can't imagine what we would be doing right now if we would have had to pay all that money out of pocket. Check with your state, they have state specific Medicaid or other similar programs.

what type of insurance does her husband have? Are either of them able to talk to their HR person regarding their insurance and other option available to them? Has she confirmed with her actual insurance company what is / is not covered - I have found that nurses in dr offices do not always ask the right questions and you are given misinformation.
She might be able to find some additional information on some of the baby / new parenting websites like babycenter.com, workingmother.com, parenting.com.
Having a baby at her age can potentially bring so many complications that can be very expensive.

I would advise her to apply for medicaid. Even though u had full health insurance I still hit Medicaid coverage while I wad prenant and it also covered my daughter for her 1st year. I can almost gaurentee that any pregnant woman will get Medicaid . It's worth a shot. Good luck . There are even some midwives that take Medicaid .

there is a program called maternity card. I read about it in Pregnancy magazine. It is a discount plan specifically for those who don't have maternity coverage and/or don't qualify for medicaid. She should check it out.

www.maternitycard.com