COBRA is Expiring, My Wife is Pregnant

[Crabcake Johnny]

If all else fails, visit the hospital and make arrangements. Two of our local hospitals actually have specific "plans" (payment arrangements) for people who slip through the cracks; no coverage and don't qualify for Medicaid.

One client I referred a few years back said the hospital gave her the network discount even though she had no coverage - which is very significant.

That said, you'll need either cash on the barrel head or you'll need to sign papers for a financial arrangement.

Works that way with a lot of things. My wife just needed an emergency crown (cracked hers about two weeks ago.) The only dentist available didn't take our discount plan, said it would be $1,600.

I wheeled and dealed and they had me sign up for a Cigna plan ($129) and did it for $460.

 

[Josh]

Should be able to get a plan under HIPAA. I don't know how it works or what they offer in your area but check with an agent who knows that market. There may also be other plans/programs available specifically for pregnant women.

On this forum we have the following agents who work the DC market:

View Profile: dgoldenz
dgoldenz (David Goldenzweig)
703-753-3376
[email protected]
High Risk Life Insurance Quotes | Insurance Experts in Virginia
Life/Disability/Health/LTC/Fixed annuities
Specialize in high-risk cases. Health insurance in VA/MD/DC, other lines of business in 25+ states.

So far this is the best advice I've seen.

 

[Bruce]

There is none! You should have bought an individual plan when you knew you were going to leave or get fired from your old job! This would have saved you money every month also? I can not tell you how many times I have talked to someone in your situation, only to be told, well I don't want to give up the bennies like low cost co-pays and such. Then they have a heart attack, or get some other pre-existing condition, and can not get an individual plan ever again. They never listened! Your wifes condition is considered pre-ex because the child could be a pre-me, or have other issues, (I hope not), and since all health plans have to include future children, and they can not exclude your child, they don't want this exposure, and the pay out $ of the birth. Go or call some local hospitals, tell them of your situation. Most have plans where you can pre-pay at a discount for the delivery cost. This is your only choice as I can see it. Live and let learn.

I have never made a negative comment regarding another forum member's post and will do my best not to do so here.

However, I do find your comments to be mostly inappropriate.

While you are correct that the OP should have been more proactive, your post presumes you have specific knowledge of DC insurance law and that the OP has no potential solutions to his situation (you stated, "There is none!" to his inquiry of possible solutions).

In fact, there are several avenues of possible resolution:

1. Conversion
2. HIPPA compliant Individual Plans
3. Income restricted plan availability

It obviously took some time for you to post your response. Perhaps a more appropriate use of that time might have been to review DC Insurance Code in order to offer some advice based on the OP's situation.

For your ease of perusal, I offer it to you here:

http://weblinks.westlaw.com/result/...L12.04&service=Find&spa=DCC-1000&sr=SB&vr=2.0

I would suggest to you that a cursory review of DC Code would suggest that there may well be possible solutions to the OP's coverage issues. I would further suggest to you that such a cursory review would have taken perhaps only as much time to perform as your post took to write.

There is probably nothing we do as health insurance agents, brokers and consultants that compensates us as poorly (or not at all) than providing sound advice to folks like the OP who have questions about serious problems.

There is also nothing we do that is as important.

 

[TXINSURANCE]

Medicaid. Medicaid. Medicaid.

Call Medicaid. In some states if pregnant income is irrelevant and all babies are free.

Congrats.

 

[somarco]

So what's the answer then?

The answer is to contact David Goldenzweig as suggested by Dave Fluker.

 

[dgoldenz]

The answer is....call me at 703 753 3376. CareFirst has options for guaranteed-issue coverage with maternity benefits. I can explain them over the phone, but don't want to type out 4 paragraphs explaining the difference between them.

 

[GreenSky]

The answer is....call me at 703 seven five three three three seven six. CareFirst has options for guaranteed-issue coverage with maternity benefits. I can explain them over the phone, but don't want to type out 4 paragraphs explaining the difference between them.

I was hoping you'd write a novel about this.

Also, I've been looking at my phone and I can't find a button marked "seven." You must have one of them there new fangled phones with words instead of numbers.

Rick

 

[dgoldenz]

I was hoping you'd write a novel about this.

Also, I've been looking at my phone and I can't find a button marked "seven." You must have one of them there new fangled phones with words instead of numbers.

Rick

I just have one of these babies:

 

[Ann H]

DGoldenz is certainly the best resource for the OP, as others have recommended.

However..... this thread leaves me disappointed in the lack of professional advice given by SOME agent/brokers to a consumer who is seeking expert guidance, simply because of a situation involving a maternity and loss of coverage. Cases like this are fodder for the opposition. This is a pregnancy. This guy and his wife have kept coverage diligently through COBRA. It's not like the guy is eating cheeseburgers all day, needs open heart surgery, and hasn't carried insurance for years.

As a group, we managed to navigate him to a correct answer and to a seasoned professional agent in his area. Some of the individual answers were excellent. But some of the individual answers were shockingly wrong, some were so incomplete they were essentially an E&O, and some were downright rude.

 

[somarco]

some of the individual answers were shockingly wrong, some were so incomplete they were essentially an E&O, and some were downright rude.

I could not agree more . . .