Humana Won't Cover Maternity

[Pepper1126]

My fiancee just found out she is pregnant, I pay for our insurance. She just lost her job with her good insurance. She lives with me. Can she apply for Medicaid under the reason being that her insurance won't cover maternity? They asked for household income and I make a good salary. We are in Georgia.

Thanks

 

[Crabcake Johnny]

So you're about to marry her, make a good salary and want to figure out how she can get Medicaid?

Why don't you pay for it - will cost around 5k

 

[Pepper1126]

I pay all bills and cannot afford cash payments.

 

[DS4]

She just lost her job with her good insurance. .........her insurance won't cover maternity?

She has/had coverage through an employer? If so, employer plan cover maternity. Is she eligible for state or federal COBRA?

 

[briko3]

She should have gotten paperwork for COBRA. She should have almost 60 days to get on it.

 

[Pepper1126]

She lost her job about 8 months ago.

 

[Crabcake Johnny]

Then she probably qualifies for the Federal high risk pool, however the birth will go to the deductible and coinsurance so anyway you slice it you'll likely end up paying around 5K.

You'll have to contact Medicaid to see if she qualifies.

Here are her options for GA: Find Insurance Options

Click the Medicaid tab and note this option:

Planning for Healthy Babies (P4HB)
The Planning for Healthy Babies (P4HB) Demonstration provides family planning and family planning-related services to uninsured women, ages 18 through 44, who have family income at or below 200 percent of the Federal poverty level (FPL), and who are not otherwise eligible for Medicaid or the Children's Health Insurance Program. The Demonstration also provides interpregnancy care services to women, ages 18 through 44, who have family income at or below 200 percent of the FPL, and who delivered a very low birth weight baby on or after January 1, 2011. HIDE

Here are the financial qualifications: http://dch.georgia.gov/vgn/images/p...169378326Rev2011FinancialLimitsChartFinal.pdf

 

[AndreaSti]

Pepper: there is some good resources mentioned here and you should look into them. Looks like you are saying she is on an individual Humana plan. If that is the case, know this: there are very few plans on the individual side in GA that offer maternity coverage anymore. That being said, any complications of pregnancy would most likely be covered (you and she should read the policy for the definition of that).

Also, looking ahead here - the baby will be covered automatically on her (or your) plan as long as you call them once the baby is born. Kids can't be turned down anyway now but still this is automatic (again you have to call them). Because you are the father you should be able to add the baby to your policy if you want to also. Anyone else out there can correct me if I am wrong, but I don't think they have to be married for the baby to be added to HIS policy instead, should they choose to do so (?)

 

[taterpeeler]

So you're about to marry her, make a good salary and want to figure out how she can get Medicaid?

Why don't you pay for it - will cost around 5k

Huh? I just had twins 23 months ago.... 46K before ppo discounts.... 26K after discount... 13K each, give or take

 

[Crabcake Johnny]

I was being smug. My wife needed an emergency c-section after over 24 hours in labor.

During her pregnancy she got diagnosed with fifths disease (parvovirus) Fifth disease (parvovirus B19) during pregnancy | BabyCenter

We then needed special weekly testing for potential hydrops. I have no idea what then entire pregnancy including birth would have cost out OOP - likely 30K to 40K.