Idaho Medicaid and Health Insurance

[table83]

OK, to make a long story short. My wife is pregnant (yay!) We are poor and we have medicaid. Medicaid supposedly pays only for the baby. So what happens if Melody (my wife) slips and breaks her arm. We are assuming that we have to pay for this out of pocket. Is that correct?

She wants to get health insurance for her incase of the broken arm scenario, but she said she applied for some at some place... blah blah blah... and couldn't get anything reasonably priced because she was pregnant. (We just took her off my school plan on the 15th of Jan so she's within the 62 days.) This doesn't make any sense to me because they wouldn't cover anything relating to the pregnancy anyway because it's a preexisting condition. So why would she be rejected?

She is also worried about getting insurance when she gets off medicaid. Is this a legitimate concern?

So again 3 questions:
If my wife breaks her arm will medicaid cover it?
Why would my wife be rejected from getting health insurance?
Is it a legitimate concern that we will struggle to buy insurance when medicaid is done?


Thanks,
You guys rock!

 

[dgoldenz]

She's not going to get any health insurance if she's pregnant. Unfortunately, neither will you...

 

[table83]

We can get her health insurance for like $180/month not all that bad considering, but not as good as it could/should be.

Unfortunately, neither will you...

Not really one of my questions, but I have health insurance. And that doesn't make any sense at all. Why would her being pregnant affect my ability to buy insurance? I do appreciate the response all the same.

 

[dgoldenz]

Where can you get her insurance for $180/month? She can't pass underwriting, unless you have something that's guaranteed-issue in your state. You can't get coverage because federal laws would mandate that the newborn child is automatically added to your insurance policy. That is a gigantic liability to the insurance company if something happens to the child during pregnancy.

 

[Dave020]

Read up here. There is a lot of good information for you. If she's on the Standard Plan, it looks pretty comprehensive. It appears from your post that she should be on the Standard Plan, but double check it. The other two non-Medicare related plans include all benefits of the Standard Plan plus the extras.

http://healthandwelfare.idaho.gov/Portals/0/Medical/MoreInformation/Idaho%20Medicaid%20Standard%20Benefit%20Plan%206-2008%20_2_.pdf

Medicaid

http://healthandwelfare.idaho.gov/P...State Plan Services Comparison 6-2008 _2_.pdf
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You can't get coverage because federal laws would mandate that the newborn child is automatically added to your insurance policy. That is a gigantic liability to the insurance company if something happens to the child during pregnancy.

He could get coverage if he can pass underwriting so long as he chooses a health plan that is a subscriber-only plan. Plans like Anthem RightPlan and such are available in these situations since no other family members can be added to the plan.

 

[dgoldenz]

Read up here. There is a lot of good information for you. If she's on the Standard Plan, it looks pretty comprehensive. It appears from your post that she should be on the Standard Plan, but double check it. The other two non-Medicare related plans include all benefits of the Standard Plan plus the extras.

http://healthandwelfare.idaho.gov/Portals/0/Medical/MoreInformation/Idaho%20Medicaid%20Standard%20Benefit%20Plan%206-2008%20_2_.pdf

Medicaid

http://healthandwelfare.idaho.gov/P...State Plan Services Comparison 6-2008 _2_.pdf
- - - - - - - - - - - - - - - - - -

He could get coverage if he can pass underwriting so long as he chooses a health plan that is a subscriber-only plan. Plans like Anthem RightPlan and such are available in these situations since no other family members can be added to the plan.

Must be state-specific then....no carriers in Virginia will give coverage to someone with a pregnant family member, even if they're not covered.

 

[Dave020]

It may be state-specific. California, yes, all carriers offering individual-only coverage plans will allow it.

 

[scagnt83]

If my wife breaks her arm will medicaid cover it?

If she is pregnant and on medicaid yes.
While medicaid is state specific about a lot of issues (especially once the baby is born), if she is covered while pregnant, she is covered for any medical condition that may arise.
From a broken arm all the way to a broken back. The reason for this is that any medical condition, no matter how minor, can adversely affect the health of the unborn child.

After the baby is born she may or may not be eligible.
In SC the mom is guaranteed coverage for 6 months after birth if I remember right, the baby is guaranteed coverage for a year until they review your income status.
You just need to read that link thoroughly. And talk to your DSS rep ..... sometimes they actually know what they are talking about.... lol

Is it a legitimate concern that we will struggle to buy insurance when medicaid is done?

Only if you cant afford it.
Previously being on Medicaid will not affect an insurance companies decision to insure you or not.
It actually might help, since it would qualify her as having previous coverage (thats a question in SC that can affect premium, not sure about other states)

 

[catowned]

I don't live in ID but medicaid will pay for it.
If something like that happens while she is pregnant, she will get sent to a perinatologist along with the ortho doc or necessary specialist. If she had to be admitted for a broken arm she will be on the women's floor instead of the ortho floor with the perinatologist being the admitting physician.

It varies from state to state and I have no idea what the laws are in ID but the only thing I've heard of medicaid for OB not paying in some areas are midwives for out of hospital births. I remember in MO they paid but it was so low the midwife we interviewed did not accept it.

Are you sure she won't qualify for medicaid after the baby is born? I would try to find out what the income limits are for three people.
Congratulations!!! What an exciting time!! Blessings to you both~