I'm childless by choice and am fortunate to have always had affordable health insurance provided by my employers, so I have no clue as to the kinds of services available to pregnant women who are underinsured or have no health insurance. I'm hoping you all can help.
Here's the situation: My brother and his wife live virtually paycheck-to-paycheck. My sister-in-law found out last month that she is pregnant -- she's now little more than two months along, I think. They're both in their early 20s and new in their jobs. She is not offered health insurance through her employer. My brother was set to enroll in his company's health insurance plan this month. This week he discovered that the plan is hardly a benefit in the sense that it would cost $600 a month for the two of them and carries a large annual deductible that needs to be first met before receiving the meager reimbursements offered.
I advised them to contact the county (Hamilton County, Ohio) to see what services are available to people like them. They were advised that they make too much money to qualify for county or state assistance. While they are well above the poverty line, they're still working poor and can't independently afford prenatal visits, nutritionist consultations, sonograms, labwork, etc... I did a search of available services in our area and found most to be those pseudo pregnancy crisis centers that are really just fronts for religious operatives to shame women from having abortions. They might get diapers and a dose of Jesus from them, but not much else. I called the local Planned Parenthood's main center and was told that they do not offer prenatal services in this area. The woman I spoke to didn't know of any other options available, except to try and work with local hospitals. Two local hospitals are willing to offer a one-price fee that includes prenatal visits and delivery, but it still cost thousands of dollars that my brother and his wife do not have. Considering that she has no benefit time to take for maternity leave, they will be even less likely to afford this after the baby is born.
Does anyone know of any other program, organization or avenue to explore?
If there's any good to be had from this situation (aside, of course, from the impending birth of my first biological niece/nephew!), it's that it's got my brother re-evaluating some of his conservative views on abortion. He's no supporter of abstinence-only education nor is he a religious conservative, but he has always been largely anti-choice. He's now beginning to understand how reducing access to abortion without also providing services that support women who choose to have babies can put would-be parents in impossible situations.
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Wow. This is really tough. I tried to google search it myself and didn't come up with much. I guess it depends on the state but some states do offer gap coverage to working poor families especially for the time surrounding pregnancy--it's a shame that Ohio doesn't seem to.
You could also look to see if there are some other non-religious low-income clinics, even out of state if it's not too inconvenient, that will pro-rate their fees for your brother/sis-in-law's income level.
There have got to be other families in their shoes. I'd check online in parenting forums and blogs to see what you come up with.
Other than that if they can afford the insurance premiums that sounds like the best bet because once the kid is born there could be complications (hopefully not) and what not, and that's probably something that they should have coverage for to be on the safe side.
Good luck. Keep us posted.
Another option would be to use a home birth midwife, which is kind of in legal limbo in Ohio (from my understanding). Home birth midwives are often willing to offer a discount for payment in full, sliding scales, or some form of barter. They are also much more cost effective to utilize than hospital services. If this is an option your bro/sis-in-law feel comfortable considering, it's one way they can have a safe, satisfying birth experience without paying a ton of money.
http://ohiomidwives.net/
While it might be expensive, if other options don't pan out, you should think about what the hospital has to offer you. Most hospitals, in my understanding, offer payment plans. While it will definitely be a financial burden on your brother and SIL, it may be something that can be worked out.
Good luck.
whatever you do , make sure they stay away from a place like this http://www.portlandprc.org/vision.asp
Good luck.
-S
Some ideas here:
http://www.americanpregnancy.org/planningandpreparing/affordablehealthcare.html
My youngest was born with a homebirth midwife, it cost us about $3000 for all prenatal/postpartum care and the birth. Complications still have to be handled at the hospital and that can be hugely expensive, though.
They should also think about how they will handle health insurance/health care for the baby after he/she arrives.
Thanks so much for that link. The programs it list sound promising. I forwarded the info on my brother and sis-in-law.
I'm originally from Ohio (north eastern) and worked in public health. Healthy Start is available if you're 200% of the poverty level. The other option might be (since they're close-ish to Cincinnati) to contact the hospitals and medical schools for free clinics. Any major city should have a free clinic. I'm sorry I can't be of more help. It's been awhile and I'm not familiar with that stuff. Maybe contact the county health department for clinic information?
They live in Cincinnati and it was one of Cincy's free clinics that told them they make too much money. Plus, the city is now facing a $40 million deficit, so they're cutting back all services.... sigh...
She should make a single appointment with an OB, get checked out and get tested for some potential major issues like Rh, etc. If the OB thinks she and the baby are healthy enough that her pregnancy should be easy and straightforward, and she lives less than 20 minutes from the nearest hospital with a L&D ward in case of emergency, she could definitely consider homebirth, if she herself is comfortable with it.
If she's not comfortable with homebirth, or there's a reason to think it won't be safe for her according to an OB who could determine such things (well, as best you can tell ahead of time, surprises always are a possibility), she should try to find a good CNM who can practice in a hospital. CNM appointments and care are cheaper than OB care, and while it's not going to be cheap, if she's at risk for complications, homebirth can become WAY more expensive than hospital birth, since there's a possible ambulance ride and NICU time to consider.
She can also limit what she gets as much as possible-- do research and get the minimum level of care that is still safe.
I wish her the best of luck. They may want to see if they can get some kind of pregnancy insurance-- the high deductible, because she is already pregnant, will be rough, but at least if she needs surgery, or NICU time, or any kind of complicated intervention, they can be covered. Maybe this site can help?
http://www.pregnancyinsurance.org/
Can your brother get alternative health insurance or does he have to take the one the company offers? My search didn't get great results, but some of the rates did seem much lower than $600/mo.
http://www.ohioquotes.com/latest-news
http://www.health-insurance.org/ohio-health-insurance
I hope all goes well.
Hi,
I would suggest you call the Federal Maternal and Child Health Bureau information line at 1-800-311-BABY (1-800-311-2229). They can help you locate free or low-cost services for pregnant women in your area. Also, a lot of prenatal care clinics receive federal funding to provide services to uninsured women, so the state's budget problems shouldn't be too much of an issue.
Hope everything works out!
Julia