Can't Afford Prenatal Care

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Can't Afford Prenatal Care

My husband and I are newlyweds who just learned that we are expecting out first baby! However, our health insurance has a high deductible ($2500) that must be met. He has a HSA account, but it has only $138 in it (new job as well). All the OBs in our area want this deductible paid within my first three doctor's visits. Therein lies the problem as we simply cannot pay the $2500 in the next few months, and I don't want to delay going to the doctor for several months while we try to save up. Any ideas?
Brigitte in Tennessee

Low-Cost Prenatal Insurance

Call your local Social Services office and ask if your state or county offers low-cost prenatal insurance. Here in California, there is a program called AIM for expectant mothers who have an income too high for Medi-Cal, and who have large deductibles with their insurance. It's regular insurance and there is still a cost, but it is much lower than standard insurance and can really help out in situations like yours.

If an option like that is not available, seek out a women's clinic to do the initial prenatal visit. The cost will be minimal. As a last resort, ask family to help or take a credit card cash advance (look out for fees and find the one with the lowest) to get your deductible covered and get you through these next few months. Now is not the time to put off care because of finances. Best wishes for your new family!

Consider a Midwife for Low Cost Prenatal Care

OK, so you've tried all the OBs in your area; now try calling a few midwives. That $2,500 deductible you would have to pay out of pocket anyway might be enough to cover the whole pregnancy, from prenatal through postpartum care. Don't think this is second-class care because it costs less. For low-risk pregnancies (which most are), midwife care and birth often produces great outcomes for both mother and baby. For more information, consult the site from the American College of Nurse-Midwives at
Amy in Highland Park, NJ

Explain Situation to Office Manager

Many doctors will allow you to pay partial payments of the co-pay or deductible. Call back and ask to speak with the office manager. Explain your situation to them and be sure to add the fact that you don't want to delay proper medical care to your new baby. As a doctor's office, they should respect/honor your concern.

As a side note for savings, many doctors' offices will have free packages of prenatal vitamins. Don't be afraid to ask for extra/additional samples to keep down your costs!
Andrea from NJ

Low Cost Prenatal Care is Available

In some areas, there is a program called WIC (Women, Infant, Children). This program helps provide affordable medical care for women who are pregnant, as well as for the child once it is born. Now you do have to fall within financial guidelines to qualify, but it is worth a try.

Additionally, check in with your local Social and Health Services Department. You may qualify for medical coverage through them that would cost you $35 to $40 a month, but you'll have a deductible of only $15 per visit.

Everywhere, it is being recognized that health care costs are putting children at risk, so you may find a state agency that is willing to help you out. I know sometimes it is a matter of pride, but this is one of those times to swallow your pride and see if you qualify for some of that state help.

Teaching Hospitals Offer Low Cost Prenatal Care

Search in your area for a teaching hospital. When I was pregnant with my daughter, I went to an OB/GYN clinic staffed by residents at a teaching hospital. The total cost for all of my care and delivery was $1000. I received the best care there. The resident doctors took their time and really made sure that everything in my pregnancy was progressing as expected.

Cash Pay/Personal Pay

Plan A: Call the doctor's offices in your area. Ask to speak to someone who handles billing, and then ask what their "cash pay/personal pay" rate is and when it would have to be paid by. Ask if they can set you up on a payment plan. I have had four babies in recent years, and even though we have insurance, the cash pay rate was always much cheaper than our deductible and takes care of the entire doctor's bill for office visits and hospital delivery. You might still have to pay down the road for any extra procedures like sonograms or no-stress tests. Our deductible was also $2500, but our doctor settled our whole bill for office visits and delivery for $1200. They accepted payments in $200 dollar increments every month or two. You should be able to find someone in your area that will work with you.

Plan B: Do some research on using a midwife. If you deliver in your home, I have heard that rates can be as cheap as $1200 for midwife visits, delivery, etc.

Plan C: As a last resort, you could always contact a crisis pregnancy center to see if they may be of help, depending on your situation.

Plan D: Hospitals usually have a charity office that helps with reducing bills and/or eliminating them all together.

With enough phone work, you should be able to put together a plan for your situation. Remember that you must have specific maternity coverage on your insurance plan for it to pay for any normal maternity things. Your plan will otherwise pay for any emergencies in your pregnancy, but it will not pay for maternity in general unless it's specifically a part of your plan. In other words, paying your deductible may not be of any help if your plan does not have a specific maternity rider (which would be another reason to ask about "cash pay/personal pay"). Congratulations on your new little one!

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Do Your Homework Regarding HSA

We recently discovered that my husband's HSA administrator will foot the bill ahead of time, even if we don't have the full amount in the account at the time of services. Generally, this is done in the early months of the year, but this may be something your husband's plan offers. It can't hurt to ask.
Lori in Brandon, FL

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