Katlyn is having trouble getting health insurance because she just graduated from college and is 15 weeks pregnant. She’s found herself in an expensive situation.
First and foremost, I am 15 weeks pregnant, unmarried, and I just graduated from college. This should be an exciting time for me, as I’m starting two new chapters in my life; unfortunately, enrolling for health insurance has become a burden.
Pregnancy is considered to be a “pre-existing condition” much like diabetes, cancer, or any other kind of health malfunction that would label me as less than perfect. I am a non-smoker, was a varsity athlete in college, and am of average height and weight. I have no other pre-existing medical conditions at all: I have no allergies, no asthma, and I’ve never had any major surgery. When I called Blue Cross Blue Shield, they denied me coverage due to my “condition”. When I asked if this would be a common concern for other health insurance companies, they said, “Yes, you will find this with all health insurance companies.”
So I called other companies. Aetna and Assurant both denied me as well. Every company told me I was more than welcome to enroll AFTER I had my baby. Being 15 weeks pregnant, it would be tough to me to find a job since I am beginning to show, so any hopes of long-term employment with health benefits would be a long shot.
However! There is a glimmer of hope! I can stay on my father’s health insurance for $400 a month through COBRA. Had I not been pregnant, I would have qualified for a health insurance plan for about $175 with BCBS. My boyfriend has health insurance through his company, but since we’re not married, I don’t qualify. I also looked into state health plans, but with my current jobs (all part-time, do not offer insurance) I make too much money to qualify. Fantastic.
Who says health care in the US doesn’t need to be fixed?
–
Thank you,
Katlyn
Unfortunately HIPAA, the Health Insurance Portability and Accountability Act of 1996, says that group health insurers cannot consider pregnancy a preexisting condition, but doesn’t have the same requirement for individual plans. That’s why they’re able to deny coverage in your case. Also, you try to should avoid any coverage gaps because according to iVillage:
HIPAA doesn’t apply to someone who previously had no health coverage at all and then gets into a group health plan through a new job. So if you had no insurance, got pregnant, then landed a new job with insurance, your new health plan would not have to immediately cover your pregnancy. You might have to sit out a preexisting condition waiting period, a period that could be longer than your pregnancy and in the meantime pay for your visits yourself.
We don’t want that to happen to you, even if $400 a month sounds like a lot to pay for health insurance.
Have any of our readers been in a similar situation? How did you get through it? Do you have any advice for Katlyn?
Pregnant without health coverage [iVillage]
(Photo: Jonathan Harford )
More From Consumerist
-
I’m A Dude. Why Is My Health Insurance Adding Maternity Coverage?
-
Many Insurers Changing Prescription Categories So Customers Pay More For Already Expensive Meds
-
Anthem BCBS Decides Boy Who Can’t Sit Up On His Own Doesn’t Need A Wheelchair
-
Is Anthem Blue Cross’ Mail-Order Drug Requirement Discriminatory?
-
This Is Why People Hate Health Insurance Companies
Amy Alkon: when you lose everything you have to bills from a condition your insurance company won’t cover (even though they should), don’t come crying to the state to help you. People like you deserve the current health care situation.
You probably shouldn’t have gotten pregnant if you didn’t have a plan to pay for it and the medical bills it generates.
Just FYI.
If you can’t afford it, abort it.
Marry the father of your child.
“Who says health care in the US doesn’t need to be fixed?”
I agree, we need some major government programs to eliminate this sense of entitlement.
Even having health insurance does not mean that you will have coverage! Take me for example; when I found out I was pregnant my husband and I were thrilled. We have had BCBS insurance for years and we reread our benefits and found that the whole thing was covered. I ended up having a high risk pregnancy but that was also covered according to our benefits. So, our son is born we are happy and a couple weeks later we receive a $8,000 bill! Of course we freak and call up the hospital and ask what it is all about. They tell us our insurance denied the ultrasounds and non-stress tests that were done before my son was born because my pregnancy was not high risk. We contacted our doctor who sent the insurance a letter telling them that it was high risk and had the hospital resubmit the charges. To make a long story short 15 months, 23 resubmits, 4 letters, one collection agency, and over 1000 minutes on the phone BCBS FINALLY paid the bill they should have paid in the first place!
I have to applaud consumerist here for posting this story: Katlyn is a good friend of mine, and I’m frustrated and saddened to hear she has to deal with the failing of health insurance in this country.
There is a potential alternative I’ll be sure to share with her, which is filing for a domestic partnership with her boyfriend. I know my employer supports domestic partnership insurance; the township/municipal government of her boyfriend’s residence will need to support that form of living arrangement. Once they file the paperwork at the local government of his residence, he has the opportunity to get her qualified for insurance.
As for pregnancy being a detractor from one’s potential of being hired, it could be considered discrimination, but it will depend heavily on the context of the workplace (e.g. a workplace of mission critical and sensitive material may not support hiring a person who is pregnant given the expected interruption in 9 months).
I’ll encourage her to write in a follow up. I really want people to continue to be aware of the failing health insurance industry in the US. We have a right to our care; care that should be provided without concern for profit or bottom line.
The primary goal of health care should consist only of the well being of its people. Anything otherwise is an omen of slow, steady disaster.
I thought of another option:
Katlyn could enroll in a graduate school to maintain her full-time student status through the summer. While it will postpone her path into the working world, she will be eligible to remain insured under her parents’ insurer.
I actually have good news! I commented on this story thinking she submitted it yesterday. Old news for a slow dog.
Anyway, Katlyn worked at the college of her undergraduate study, and her manager wanted to hire her as a full timer.
While, she lucked out, there still exists a problem of people falling through the cracks of the US Health Insurance Industry.
I’m glad though, that my friend’s in a better position now.
wow. a few things:
1. many of you are blaming the woman for being pregnant as if she got pregnant by divine intervention. there’s a man involved in this, and i don’t see anyone hating on him. women don’t “get themselves” into pregnancy alone.
2. assuming the pregnancy was unplanned or planned is not the issue. the issue is that our society will allow its some of its most vulnerable people (those carrying the future of this country) to be uninsured to begin with. you all act like you are where you are in life because of the so-called bootstraps theory (as in, you did everything because you worked hard and deserved what you got). you didn’t become who you are independent of a society, and likewise it is all of our responsibility to look out after each other.
3. unrelated to this issue but to those who were mentioning being responsible about pregnancy: you’d be surprised how awful sex education is in this country. my high school’s version of sex ed was showing us slides of genitals infected with stds and playing meatloaf’s “paradise by the dashboard light”. i’m not kidding. birth control wasn’t mentioned, and no doubt kids since then (i’m 27) have heard more of the same, what with bush’s abstinence only education funding for sex ed. have any of you heard the recent statistic that 1 in 4 teenage girls has an std? that’s effed up. don’t tell me that a 13 year old knows how to make an informed decision when she’s being fed crap.
4. one more unrelated point: for those advocating abortion, more than 90% of counties in the u.s. don’t have an abortion provider. some states only have abortion providers one day a week that are flown in from other states. do a little homework about the state of reproductive rights and maybe you’ll be more sympathetic. imagine if this were your sister or daughter that people were talking to as if she were an irresponsible whore.
What I find disgusting is that if you work, you pay thousands of dollars for “poor” people to have health insurance which covers childbirth for free, yet you have to pay an extra $400/mo on top of the taxes to get any coverage. Shame on the government for not stepping up and fixing this problem!
I have some advice which may be helpful. First and foremost(!!!) is the health of you, your baby, and how your pregnancy progresses. I was in the same situation a few years ago when living in Georgia. Someone suggested talking to the local welfare office to see if they had anything to help. Ugh. Welfare office. But I went. They had a “healthy baby” plan for those without insurance in the state. They realized that healthy kids start with good preventative care before they are even born. Checkups, tests, hospital birth, everything was covered. (Temporary food stamps were also available so the mother could eat healthy.) I took them up on it, and signed on with a birthing center. Everything was covered until a few months after the baby was born. Then, I could sign up for regular welfare, (which I did not do) or have other private coverage take over and cover the baby, too. Swallow your pride and give the welfare office a shot. Try other “public health” agencies in your state. It doesn’t hurt to do some digging and ask!
I feel for the girl. I really do. I am 9 weeks pregnant, work in a straight commission sales job that has been really tough in this economy and losing my health insurance. I worry every day about getting fired. I have to take shots of a blood thinner lovenox 2x a day during this pregnancy that run about $3000 a month without insurance. I am all for universal health care. Either that, or we need a serious fix to our system that includes AFFORDABLE trips to the Dr. or procedures that don’t bankrupt one of the 7 people in this country who have insurance. Why should it be a privilege to have insurance and not a right? Obviously we Americans have shown that we can’t handle this ourselves. It’s time to let the govt step in.
Sorry, typos above. I fear losing my health insurance due to low sales in this economy. Also it’s one in 7 people who do NOT have health insurance. Maybe that was a freudian slip about one in 7 people having insurance. Seems about right…
I really can’t believe some of the comment that were made regarding this issue. For all of you that act like you are so perfect and would never be unmarried and pregnant, please get a life. It could very well happen to you. To those abortion suggestors: What if your mother decided to have an abortion when she was pregnant with you, married or not, because it would have been to expensive? You would not be here to open your big mouths. I am in the same situation as the original writer of the blog, and I work full time, everyday, and I don’t qualify for any assistance and don’t have insurance. But you look around and see all these women with no job, sit at home everyday watching soaps, no responsibilities at all, and they can get public and state assistance. You have got to be kidding me. And by the way, yeah, there would have been plenty of ways to prevent my pregnancy, but now that my baby is conceived, I don’t wish that I had used protection, and I sure as hell don’t wish he would go away.