At the beginning of 2015, my hubby and I decided to take the risk of going without insurance for the entire year. Since we were both young (enough), healthy (relatively), and our daughter was covered by Child Health Plus, we said screw you to Obamacare. Of course, we had to mess that plan up by getting pregnant. In early fall, we were pregnant and uninsured, which is actually a fairly common scenario. So common, in fact, that a quick search on Google yielded 56.6 million results.
The most common program for uninsured, pregnant women was Medicaid. When I first got Child Health Plus for our daughter, I was told that my income was too high for any Medicaid assistance, which was no surprise to me. But it was just low enough to qualify for Child Health Plus. When I was researching affordable health care as a pregnant, uninsured woman, I found out that the Medicaid income limits were higher for pregnant women.
But of course, I was still above the income limits. (Apparently, the lesson here is if you want health insurance in America, you have to be poor.)
After reading online forums about mommies and babies, I called my Ob-Gyn’s office and asked for their advice. Their billing department suggested I contact the hospital I had my daughter at, because they had a specific clinic that catered to the uninsured, which had an Ob-Gyn office. At first I was a little hesitant, but when they said that my specific Ob-Gyn doctor, whom I loved, worked there a few mornings a week, I was sold.
When I spoke to the financial department at my hospital, it turns out they have a financial assistance program for the uninsured.
After sending in some paperwork and a few paystubs, I was able to get 50% of any medical bill that went through their financial system, which included the Ob-Gyn clinic. The 50% off would even apply after I got insurance through the healthcare exchange in January 2016, which was four months away.
Being the numbers driven person that I am, I asked what the typical prenatal appointments and procedures cost, and started crunching numbers. Drawing back on the prenatal appointments when I was pregnant with my daughter, the first prenatal visit includes an ultrasound ($400), papsmear ($591), and initial bloodwork ($850). Of course, there was also the doctor ($470), and the specialist to analyze the ultrasound and tell the doctor what it showed ($170). The ultrasound specialist is a separate charge from the hospital system, thus not included under the “charity discount”, the nice name the hospital financial department gave my 50% discount on the bill. So, the total for the first prenatal visit should come to $1325.50 (50% of $400+$591+$850+$470, plus the $170 for the radiologist, without any discount), assuming a low risk pregnancy and no complications.
The next two prenatal visits, about 12 weeks and 16 weeks, are $116 each, plus the doctor to listen for the heart beat and ask how I’m feeling, $470 each, making each one $586.00. Taking off the 50% makes each one $293.00.
That brings us to the 20 week mark, halfway through the pregnancy, when it’s time to check for the gender and more blood tests. Since that would have been January 2016, when I would have been able to pick up insurance through the healthcare exchange, I didn’t bother calculating the costs. But the financial department did tell me that a C-section without any complications is around $11,500, which includes the hospital stay and doctor, but not the anesthesia.
The estimated cost for the first three prenatal visits totals $1911.50 ($1325.50 + $293.00 + $293.00).
Compare that to the estimated cost of carrying health insurance for the entire year. When I checked the health care exchange at the end of 2014, the lowest premium was around $350 a month, making the annual cost $4200.00.
Based on those numbers, it was definitely worth the risk of not getting insurance. As long as you don’t have any complications, or end up in the emergency room like I did. I ended up miscarrying, which is not a story for the faint of heart. I had an ambulance ride to the ER, and an overnight stay at the hospital so that I could get a blood transfusion. Good thing I had the 50% charity discount.