Insurance Question

[amyk]

I am probably going to be leaving my job in a month or so, and my husband is self-employed, so we will have to purchase our own health insurance. Do any of you ladies have any positive or negative comments about your companies? We would like to have another baby in the future, and I know it's going to cost a bundle, so I want to make sure we're signed up with a reputable company (IF I can even GET someone to insure me after these last two pregnancies!) I'm curious especially about PHCS, Fortis, Unicare, and Blue Cross/Blue Shield PPO plans. Any help would be appreciated.

Amy

Chloe (8/6/01) 35 weeks, p/e, hellp
Tristan (9/3/03), 32 weeks, p/e and hellp AGAIN

[amandab]

Amy,

We've been on Blue Cross/Blue Shield of Texas, through work and also as individuals. Never had to file any claims when we were briefly covered as individuals. But I have no complaints about the two years we were with them through work. They seem to have a really big network, and we never had any claims processed incorrectly. I have heard if a claim does get processed incorrectly, it is very difficult to get it corrected, but I have not experienced that myself. I also remember that maternity coverage is additional, and it is very expensive. So you'll definitely want to analyze whether you need that or not.

Good luck with your search!!

Amanda

Amanda
~i~ Aidan Timothy
4/14/03 29 wks
Expecting again!!!
EDD 6/13/04

[amyk]

Thanks, that helps. We've applied with PCHS and I had to give my medical history to the agent recently. Mind you, I've never had anything go wrong with me other than these two bouts of p/e/hellp, but after going over all of it with her, plus both kids' NICU stays, all the agent said at the end was," Well,thank you for your interest in our company." I swear I could almost hear her say "anyway" at the end of that sentence! I'm pretty sure I'm about to get denied unless I swear in blood I'll get my tubes tied.

Amy

Chloe (8/6/01) 35 weeks, p/e, hellp
Tristan (9/3/03), 32 weeks, p/e and hellp AGAIN

[julie f]

Amy,

We have Blue Shield of Ca (HMO) and I've absolutely loved it. So far, the bills we have received from my hospital stay and my son's NICU time have been over $100,000 and we have only had to pay $164.70. Unfortunately, my husband's employer is changing as of 1/1/04 so, we'll then be with PacifiCare. Thankful to have it though as we would like another baby as well.

Is it possible that they would cover you for everything excluding pregnancy? If so, maybe you could apply for your state's program to cover the pregnancy related expenses. Also, is your husband a member of any association through his line of work? For example, if he is a contractor, is he a member of a local or national contractor's association? I know many times they will have group insurance plans you can join and that mught be better than getting individual healthcare as my understanding is that you cannot be denied for a pre-existing condition with group ins.

Good luck and let us know what you find out!


Julie
Zachary James, 7/22/03-7/27/03, born at 26 weeks due to severe pe

[amyk]

Hmmm...that's given me something to consider. I hadn't really thought about a professional association group plan. My husband has thought about getting a group plan for his business, but none of his employees want medical coverage. Can you believe it?
All the individual plans I've looked at seem okay, but none of them cover maternity care. One rep told me, "...but we do cover diseases of pregnancy." I certainly don't want to be in a position where I am wishing for p/e!
Thanks again for the help!

Amy

Chloe (8/6/01) 35 weeks, p/e, hellp
Tristan (9/3/03), 32 weeks, p/e and hellp AGAIN

[lgw]

What about COBRA coverage through your employer?

[natan]

I hate to be the negative type,[V] but if you can wait until your husband is working again you might be in better shape. Not all insurances cover all types of procedures, you won't find out how much it costs until after you had it done.

Better safe then sorry when it comes to being insured.

Deborah

[taras mom]

If you're happy with your current coverage, it's worthwhile to look into COBRA.

Carol (38)
DH Bill (40)
Tara Mairichi
12/7-12/9, 2002
The Mightiest Little Angel

[mada]

Hey Amy,
I am not sure how insurance works state to state, but we have Humana and I believe that Maternity is covered with out it even being an option. It's part of the plan. My husband has his own business too and I think the way it works is not how many people want the insurance, but how long he's been in business as far as getting good coverage....We got Humana after I had Sam with PE and he was in NICU as well and they didn't even ask about it!!! So, worth a look into. there website is www.humana.com

Mada Harpster

Sam 6-29-00 36weeks P.E.
Ben 11-03-01 No P.E.

[amyk]

Wow, you guys are great! I knew this was the right place to come for advice! I'm still in the same boat though. I'll just keep working until we find something. I really won't need maternity coverage for a year or two, so we may just go with BC/BS or something like that for the next year.
Mada, my job is switching it's current carrier from United Healthcare to Humana at the first of the year. I'm seriously dreading it, not because of the company, but because neither my OB/GYN nor the kids' pediatrician accept it. I just can't imagine switching doctors, but it looks like it may come to that.

Amy

Chloe (8/6/01) 35 weeks, p/e, hellp
Tristan (9/3/03), 32 weeks, p/e and hellp AGAIN