If you’re pregnant and don’t have health insurance, you probably feel vulnerable and overwhelmed. While individual health insurance plans that include maternity coverage are available through the Affordable Care Act's health insurance exchanges you can only enroll in those plans during open enrollment.
If you missed Obamacare open enrollment, certain circumstances will give you another chance to enroll. See "I Missed Obamacare Open Enrollment. What Now?"
What follows below are alternatives if you need maternity insurance now, if you're not eligible for insurance through Obamacare, or if you'll have to wait until next open enrollment to get an Obamacare plan but need prenatal care before then.
Local Health Department
Your first stop should be your local Health Department. Many Public Health Departments provide maternity care. Usually these services are limited to low income people, but if you don’t meet the income criteria, they can still provide a wealth of information on what other resources are available in your area. Use this tool to locate your local Health Department.
Community Health Center
Community Health Centers provide affordable care to people with limited access to healthcare. While they don’t provide maternity insurance, they do provide comprehensive primary and prenatal care with fees based on your income and ability to pay. Since not all communities have one, check to see if there is a Community Health Center near you.
Medicaid is a government program that provides health insurance to low-income people. States differ about who qualifies as a low-income person. If you qualify, Medicaid’s maternity insurance coverage can be retroactive, covering prenatal care you got even before you applied for Medicaid. And, when you qualify, your baby will also be covered when it’s born.
Medicaid allows enrollment all year long so you're not constrained by an open enrollment period.
Children’s Health Insurance ProgramThe Children’s Health Insurance Program provides health insurance to uninsured children, but in a few states, it also provides maternity insurance. Although it focuses on people who can’t afford health insurance, CHIP programs allow higher incomes than Medicaid does. Even if you don’t qualify, your baby might qualify when it’s born. Like Medicaid, CHIP allows enrollment all year long.
About 180 hospitals and health clinics are obligated to provide free or low-cost care because they accepted grants or loans under the Hill-Burton Act. Go to the admissions office of one of these facilities and tell them you want to apply for Hill-Burton free or reduced-cost care. You’ll need to meet low-income requirements, but you don’t have to be a US citizen.
The facility is only obligated to spend a limited amount of money each year on Hill-Burton care, so you’ll have to use their services before that year’s money is gone. This covers the hospital’s charges, but not necessarily the doctor’s charges since it isn’t truly maternity insurance, it’s a type of charity care.
Charity Care Organizations
Organizations like Catholic Charities and Lutheran Services offer programs to help women with maternity care. Services vary by location. Basic services include counseling and referrals. But, some locations provide services as extensive as maternity homes that provide free maternity care, postpartum care, parenting classes, and room and board. At the least, they’ll educate you on what other resources are available in your local area.
Young Adult Coverage Under a Parent’s Group Policy
If you’re less than 26 years old and don’t have health insurance from your job, you might qualify for coverage under your parent’s insurance. Even if you’re married or living on your own, you can be included in the health insurance your parent gets from his or her job. You might have to wait until open enrollment to sign up. Make sure the plan offers maternity insurance coverage.
Planned Parenthood isn’t just for birth control and abortions. Some, but not all, Planned Parenthood locations provide prenatal services. Some, but not all, Planned Parenthood locations base their charges on your income. If your local Planned Parenthood doesn’t provide prenatal care or have a sliding-scale fee structure for self-pay patients, they’ll be able to refer you to other resources within your local community.
Negotiate a Self-Pay Rate
If you end up paying out of pocket, negotiate discount rates in advance and set up payment plans. Frequently, hospitals have a rack rate, a self-pay discount rate, and an even lower charity rate. If you don’t ask about the charity rate, they might not volunteer it. Asking what the charity rate is, as well as how to qualify for it, will help you negotiate because you’ll know the bottom line, even if you don’t qualify for it.
Discount Medical Plan Organization
If negotiating your own self-pay discount scares you, you can work with a Discount Medical Plan Organization. These companies provide pre-negotiated discounts to their members for a monthly fee. This isn’t true maternity insurance since you’re paying the doctor and hospital yourself. But, the discount has already been negotiated for you by the DMPO. Before you enroll, make sure your doctor and hospital participate as many plans have a severely limited selection of participating health care providers.