How to get the most out of your pregnancy health insurance

28 06 2011

Hey, everyone! Thanks for checking out my first post! I wanted to  start writing about something that was relevant.  That was helpful. So I decided to start writing about something that has become an ever present obsession in my life lately: saving money. That includes saving money doing awesome things like going to museums, shows, festivals, skiing, vacationing, and shopping. And also figuring out how to pay for the everyday necessities. Like groceries, books for school, and bringing a child into the world.

I found out some months ago that I was pregnant. I had this picture in my head that the only reaction I’d ever have when the positive lines came up on the stick would be uncontainable excitement. But when I saw the surprising confirmation on that thing I had just drenched with my own urine (the first of many disgusting realities of pregnancy,) the only thing I felt was fear.

I was with a great guy. Still am. Who supports me 100%. Who couldn’t be more excited about having a child. I am extremely lucky. But I was paying a lot of money for really poor health insurance just for myself and struggling to pay bills each month while working 40 hours a week at a job that already took a lot out of me. I had no idea how I was going to get through my pregnancy with all the prenatal appointments, hospital costs, baby gear, and then take care of the baby after all was said and done. I didn’t want to go on welfare. I’ve always had this social stigma against it. I confused any use of the system as all out abuse.

But you know what I learned after I saw those pink lines come up? HUMILITY. A child was coming into this world, and it was my responsibility to take care of them the best way I could. And if I had paid all those tax dollars to programs like these, I couldn’t allow my guilt and pride to get in the way of a program that could help take the best care of my child as I could. So I applied for state sponsored health insurance. And in this part of the country, it was confusing. And no one wanted to or could help me figure it out. After tons of phone calls and hours of sifting through paperwork, I figured a lot of it out. And now comes the practical part of my blog entry: sharing what I’ve learned about state-sponsored health insurance for pregnant women in Pennsylvania.

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Step 1:  Apply

The first step is just applying. You can do it online or at your welfare office. PA’s compass website has links where you can find out if you qualify and apply. If you’re confused about whether you qualify or not, just apply. It can’t hurt. Shortly after you will receive a letter and/or phone call from the welfare office requesting documents proving your identity (two forms of I.D. unless you have something like a passport,) pregnancy confirmation paperwork (which you can obtain from a doctor, or someplace like Planned Parenthood or Adagio Health for cheaper options if you don’t currently have insurance,) pay stubs for the past month, rent/mortgage paperwork, and possibly current utility bills. If you’re applying in person, I would highly recommend bringing all this paperwork with you when you go down to apply.

Step 2:  Choose a Plan

Then you either get approved or disapproved. If you’re approved, they send you all this information that really tells you very little. They tell you to pick from these three plans: Gateway, United Health Care (although I am fairly certain they are in the process of changing their name,) and UPMC. BEFORE YOU PICK YOUR PLAN, MAKE SURE YOUR OB ACCEPTS IT! Not just your OB, but whichever hospital they deliver at. You should be provided with a list that tells you which of these plans are accepted at which hospitals in your county. If you’re not, just ask your doctor’s office. They know which insurances they accept. I chose Gateway because I knew people who had used it with no problems and my doctor and hospital accepted it.

Step 3:  USE YOUR PLAN!

I’m all about utilizing every aspect of my plan. My prescriptions have very low co pays. Like $1 low. The other two plans are very comparable. On top of that, Gateway has a program calls MOM Matters. Make sure you are signed up for this! Make sure Gateway knows you are pregnant! All you have to do is go to all of your prenatal appointments (which you’re doing anyways) and then they give you your choice of an infant car seat, a stroller, or a pack ‘n’ play. In addition, they provide you with a breast pump if you are breastfeeding. They either have forms at your OB’s office, or, if they don’t, you can call Gateway and request that they get one to you or the doctor. UPMC has a similar incentive program, only instead of being called “MOM Matters,” its called New Beginnings. I am not sure if United Health Care offers an incentive program for mothers-to-be, but I would call and ask.  You and the baby will be covered until six weeks after the birth.

Helpful Links & Numbers

Compass Website
Gateway Health 1-800-392-1147
UPMC 1-800-286-4242
United Health Care 1-800-414-5349

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