Getting Prenatal Care When You Have a Low-income and No Insurance


I think that one of the things that women all over the world tend to be scared of is an unplanned pregnancy. I also truly believe that this is only more true for single moms who already have children, or for the woman who knows that she will be a single mom. It is incredibly important for every pregnant woman to get adequate and early prenatal care, which is a lot easier said than done if you already have a tight budget and no insurance or inadequate insurance.

Medicaid

Even if you were not eligible for Medicaid before you became pregnant, you might be pleasantly surprised to discover that you are eligible now. Medicaid is available in every state in the United States and is a program that is paid for by the federal government. Both uninsured and under-insured women may be eligible for this program, with Medicaid paying all medically approved charges to approved doctors, clinics, hospitals and other medical facilities. If you have existing insurance, Medicaid will often pay what is not paid for by the insurance, so that you would not be required to pay deductibles or co-payments.

Each state has different qualifications for their Medicaid program, but in general, you may be eligible if:

1) You are pregnant, and the total income of your household does not exceed 133% of the Federal Poverty level
2) You are pregnant with an income of more than 133% of the Federal Poverty level, with certain limitations. These limitations will vary by state, but generally require for you to pay a portion of your prenatal medical costs, similar to the deductible and co-payments of traditional insurance.
3) You fall within certain “Special Groups”, with qualifications that can vary dramatically in different states.

If you are pregnant, and need help paying for your medical expenses, it is probably not necessary for you to wait to be approved. You may be able to find a doctor or clinic that would accept you with your application for Medicaid still pending, which would help you to get earlier prenatal care, including your prescriptions for prenatal vitamins. If you can’t find a clinic to help you, you could ask your local social services agency for a referral, or you could see if they would be able to expedite your application.

Regardless, if you are approved, they should be able to give you a temporary Medicaid card within a day or two after the decision was made. Medicaid can often pay for up to ninety days before you applied, so if you’ve had recent medical expenses, send the offices that are billing you a copy of your Medicaid card, along with a brief note advising that you were just approved and would like them to bill Medicaid. However, you will not be paid back for things that you have paid, so try not to personally pay anything for your medical costs unless you have no choice. If you are found not to be eligible for Medicaid, you can always file an appeal, particularly if your recent circumstances changed , besides the pregnancy that was reported in your initial application.

Uh-oh, You’re NOT Eligible For Medicaid…What Now?

If you have been turned down for Medicaid, and you know you need some sort of medical assistance, you may feel like you’re out of luck. That could not be more false! There are a number of facilities that offer medical care, including prenatal care, for free or on a sliding scale. To find the closest one to you, you can call 211 ( if available in your area), visit http://www.211.org/, or again, ask your local social services office. If you still can’t find someone to see you, you could call the local hospitals. They will usually be able to refer you to someone who can see you. Trust me, they see what can happen if a pregnant woman does not get the prenatal care that she needs, and they will usually help you in any way they can to make sure your baby and pregnancy are healthy.

Free Clinics

The phrase “free clinics” is often not very accurate. It is common for free clinics to actually go on a sliding scale, according to your family income and family size. As a result of those guidelines, frequently people who have an income in the middle or even upper range may be able to receive health care at these clinics. Those with a higher income will pay more for their medical care, but you will usually not pay as much as if you were paying full price and out of pocket at a clinic.

You may also be able to get some or all of your necessary prescriptions, including prenatal vitamins, at a discounted price here. If you go here, you will often be seen by medical students or interns, much as you would if you were going to a teaching hospital. That’s often a good thing, as you are being seen by people who are still very enthusiastic about what they are doing and are learning new techniques that could help if you have any complications, while they are being overseen by a licensed doctor with a lot of experience in his or her field. You have the benefit of a lot of enthusiasm, tempered with someone who has seen it all and will not be easily fazed. A free clinic will often run in conjunction with a larger hospital, teaching hospital, or medical school, so if you have one of those near you, you may have just found out where you are getting your prenatal care from.

Churches

So, by now, you probably know that you might be able to get assistance with a lot of things from your church. Help with your electric bill, food to get by till payday, even gas for your car…sure! Did you know you might be able to get your prenatal care there as well? Well, in some communities you might be able to, and hopefully, your community is one that does.

One thing that seems to have become more common in the last decade or two is for churches to either form or host volunteer clinics at least one night or two a month. That is not to say that it is common or expected, but the churches that offer this service are not nearly as rare as they were a few years ago.

You will usually have to go to the church at night on a weekday, and you will be screened. You may be asked to provide proof of your identity, family size, citizenship, income, and your pregnancy. It is not guaranteed that you will be seen the first time that you go. When you are seen, you will be seen by a doctor who has volunteered ( on their own time and for free) to see patients in this unique clinic setting.

Try not to get impatient, even if there is a long wait or you are not seen the first time you go, since volunteer clinics have asked patients to not return, and then you would be back where you started.

At this type of clinic, they will probably only be able to give you the most basic exam, and they may have to ask you to go somewhere else for your blood tests, pelvic exam, or ultrasound. You may also be asked to see the physician again, and occasionally, the doctor you see here may be willing to see you throughout your pregnancy, in his or her office, at a discounted cost. That’s not a guarantee, but I know of at least one person who received that gift. They might also be able to refer you to alternate sources of prenatal or medical care that are unique to your area.

Your Health State Department

Most, if not all states in the United States, provide at least some medical care through the Health Department. You may very well be able to receive the bulk of your prenatal care through your local Health Department for free, or for a very low cost. If you go here, it is probably not going to be like the doctor’s offices that you are used to.

They will usually see people on a first-come, first-served basis, which means you should get there early, bring lunch or a snack, and a book because you could very easily be there for a while. It has been noticed by some people that some parts of the month are busier than others. That means that if you are concerned about the wait, you might consider calling the Health Department to see if they have times that are less busy than others. If they don’t answer when you call, keep calling, this office is notoriously busy and they seem to put answering the phone as a very low priority sometimes.

Prenatal care is the first and best gift that you can give your new baby. It can help you screen for birth defects, as well as treat and prevent problems that can arise during the pregnancy. Besides the obvious rules of not drinking or smoking, prenatal care is the surest way to be certain that in nine months or so, you are able to take your healthy, full-term baby home with you.