Medicad.... who is it meant for??

[passthesalt]

Hello, I am new to this forum, my boyfriend got me hooked when I saw some of the topics on here I wanted to get my own account and get my opinions on some of the topics that interest me...

I am a college student who is currently pregnant, I had no health insurance when I found out we were expecting because I wasnt planning on getting pregnant. I have heard so many different stories as to why we have Medicad, and I figured since this is a political site I would ask, "who is Medicad meant for?" I am going to school to better myself and the future of my offspring, but because of that I do not have the means to pay for health insurance because health insurance prices are outrageous to someone who works part time and goes to school. PLUS if you are pregnant no insurance company will take you because it's a "pre-exsisting condition" since when is pregnancy a bad thing?

So when I was talking to my parents and my future parent in-laws, all of which are VERY conservative, are not happy with the fact that I am on Medicad. However, when I asked if they wanted to pay for my medical bills, they didn't want to. So I ask again, who is the Medicad program for?

[sgdp]

Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law.

Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant.

Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups. Low income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the TANF program or from the SSI program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses.

http://www.cms.hhs.gov/MedicaidGenInfo/

Children under age 6 and pregnant women whose family income is at or below 133% of the Federal poverty level. (The minimum mandatory income level for pregnant women and infants in certain States may be higher than 133% percent, if as of certain dates the State had established a higher percentage for covering those groups.) States are required to extend Medicaid eligibility until age 19 to all children born after September 30, 1983 (or such earlier date as the State may choose) in families with incomes at or below the Federal poverty level. Once eligibility is established, pregnant women remain eligible for Medicaid through the end of the calendar month in which the 60th day after the end of the pregnancy falls, regardless of any change in family income. States are not required to have a resource test for these poverty level related groups. However, any resource test imposed can be no more restrictive than that of the AFDC program for infants and children and the SSI program for pregnant women.
http://www.cms.hhs.gov/MedicaidEligibility/03_MandatoryEligibilityGroups.asp#TopOfPage

It depends what state you live in, but it's intended for low-income persons.

[EmmanuelGoldstein]

Regardless, please look into this:

http://www.fns.usda.gov/wic/

Excellent program.

[ValricoKate]

Hello, I am new to this forum, my boyfriend got me hooked when I saw some of the topics on here I wanted to get my own account and get my opinions on some of the topics that interest me...

I am a college student who is currently pregnant, I had no health insurance when I found out we were expecting because I wasnt planning on getting pregnant. I have heard so many different stories as to why we have Medicad, and I figured since this is a political site I would ask, "who is Medicad meant for?" I am going to school to better myself and the future of my offspring, but because of that I do not have the means to pay for health insurance because health insurance prices are outrageous to someone who works part time and goes to school. PLUS if you are pregnant no insurance company will take you because it's a "pre-exsisting condition" since when is pregnancy a bad thing?

So when I was talking to my parents and my future parent in-laws, all of which are VERY conservative, are not happy with the fact that I am on Medicad. However, when I asked if they wanted to pay for my medical bills, they didn't want to. So I ask again, who is the Medicad program for?

If you and your bf are sharing the same ip you may want to check in w/ the mods and let them know, otherwise it may come up as an issue later.

[jungulator]

IPLUS if you are pregnant no insurance company will take you because it's a "pre-exsisting condition" since when is pregnancy a bad thing?


It is illegal for them to classify pregnancy as a pre-existing condtion.

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

Are there illnesses or injuries that cannot be subject to a preexisting condition exclusion?
Yes, as follows:

*

Pregnancy, even if the woman had no prior coverage before enrolling in her current employer's plan.
*

Conditions present in a newborn or a child under 18 who is adopted or placed for adoption (even if the adoption is not yet final), as long as the child is enrolled in health coverage within 30 days of birth, adoption, or placement for adoption. In addition, the child must not have a subsequent, significant break in coverage (defined as 63 days). For instance, a significant break might occur if a parent lost his job and health coverage for himself and his family shortly after a child’s birth. This break will be discussed in the Creditable Coverage section.
*

Genetic information. For example, if a woman is found to have a gene indicating she is at a higher risk for breast cancer, she cannot be denied coverage if there is no diagnosis of the disease.

[passthesalt]

If it is illegal then how come no insurance company will cover you if you are already pregnant? I know with some insurance companies you have to be with them for one year before you get pregnant because then they will not cover it. How is that fair?

[passthesalt]

If you and your bf are sharing the same ip you may want to check in w/ the mods and let them know, otherwise it may come up as an issue later.

Thank you, we will!

[jungulator]

If it is illegal then how come no insurance company will cover you if you are already pregnant? I know with some insurance companies you have to be with them for one year before you get pregnant because then they will not cover it. How is that fair?

They aren't supposed to. I don't know what course to take, that's better answered by an attorney, but under HIPAA they aren't allowed to count that.

[johnrocks]

I guess it's for college kids who decide to engage in sex and get pregnant and we,the taxpaying public,is there to help you out with your little bundle of joy.

[cutbucket]

When I was pregnant, I had to get temp dissability, because the painters union does not have maternity leave. It was only for 6 months then it ran out.

[jimjames418]

If it is illegal then how come no insurance company will cover you if you are already pregnant? I know with some insurance companies you have to be with them for one year before you get pregnant because then they will not cover it. How is that fair?
Most insurance companies require coverage for 270 days prior to the birth for the insurance to pay for the delivery. But the baby can be added to the policy if paperwork is completed within 30 days of birth.

[jimjames418]

I guess it's for college kids who decide to engage in sex and get pregnant and we,the taxpaying public,is there to help you out with your little bundle of joy.
Now John, you know we are supposed to pay all the bills for everyone who fails to take responsibility for themselves. And we are supposed to smile and say we like it. :think:

[passthesalt]

I don't want to "take advantage" of the Medicad program, because I have also been employed since I was able to work. I do however feel that the people that do take advantage of the system give EVERYONE who uses it a bad rep. I mean, I am going to school, me and my boyfriend have been together for 7 years, he is in the transition of taking over the family business, but at the same point we don't have 20,000 dollars lying around either to pay for the medical bills upfront. He is starting over from rock bottom too. Both of our parents are "well off" as some people would put it, but even they don't have that kind of money lying around. I figure as long as I am doing something to better myself in the future instead of milking the government I am ok. however, people who I do talk to look down on me for being on the program. I mean am I supposed to have my baby in back alley? As a tax payer myself I realize that these programs are here to help out certain individuals who can't afford it, but I still feel like people look at me and are like "there goes another low life just trying to have the government pay for everything."

[johnrocks]

Having a baby doesn't cost $20000 if it's a normal procedure, this reminds me of the Wall Streeters, let's be able to party like it's 1999,let's be able to make as much as possible,don't want to share the rewards but we need "Uncle Sammy" there to protect us from undue risk. Don't have the money then don't do the deed is my advice.

[passthesalt]

Now John, you know we are supposed to pay all the bills for everyone who fails to take responsibility for themselves. And we are supposed to smile and say we like it. :think:

So I am understanding that you have never had to take any kind of help from any governmental program? Such as student loans? Trust me, I know plenty of people who should NOT be having kids, but who am I to judge them? I think it's equally unfair for you to sit there and say that we have to to pay the bills for everyone who "fails" to take responsibility.... And you have been responsible your whole entire life? And I am sorry, I did not know that having a baby was a sort of failure.

[passthesalt]

Having a baby doesn't cost $20000 if it's a normal procedure, this reminds me of the Wall Streeters, let's be able to party like it's 1999,let's be able to make as much as possible,don't want to share the rewards but we need "Uncle Sammy" there to protect us from undue risk. Don't have the money then don't do the deed is my advice.

Have you had a baby? The prenatal visits, the hospital stay, the ultrasounds.... they all add up. Do some research on the prices of prenatal care and the actual delivery and don't tell me it doesn't add up, and that's not counting the care after the baby is born for their first visits to the doctor.

So let me get this right, are you saying that pell grants for college students are a bad thing too? Isn't that in a sense taking advantage of the government? That is governmental money that as TAX PAYERS we also pay for... For the students who grew up in a poor home, are you saying we shouldn't allow them to go to school and better their lives?

[johnrocks]

Have you had a baby? The prenatal visits, the hospital stay, the ultrasounds.... they all add up. Do some research on the prices of prenatal care and the actual delivery and don't tell me it doesn't add up, and that's not counting the care after the baby is born for their first visits to the doctor.

So let me get this right, are you saying that pell grants for college students are a bad thing too? Isn't that in a sense taking advantage of the government? That is governmental money that as TAX PAYERS we also pay for... For the students who grew up in a poor home, are you saying we shouldn't allow them to go to school and better their lives?

College is high because of government loans and pell grants, people used to didn't have to get loans to go to college, I'll be 48 in 2 weeks and I got through 4 years without a loan, I worked, my Parents helped, I didn't go to Harvard or Princeton but I got a good education at La. Tech University, Terry Bradshaw and Karl Malone,good enough for them,good enough for me. Yeah, I know about kids,got one, you need to get your priorities in line, go to school,get your education,get your career going,get married,start a family, you put the wagon in front of the horse.

Good luck though, I mean that.:hug:

[stoked]

It is illegal for them to classify pregnancy as a pre-existing condtion.

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

Yeah but you know what they'll do is say that your application was rejected because you once wore a bandaid. Unfortunately, they can get away with whatever they want. You know, if the government wanted to fix things, all they'd have to do is make insurance like any company group policy, where they can't reject anyone.

[foxgurrrl]

Regardless, please look into this:

http://www.fns.usda.gov/wic/

Excellent program.

I was just going to say this. ;)

And it's true. You can get free milk, cheese, cereal, eggs, peanut butter, beans, etc. for being pregnant so your baby will get nutrients and after the baby is born, you can get formula for him/her.

[gb2004]

I guess it's for college kids who decide to engage in sex and get pregnant and we,the taxpaying public,is there to help you out with your little bundle of joy.

:)):))

[foxgurrrl]

I don't want to "take advantage" of the Medicad program, because I have also been employed since I was able to work. I do however feel that the people that do take advantage of the system give EVERYONE who uses it a bad rep. I mean, I am going to school, me and my boyfriend have been together for 7 years, he is in the transition of taking over the family business, but at the same point we don't have 20,000 dollars lying around either to pay for the medical bills upfront. He is starting over from rock bottom too. Both of our parents are "well off" as some people would put it, but even they don't have that kind of money lying around. I figure as long as I am doing something to better myself in the future instead of milking the government I am ok. however, people who I do talk to look down on me for being on the program. I mean am I supposed to have my baby in back alley? As a tax payer myself I realize that these programs are here to help out certain individuals who can't afford it, but I still feel like people look at me and are like "there goes another low life just trying to have the government pay for everything."

Don't let anyone get you down. I had a baby six months ago and am a single mom. I was on WIC. I also served in the army and have done community service and contributed to society, so if I need a helping hand, I don't feel guilty at all. I did have insurance because of the army -and I still do because I am in the national guard now - the only reason I signed up was to get health insurance for my daughter, I REALLY did not want to do it :(

If at all possible, try to find a method to pay your own way - OBVIOUSLY. But if you need help, take it. It's there for that purpose. As long as you are not abusing the system, it's there for people who need temporary help.

[passthesalt]

College is high because of government loans and pell grants, people used to didn't have to get loans to go to college, I'll be 48 in 2 weeks and I got through 4 years without a loan, I worked, my Parents helped, I didn't go to Harvard or Princeton but I got a good education at La. Tech University, Terry Bradshaw and Karl Malone,good enough for them,good enough for me. Yeah, I know about kids,got one, you need to get your priorities in line, go to school,get your education,get your career going,get married,start a family, you put the wagon in front of the horse.

Good luck though, I mean that.:hug:

Yeah, and my parents also went to school WITHOUT the help of their parents, so I know what it's like to have to deal with doing things on your own. Who cares about Princeton or Harvard, my point is that at least I am doing something with my life instead of sitting at home living off the government the rest of my life. And yes, don't lecture to me about getting my priorities straight.... I have parents and as far as I am concerned they did a VERY good job raising me. But you know what, we all grow up and make decisions for ourselves, and sometimes it doesn't work like that. And no offense but because you are older the cost of having a child then is not what it is today. And I understand how things SHOULD go, but guess what it's the 21st century and things don't always go the way they should.

[Gabby]

..... PLUS if you are pregnant no insurance company will take you because it's a "pre-exsisting condition" since when is pregnancy a bad thing?
Someone else posted a link with the info about not being able to deny insurance based on pregnancy. From what you have said here, is sounds as though you have not actually tried to get insurance but are talking based on assumptions. If you were turned down based on pregnancy call your state insurance commission and raise hell.
But it sounds to me like you cannot afford insurance anyway who why are you complaining? You have free coverage. That’s better than most of us have… and you have it at the expense of everyone else.
Now about is pregnancy a bad thing. Health insurance companies do not judge it good or bad. It just is. You have stated that it would cast $20,000. Why would an insurance company want to take on a client for say $150 or more a month and yet they will have to lay out $20,000 in short order. The problem insurance companies have is that women will sign up for insurance just to have the baby and cancel once the baby is born. So they never collect enough premiums to even start to pay for their outlay. Surely you can do the math.

[Gabby]

..... So when I was talking to my parents and my future parent in-laws, all of which are VERY conservative, are not happy with the fact that I am on Medicad. However, when I asked if they wanted to pay for my medical bills, they didn't want to. So I ask again, who is the Medicad program for?

They are probably not just unhappy that you are on Medicaid. If they are very conservative the pregnancy out of marriage probably bothers them too. I’m wonder if that’s part of the issue.

You are a college student? Aren’t you on your parent’s medical insurance? I have two children in college. They are both still on my policy at work. They can stay on it until they are 25.

Why your parents pay your bills? You felt that you are adult enough to make the decision to get pregnant before finishing school, before having a good job and before getting married. So obviously you are adult enough to pay the bills of your own making.

Instead of complaining that some people are not really happy about you being on Medicaid, maybe you should be glad that there is a safety net. Others have posted things like WIC. There is help for you.

Here is what is getting tax payers upset these days… something between 50%-70% of all pregnancies are now out of marriage. Most are women with no husband or other man to support her and the child through pregnancy and onward. Most of these women/girls are on programs like Medicaid.

Medicaid is not free… someone has to pay for it. Because these women did not plan right and because the fathers of these children are not taking responsibility for them, we have to pay higher taxes. The children of all us tax payers get less because we have to pay high taxes to cover things like Medicaid and welfare.

I believe that society should take care of those in need…. Those who had things happen to them that were unfortunate or unavoidable. I also feel that people have a responsibility to avoid putting themselves in a bad position so as to not over strain the societal support systems. It seems that many today just don't take that responsibility seriously.

[Mimiheart]

I had three kids, paid out of pocket for all three of them with a midwife. It's not cheap (but cheaper than paying a doctor and hospital out of pocket), and it has to be something you'd be willing to do--no hospital, no drugs... but it was 100% worth it. They will take care of prenatal care and the birth itself.

[EmmanuelGoldstein]

Don't let anyone get you down. I had a baby six months ago and am a single mom. I was on WIC. I also served in the army and have done community service and contributed to society, so if I need a helping hand, I don't feel guilty at all. I did have insurance because of the army -and I still do because I am in the national guard now - the only reason I signed up was to get health insurance for my daughter, I REALLY did not want to do it :(

If at all possible, try to find a method to pay your own way - OBVIOUSLY. But if you need help, take it. It's there for that purpose. As long as you are not abusing the system, it's there for people who need temporary help.
Exactly. I have no problem with these programs that offer help to people in her situation.

[Spiked101]

All i would say is, don't be stingy with others. If you have received help when it's needed, remember that time and give back to others in their time of need.

That is all.

[sircharliebrown]

I don't want to "take advantage" of the Medicad program, because I have also been employed since I was able to work. I do however feel that the people that do take advantage of the system give EVERYONE who uses it a bad rep. I mean, I am going to school, me and my boyfriend have been together for 7 years, he is in the transition of taking over the family business, but at the same point we don't have 20,000 dollars lying around either to pay for the medical bills upfront. He is starting over from rock bottom too. Both of our parents are "well off" as some people would put it, but even they don't have that kind of money lying around. I figure as long as I am doing something to better myself in the future instead of milking the government I am ok. however, people who I do talk to look down on me for being on the program. I mean am I supposed to have my baby in back alley? As a tax payer myself I realize that these programs are here to help out certain individuals who can't afford it, but I still feel like people look at me and are like "there goes another low life just trying to have the government pay for everything."

Have you really looked into private insurance? I'm thinking you haven't. Pregnancy is not considered a "pre-exisiting" condition. But if you had looked into/applied for a private insurance policy, you would know this.

Also, a normal pregnancy doesn't cost even close to $20,000 - Not even if you have a c-section. Something else you would know had you done your homework.

How quickly did you apply for the Medicaid? I have a feeling not long after the pregnancy stick was dry. College student? What about your insurance with your parents. Hmm.....I'm starting to wonder if you saw a free thing (medicaid) and wasted no time at all putting your hand out.

[jimjames418]

So I am understanding that you have never had to take any kind of help from any governmental program? Such as student loans? Trust me, I know plenty of people who should NOT be having kids, but who am I to judge them? I think it's equally unfair for you to sit there and say that we have to to pay the bills for everyone who "fails" to take responsibility.... And you have been responsible your whole entire life? And I am sorry, I did not know that having a baby was a sort of failure.
The only government program I have ever participated in money wise was the GI bill to help fund my college. I got $95 per month for two years. Big deal.

My wife and I have three children, the first was a premie and lived only four days. I had no insurance to cover any of the costs associated with any of the births, or early childhood care of my kids. I paid for it out of my own pocket.

And yes, you are responsible for your condition. You do know what causes pregnancy don't you? And since you are in college I am sure that your high school taught you how to avoid that condition. Safe sex provides protection against things other than STD's.

[EmmanuelGoldstein]

All i would say is, don't be stingy with others. If you have received help when it's needed, remember that time and give back to others in their time of need.

That is all.
Excellent advice :hug:

[EmmanuelGoldstein]

According to a 2003 report by the Agency for Healthcare Research and Quality (AHRQ), a part of the U.S. Department of Health and Human Services, the average amount charged to patients for prenatal and postnatal care was $133 per visit.

Therefore, 14 appointments at a cost of $133 each adds up to $1,862. Tests such as laboratory blood work or ultrasound may add to these costs.


Costs associated with vaginal and C-section births (with and without complications) are as follows:


Vaginal delivery without complication = $6,200


Vaginal delivery with complication = $8,200


C-section without complication = $11,500


C-section with complication = $15,500



Note that these charges are for hospital expenses only, including room charges. Doctor's fees are not included.

------

This is 6+ years old. I'd be willing to bet the cost has gone up since then. When you factor in lab work, ultrasounds and doctors' fees (including any anesthesia charges for epidurals, etc.) you're probably looking at $10,000 minimum, more like $15,000. And that's without any complications or additional diagnostics, hospital services or consults. Without knowing her location and circumstances, $20,000 isn't out of the realm of possibility.

[TexasGreatGranny]

Medic Aid in Texas is for low income people with children (under 24,000.00 a year) most work... Also senior citizens living on SS may qualify for medicaid which is called qmb but it is medic aid. Where I live in East Texas many many doctors will not take patients on medicare alone so seniors would be out of luck if not for medic aid. In Texas if you are on the welfare roles you have to be willing and able to work. They will help you find work and will help with more education if its needed. If you are not willing to put out a little effort, you don't qualify but your children may still get benefits.... including wic