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Baby Health Insurance California Question & Answers

2013 July 21
by Sarah Fields

Sandy asks…

Im 6 weeks pregnant with no health insurance in california?

Im 6 weeks pregnant, i got my proof of preganancy at a free clinic, i applied for medical.. how long till i know im approved? I work part time, i dont make enough money at all… maybe 400 before taxes. i pay 400 rent, i split rent with my bf that i live with. he has a good job. would that effect my media-cal application? are they going to want my roomates info? and with him being my bf does that make a difference? we are not married so will they still use that?
I do have a job. i work for the city helping kids, but it is part time and they do not offer insurance.

Sarah Fields answers:

Medi-cal looks at the total income in the home and that includes your boyfriends income. Many people cheat the system and say they do not live with their baby’s dad when they really do. That is welfare fraud.

If your boyfriend earns good money you should get married to get his health insurance. You were good enough for him to have a baby with, you should be good enough to be a wife too.

If your boyfriend makes good money then you will not qualify for medi-cal.

Donald asks…

Need to find an insurance that will cover infertility treatments?

Please can anyone help me. I have AETNA as my insurance provider. But it will not cover any infertility treatments. I really want to have a baby. My clock is ticking “35” So I will appreciate any info. I can get. THANK YOU!

Sarah Fields answers:

Actually there are some health insurance policies that cover some aspects of fertility. Unfortunately they vary widely by state. Some states even have laws regarding how much an insurance has to offer for fertility.

“Since the 1980s, 14 states, Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia, have passed laws that require insurers to either cover or offer coverage for infertility diagnosis and treatment. Twelve states have laws that require insurance companies to cover infertility treatment. Two states, California and Texas, have laws that require insurance companies to offer coverage for infertility treatment. While most states with laws requiring insurance companies to offer or provide coverage for infertility treatment include coverage for in vitro fertilization, California and New York have laws that specifically exclude coverage for the procedure.”

– http://www.ncsl.org/Default.aspx?TabId=14391

(from this link you should be able to find laws specific to your state.

If you are paying for your own insurance (not through employer) then there are some things you should remember.

First: DON’T TELL THEM. They can deny you coverage if you do.

Second: A lot of infertility stems from issues that a women might want to resolve whether or not she was to want to get pregnant. Thyroid, Progesterone, nearly any test for hormones.

Third: It’s all about the billing codes. As per #2 up there, learn to ask the right questions, chart your cycle and take it in to your gyno to ask why you don’t seem to be ovulating. If you go in saying “I want my body to work the way it was intended to work” they won’t be able to bill it as infertility.

Fourth: Most insurance that covers things that can really ONLY be related to fertility (IUI’s) are usually only through employers that get the extra package of fertility insurance to lure in couples to the company.

I personally am not lucky enough to be in a state that requires anything to be covered (Florida) HOWEVER I have an amazing OBGYN that is helping be get my hormones in check, which is going to (incidentally) bring me closer to being more fertile. She also doesn’t see anything wrong with using my pap as a time to discuss my ovulation.

Mark asks…

Why dont liberal states have government mandated healthcare?

since liberals always love to praise other country’s that either fund everyone’s healthcare or health insurance or put price controls on healthcare, yet no historically liberal state in the U.S. has any of these policies. California‘s even more liberal than Canada.

My liberal friend alway brags about how cheap healthcare in japan is, yet fails to recognize how much of taxpayers money pays for it.
John S, then why does Japan have government healthcare? If they were a state they would be one of the smallest in the country.
John S, then why does Japan have government healthcare? If they were a state they would be one of the smallest in the country.
you liberals are so dumb. What does the fact that MA has gov healthcare have to do with it? It was promoted and passed my a Conservative by the way.
You Liberals hypocrisy is pointed out and all you do it make excuses, point fingers and change the subject.
tehabwa, He was President, thats the point. Duh!

Sarah Fields answers:

In 2010, Peter Shumlin ran for Governor of Vermont, with single-payer health care on his platform. That’s one of the main reasons many of us voted for him. He was just re-elected this year.

While the health care law was signed by Gov. Shumlin in 2011, it can’t be implemented until at least 2017 because of federal waivers that must be obtained. That’s the answer to your question: some states ARE moving to reform health care, but it takes many years to change the system.

We can’t judge the plan in Vermont yet, because they are not even going to decide on the exact financing of it until 2015, since it cannot be implemented until 2017.

The cool thing about Vermont is that with our low population, we can try out new public policies if the voters support these ideas. When our public policy “experiments” show good results, other states may copy the results. For example, Vermont was the first state to legalize civil unions for gay couples. When Vermont didn’t get burned to a crisp by some angry god, and heterosexual marriage was not destroyed in Vermont, it was clear that civil unions hurt no one, and civil union laws and gay marriage followed in other states.

Even though Massachusetts was the first to reform their health care system, they have pretty much the same plan that Obama signed for the nation, which was designed by the same guy. It is a baby step toward a national single payer plan. In the meantime, Vermont will lead the way in single payer health care, and other states may follow.

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