Pregnant and Uninsured in the US -- help!
June 30, 2015 9:30 AM   Subscribe

I am not irresponsible! I am a US Citizen who lives in a European country, where I am on state health insurance. We are back in the US for three months, and have temporary, emergency health insurance here. (We are not eligible, as non US residents, for ACA insurance.) I find myself unexpectedly but happily pregnant, with a few more months in the US to go before we return. How do I get prenatal care?

We are not low-income (I don't make much money as a freelancer but my husband makes a decent salary). We will be in MA, Washington, D.C., and NC over the course of the summer. I think from past pregnancies (this will be my third) that I would need at least one prenatal appt and one ultrasound by the time we return (when I would be about 14 or 15 weeks as far as I can tell.)

We COULD go back home earlier, I guess, but that would be a bummer for a million reasons, and quite expensive. But I imagine getting prenatal care out of pocket here is going to be ridiculously expensive (thousands, yes?) Is there any way to do this I'm not thinking of?

Throwaway email:
posted by anonymous to Health & Fitness (11 answers total) 1 user marked this as a favorite
Both of my kids were born at DC's Family Health and Birth Center, which I cannot recommend enough. They provide excellent prenatal care on a sliding scale to the uninsured. Staff is caring and deeply committed to healthy kids, families, and social justice.
posted by ryanshepard at 9:34 AM on June 30, 2015 [1 favorite]

It might not be thousands - you can call doctors, etc., and ask for pricing information if you're paying out of pocket. Prices will vary WILDLY, though. Like, one place might charge 4 or 10 times as much as another. I know nothing about Healthcare Bluebook but it purports to give you a typical price for different types of services in different areas.

I really think you stand a good chance of doing this for under $1000 if you shop around.
posted by mskyle at 9:47 AM on June 30, 2015

I'd give Planned Parenthood a call. If they can't actually help, they might be able to give you a referral. Some Planned Parenthoods are more grim than others. And there might be protesters but it's kind of fun going there for non-abortion services and having people tell you not to kill your baby ("I HAVE A YEAST INFECTION YOU ASSHOLES").
posted by kat518 at 10:30 AM on June 30, 2015 [5 favorites]

Sometimes (not always, but sometimes), docs will let you pay out of pocket at a reduced fee, knowing they won't have to bite off stuff due to insurance or whatever. When I worked in an office we did this semi-often especially in needy circumstances. Not all of healthcare is totally heartless. :)

Also, don't know if you're high risk in any way but many OB's won't do an US until 18-20 weeks for the full fetal survey anyways, unless there's some risk factors or they need to get more precise dating on how far along you are in pregnancy. Often they won't do your first appt until around 10 weeks as well. I'm in MA and I am on an HSA plan so I get all my med bills in itemized format - I know my prelim 1-hr appointment for med history was billed to insurance for around $350, of which 270-something was "allowed" by the insurance company, so the office bites off the remainder of that charge. If if you are planning to be back home around 14 weeks you may be able to visit a provider here for a health history and a listen o the baby's heartbeat by Doppler and perhaps a bedside ultrasound (less involved, just your OB or NP checking out baby for size and a heartbeat flicker without a radiologist's interpretation) for a relatively affordable price and leave the rest of your prenatal stuff until you get back home.

Congrats and hope you enjoy your stay in the US despite our overly complicated HC system! :D
posted by takoukla at 10:34 AM on June 30, 2015

Another option, if you're low-risk, might be to find a midwife for prenatal care.
posted by Ms Vegetable at 10:52 AM on June 30, 2015 [3 favorites]

It might just be cheaper to fly back to Europe for your regular Dr. visits.
posted by Mr. Big Business at 11:00 AM on June 30, 2015

Before 14 weeks or so you would just be seeing a regular family doctor, not an ob so I agree it's best to just call around and find someone who will see you for a reasonable fee.
posted by betsybetsy at 11:07 AM on June 30, 2015

Seconding Planned Parenthood - if they can't help you for a reasonable fee, they'll know who can. I had a high-risk second pregnancy, and had only one visit and one ultrasound (dating scan) by the time I was 14 weeks along, so I don't think you'll really need all that much care before you leave the states.
posted by peanut_mcgillicuty at 11:11 AM on June 30, 2015

Do you have a GP or OB in your home country? I would call them and see what they suggest you need by way of care. Also, call your travel insurance company and see what they cover.
posted by kjs4 at 5:51 PM on June 30, 2015 [1 favorite]

Pregnancy is a special circumstance for getting ACA insurance. It might be worth going on or calling to see if you can get anything.
posted by bearette at 7:24 PM on June 30, 2015 [1 favorite]

We will be in MA, Washington, D.C., and NC over the course of the summer.

Are any of these to be your base while you are here? If so, then it would be reasonable to try to find one center/OB who would handle your first trimester care such as base line blood work, sonograms, and any emergent issues such as bleeding, etc. But if you instead need a center/OB in three different areas, then it might be worth investigating flying back around 10-12 wks for a visit with your caregiver there.

Also your European caregiver or another contact may be able to provide a rec to an university based clinic; many of these such as Hopkins, for instance, are used to dealing with international patients who come to the US for specific treatments or are here with partners who are undergoing medical/research training at the institution.
posted by beaning at 7:42 PM on June 30, 2015 [1 favorite]

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