I’m dealing with a frustrating situation and looking for advice. I’m based in Missouri, and the Mercy hospital network is going out-of-network with Anthem/BCBS starting January 1st. This affects over 500,000 people, and unfortunately, I’m due to give birth in early January.
I’ve spoken to both Mercy and BCBS, and they confirmed I could file for a continuance of care, which would allow me to stay covered in-network for my delivery. However, I learned that the continuance of care would only apply to me—not my baby, who would be considered a new member.
The Mercy hospital requires a minimum 48-hour stay for both me and baby. Without in-network coverage, we could face a huge bill. I’m trying to figure out my options:
Should I consider switching hospitals to one that’s still in-network? Finding a new OB so close to my due date could be challenging.
Are there any loopholes or options to get baby covered? Could baby be enrolled in Medicaid or CHIP to help with coverage?
We’re a single-income household with an EPO plan through Boeing, and BCBSIL is the only insurance offered. Out-of-network, we’d have to pay every penny out of pocket, with a family out-of-pocket max of $14,700. We could change plans, but out-of-network would still require us to pay at least 40%.
To complicate things, there’s a possibility of a layoff in mid-January, which would leave us without coverage in February.
Any advice on whether to switch hospitals, insurance, or just try to work within our plan would be greatly appreciated!
Sorry you’re dealing with this stress. If baby isn’t covered, it may be best to look into delivering at an in-network hospital to avoid financial strain. Maybe your OB could refer you to someone with privileges at an in-network hospital.
@Brice
This is tough because I was planning on a natural birth with midwives at Mercy. I’ll discuss options with the birthing center and my doula to see if they can help.
You could look into enrolling baby in a healthcare.gov plan that includes Mercy in-network instead of adding baby to your employer’s plan. This could help if baby isn’t eligible for in-network coverage through BCBS.
North said: @Ridley
Is that possible? I didn’t realize baby could be on a different plan than us.
Yes, it’s possible! Anyone who qualifies can be on their own plan. Depending on income, baby may also qualify for CHIP or Medicaid, which can be affordable options. If you go this route, just be sure to get the hospital baby’s insurance info as soon as possible.