Should I switch my wife from my COBRA plan to Medicaid?

Question

My wife is 6 weeks pregnant and we are currently under the COBRA plan from my previous employer. The COBRA monthly payment is very high and I am not sure when I am going to get another job. So I am planning to enroll my wife under Texas Medicaid Star program in order to reduce my monthly payment. Is this a good idea or should I just stick with COBRA. Does Medicaid pay for all procedures before and after pregnancy ? What about complications during the delivery ? Does Medicaid pay for it? Are there any surprises we should know about if we were to use Medicaid ?Also, what is the quality of doctors and hospitals who accept Medicaid versus non-Medicaid ?

Answer 1

If it's medicaid through CHIPS, here in TX you have to be uninsured for six months before you can go on it.  That's a pretty big surprise.

Also, not all hospitals or doctors will take Medicaid.  Quality of care is going to depend on where you are located.  Here in Houston, we have a lot of uninsured (illegal) women giving birth in the county hospital, I would strongly recommend you try to avoid it - recovery is six women to a room, and a lot of women give birth in the halls, as they do 3,000 babies a month.

Answer 2

Knowitall had some good statements but doesn't know it all. There are no short term medical policies that include maternity, and the permanent individual policies that do include maternity will not accept a pregnant woman so an individual plan is not an option for you.

Medicaid is based on income. In my state a couple must make less than $2200. You can check your states' Medicaid department for information and income limits.

Medicaid will pay for all procedures and complications but most states have a sliding scale based on income on how much they'll pay.

Many doctors will not accept Medicaid so you'll need to check to see if her doctor accepts it. The doctors that do give you the same treatment they give other patients. That is not always the case with the staff, however.

Answer 3

COBRA is a joke.

Answer 4

If you qualify for Medicaid, i would use the Medicaid.  It will cover your wife and the baby after the birth and any complications.  Funny, u ask about the quality of the physicians...just bcuz the doctor accepts Medicaid it does not make the quality of the service, or the physician any less....there are more physicians that accept Medicaid than physicians who do not.  Almost all hospitals accept Medicaid also....good luck

Answer 5

Medicaid is administered by each state, so the answers to your question vary by which state you are in. It would be cheaper to be on Medicaid than under COBRA, if she qualifies for it. If you can afford to get the child into the state children's health insurance plan (SCHIP) that would be a good idea if Medicaid doesn't work out. You should also look into WIC (Women, Infant, and Children Nutritional Plan) in  your state to help out with the food bills.

Answer 6

You have a few options:

1.  Ask your former employer if they have any other medical plans that cost less--when the active employees go through open enrollment, you and your wife can change, too.

2.  Some states require you to exhaust COBRA before you can go on a state sponsored health program. Be sure to ask about this before you terminate her COBRA.

3.  Some states will help you pay for COBRA, instead of putting her on Medicaid.  Ask about this at Health and Human Services.

4.  I've heard that Medicaid, in some cases, only pays 50%--you might want to check that out, and determine if staying on COBRA will be cheaper!

5.  Yes, some doctors will not participate with Medicaid--ask her current doctor before she switches.

6.  Also, is there any chance at all that you lost your previous job due to foreign competition?  If so, there is a federal subsidy for COBRA that you could try for, it's called the Health Care Tax Credit, and it's available if your former employer is or becomes "TAA" certified.  (You can call the Department of Labor about this without getting that employer into any trouble.)

7.  And finally, it is possible to buy a short-term individual health policy, and they are typically much cheaper, although your wife does have a condition that will be factored in.  Look for an insurance agent who works with individual coverage for a quote.

Best of luck--I know that being uninsured is a scary prospect, so you are wise to check out all of your options.