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Paying for Your Pregnancy: Resources for Expectant Moms Living With HIV in the U.S.

November 17, 2012

woman's wallet

Table of Contents


Introduction

Pregnancy is one of the happiest times in a woman's life. There's a lot of joy in motherhood. Unfortunately, along with the joys can come a lot of concerns, many of them having to do with money: Where can I go for quality, low-cost prenatal care? How will I eat right on a shoestring budget while I'm pregnant? What if I'm having trouble affording care, but I make too much money to qualify for many support programs?

Your local HIV/AIDS service organization is a great place to start in your search for affordable services that fit the needs of pregnant women living with HIV. As part of their historic commitment to serving whole families affected by HIV/AIDS, especially women, many community programs funded under Part D of the Ryan White CARE Act will cover or connect you to prenatal care. But even if you don't qualify for Ryan White programs or community food banks, there may still be assistance out there for you.

This article spotlights some valuable programs and resources you can use to help cut some of the costs of a healthy pregnancy.


General Health Care Costs

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Program: Medicaid

Description: Medicaid is a federally funded, state-run program for people who do not have health insurance, or do not have enough coverage. There may be special eligibility for pregnant women and infants in your state.

Who is eligible? The federal government has a set of general guidelines for eligibility. You must either be categorically needy (having an income at or below 133 percent of the federal poverty level) or medically needy (making too much money to qualify based on income, but meeting other expanded-eligibility requirements due to pregnancy). Individual states may have additional requirements for eligibility, so check with your state's Medicaid program before you apply.

What you need to have before you walk in the door: Proof of pregnancy, proof of U.S. citizenship or non-citizenship, and proof of income.

What you can expect: You should receive a list of providers that accept Medicaid. Medicaid will cover all costs associated with pregnancy, delivery, and any complications up to 60 days postpartum. It will also cover prescription medications, including your HIV medications.


Program: AmeriPlan and Other Discount Medical Plan Organizations

Description: Discount medical plan organizations (of which AmeriPlan is the largest) offer discounts on medical, dental, vision, chiropractic and pharmaceutical services. They negotiate with providers to offer services at discounted prices. It is not an insurance plan or medical organization.

How does it work? You pay a monthly fee for a health and dental program based on your and your family's needs. You receive membership cards for each person in your household. Present your card at the time of service at one of the providers that is within the network and pay the discounted price for services rendered.

Will you qualify with HIV? Since this is not health insurance or a health organization, your HIV status should not be a factor.


Pregnant Women and the Affordable Care Act

Check out some of the changes to the U.S. health care system that may be of particular interest to expectant mothers living with HIV:

  • Since August 1, 2012, eight new preventive services have become available through many health plans without additional individual cost, a move which benefits some 47 million women in the U.S. These eight services include screening for gestational diabetes, a serious pregnancy-related condition.
  • If your baby is born with a health condition, no new or job-based health plan can deny or limit coverage to him or her on that basis.
  • Starting in 2014, prenatal and newborn care will be covered under all new individual, small business and Exchange plans.
  • Starting in 2014, so-called "pre-existing conditions," including pregnancy and HIV, will no longer be grounds to deny or overcharge for health coverage.

Read more, or watch a video, about pregnancy resources under the Affordable Care Act.


Prenatal and Postpartum Care

Program: March of Dimes

Description: In addition to providing information on how to have a healthy pregnancy, the March of Dimes also provides free prenatal care in selected states. Bonus: The prenatal care comes to you, to cut down on travel expenses. Check your local chapter for more details.


Program: Planned Parenthood

Description: Planned Parenthood has over 800 care centers across the U.S. It provides prenatal care, pregnancy planning services, counseling and postpartum services. Many of its services are free or low cost, and Planned Parenthood accepts Medicaid.

Will you qualify with HIV? Planned Parenthood physicians are trained in HIV care and can help you manage your HIV medications and pregnancy in a healthy way.


Taking Time Off: New Parents and the Family and Medical Leave Act (FMLA)
FMLA Employee Guide

Here in the U.S., we may not be sitting pretty with multiple months of paid maternity leave as in most other developed countries, but as of 1993, at least we have FMLA!

FMLA is a federal law securing 12 weeks of time off with newborns for parents who qualify, without their having to worry about being fired for it. If your job doesn't offer any (or enough) maternity leave and you're in a position to take unpaid leave after giving birth (and/or before, since prenatal bed rest can be covered), FMLA may be the way to do it.

Not everyone qualifies -- you have to have been working for your employer at least 25 hours per week, for a year minimum, and your company must be large enough to employ 50 people in a 75-mile radius, among other caveats. Take a look at the employee guide on the right, and talk to your boss or your company's human resources official to see if time off through FMLA might be a good fit.


Food and Nutrition Programs

Program: The WIC Program

Description: The Special Supplemental Nutrition Program for Women, Infants, and Children, also known as the WIC Program or simply WIC, is a federal program that funds state-level agencies to assist women and their children in getting vouchers, checks or cards to purchase nutritious foods from participating vendors, including some farmers' markets.

Who qualifies for WIC? Women who are pregnant or in the postpartum period, and children up to age 5, all qualify for the program. Your income must be at or below 185 percent of the U.S. Poverty Income Guidelines ($41,348 for a family of four). Also, you must be determined to be at "nutrition risk" by a health professional due to a nutrition-linked medical concern.


Program: SHARE Food Program and SHARE Food Network

Description: Serving the Northeast and Mid-Atlantic regions of the U.S., these non-governmental programs offer food packages (enough food to last between two weeks and a month) for a low cost and a couple of hours of volunteer service. They are usually in selected churches, community centers, etc. These are not national programs, but you may be able to find a similar program in your area.

Who qualifies to participate in SHARE? Anyone who is willing to pay the low cost (as little as $20) and volunteer the hours can participate. This program is not income based.


Additional Tips for Covering the Cost of a Positive Pregnancy
  • Try to negotiate a payment plan with your provider. Most doctors and hospitals want the best for you and your baby. So if that means working out a payment plan or putting you on a sliding scale for payment, so be it.
  • Check out your local health department for prenatal supplements. Many county and state health departments provide prenatal vitamins for free or reduced cost.
  • If the need arises, explore your state's requirement for Temporary Assistance for Needy Families (TANF). This is another government program created to help supplement the cost of living for women and their children. The qualifications vary slightly from state to state, so be sure to check with your local department of human services to get the details.
  • Got more questions about your health benefits or legal rights as a pregnant woman living with HIV? Ask away! Two of TheBody.com's forum experts -- Jacques Chambers, C.L.U., in the Workplace and Insurance Issues forum and Christa Douaihy, Esq., in the forum on Legal Issues and HIV -- are there to help.


Candace Y.A. Montague is a native of Washington, D.C., and covers HIV news all around the District. She has covered fundraisers, motorcycle rides, town hall meetings, house balls, Capitol Hill press conferences, election campaigns, protests and an International AIDS Conference for The D.C. Examiner.com, emPower News Magazine, the Black AIDS Institute and TheBody.com. One of her two master's degrees is in community health promotion and education. She is also an educator and a mother of two.


Copyright © 2012 Remedy Health Media, LLC. All rights reserved.


This article was provided by TheBody.com.
 
See Also
What Did You Expect While You Were Expecting?
HIV/AIDS Resource Center for Women
More on HIV & Pregnancy

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