Pregnancy in one state, delivery in another

I’m in college and got pregnant by accident.  I’m getting pre-natal care and am doing fine.  I plan to finish my classes which end a week or so before the due date.  My boyfriend’s parents want me to have the baby there; they live three hours’ drive away in another state.  My parents have not been supportive at all, and want nothing to do with the situation.  It’s too bad, because they live here in the same state and could be a big part of this.

Here’s the issue: the pre-natal clinic where I’m getting care is planning my delivery.  Can I just show up at another hospital to deliver?  Do I need a doctor where my boyfriend’s family lives ahead of time?  And will my insurance (through my parents) pay for all this?  I want to have the baby with his family because they have been so nice about it, but I have a feeling I’ll have to go to my parents’ where their health insurance will pay for things.  I can’t figure out what to do.

Suffering from Baby Brain

Dear Suffering from Baby Brain,

You have two sets of questions: one about health care providers and another about health insurance.  Let’s tackle them one at a time.

You are correct that having a doctor in your boyfriend’s hometown would be helpful.  By federal law, a hospital cannot turn away a patient who is in active labor.  So, while you can “just show up” at a hospital, it would be better to have a doctor on hand who is familiar with you and your pre-natal care.

Ask your boyfriend’s family to help you find an obstetrician, and go and see him or her for a visit.  Your pre-natal clinic can forward your files and help you and the doctors (or midwife) plan your delivery.  Assuming you will be returning to school, you will need that clinic for other care in the future.

Now for the health insurance question.  Your plan through your parents is paying for your pre-natal care, but there may be restrictions on how it pays for out-of-state providers, or for providers who are not in their “network”.  Your first step is to call the toll-free number on the back of your ID card and talk to a customer service representative. Or you can go onto the insurer’s website and look for a directory of participating providers.  Either way, you need to find out whether the plan pays for providers in your boyfriend’s state.

It’s important to find out what your health insurer will or will not pay for before the Big Day.  You may need to get an approval before going to the out-of-state hospital; this is often called “Prior Authorization” or “Pre-Admission Certification”.  Or, you may find out that the plan does not pay for out-of-state providers or providers who are not in their network.  Once you know, you can decide what to do.

The important thing is for mother and baby to be well.  The grandparents can visit, babysit, and goo and gah to their hearts content after the baby is born!

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.