Medicaid, employer plan — choice gets made for you

My husband lost his job last July. I found out I was pregnant in December and got on pregnancy Medicaid. In the meantime, he got a job (barely above minimum wage) with no insurance. He just started a better-paying job two weeks ago, and I am 6 months pregnant. My fear is that when his insurance kicks in at the end of the 90 day period, I will lose my Medicaid, and the remainder of my pregnancy and the delivery won’t be covered. I have a high-risk pregnancy, and I go to my doctor twice a week to have non-stress tests and occasional ultrasounds done. Getting onto his insurance will cost us $300 a month (not to mention the deductible we’ll have to meet), something we can’t afford if we try to move out of my parents’ house.

Do I have any options? Do you think they will take away my coverage completely? Do we need to just bite the bullet and fork over the $300 to get me (and our toddler) on his insurance and hope for the best? Thanks for any information (or hope!) you can give.

Joy in Texas

Dear Joy in Texas,

Your Medicaid will not automatically end when and if you get health coverage from your husband’s employer.  In Texas, if your income is less than $3,222 per month, you would keep your Medicaid as a pregnant woman.

Once the child is born, you would lose your Medicaid coverage.  At that point, your only option would be to join our husband’s company-sponsored plan.  You cannot get subsidies (government help) to buy health insurance from the exchange if you have a group plan offered to you and the plan meets health reform’s minimum standards.

You can postpone joining your husband’s plan until your Medicaid ends.  Losing your Medicaid coverage is a change that will allow you to join your husband’s plan “late”.  At least you won’t start paying the $300 until you absolutely have to.


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.