Insurance Help for Pregnant Women - Jessica's Story

Every day in north-central West Virginia, Jessica goes to work as a dedicated community advocate and program director, working to improve the lives of and provide services for those in her county who struggle to make ends meet. She works to connect them to community agencies who can help find or provide housing, food assistance, parental training programs, and other resources aimed at helping our fellow mountaineers. But sometimes those who help others also need help themselves.

Jessica’s healthcare story began in December of 2017.  She was shopping at Walmart to buy gifts for her community's Angel Tree drive and—without warning—began to vomit. Jessica scheduled an appointment with her doctor and tests were ordered (blood work and HIDA scan).  Around the same time that Jessica was dealing with this unexpected illness, she accidentally missed a January payment for her health insurance by four days.  This meant she had no coverage for the month of January and the scan and medical tests ordered by her doctor added to her past medical debt. Even with insurance reinstated, she had already reached her “maximum amount of scans allotted” by her insurance company so had to pay out of pocket—further adding to her medical debt.  Unfortunately, Jessica was still dealing with that medical debt aftermath when we met her this year.

“I couldn’t pay my car payment because you’ve got doctors bills and copays.  So I had that debt on top of all the medical debt. They ended up repossessing my car.”

Jessica is one of many West Virginians who struggles to afford monthly premiums and deductibles even with the financial help provided under the Affordable Care Act for insurance sold on our state marketplace at healthcare.gov. 

With the joyful news that Jessica was pregnant also came more financial worries about medical bills.  Her health problems and pregnancy require her to have more medical treatments, exams, tests, and blood work completed on a weekly basis. Even as Jessica worried about the mounting bills for medical expenses, she recognized the importance of good prenatal care including ultrasounds for her pregnancy at a cost of $155.00 each.  There was a point in time where a physician even mentioned to her to “quit her job and get Medicaid.”  While we were listening to Jessica tell her story she mentioned, “It’s looking good to quit my job and stay home, get Medicaid, food stamps (SNAP), WIC, and HUD housing.”

As we listened to Jessica's story, we recognized that a new law in West Virginia would help Jessica.  

In 2019, the West Virginia legislature passed a bill that expands Medicaid and Children’s Health Insurance Program (CHIP) coverage to low-income, uninsured pregnant women at new higher income levels.  Prenatal care, delivery, and 60 days postpartum care are covered.  Women with family incomes up to 300% of the federal poverty level are eligible. How much is that? It depends on the size of your family - See this federal poverty level chart. 

Jessica applied for help through this new law that West Virginians Together for Medicaid had worked hard to pass in the recent state legislative session.  Jessica is lucky that the new law was able to save her from "falling off the insurance cliff" — the situation where Jessica's income is "too high" to qualify for Medicaid and yet she still struggles to afford her insurance premiums and copayments for private insurance, and to pay for uncovered services under limits in a private plan. The new law meant Jessica could get the care she needs without the stress of high price tags during her pregnancy and for 60 days after her baby is born. 

Jessica was accepted into the new expanded coverage for pregnant women the first day it went into effect - July 1, 2019.  Thanks to this new law. Jessica can keep working  — which not only provides much needed financial stability to her family but also allows her to continue to help her community and others like herself struggling to make ends meet.

West Virginians Together for Medicaid thanks our legislature for passing this new law that gives more West Virginia families a healthy start and we grateful to Jessica for sharing her personal story.  If you are interested in sharing your Medicaid or CHIP story, reach out to us on Facebook (https://www.facebook.com/WVTFM/) or Twitter @WVTFMedicaid by sending us a message or give our Story Collection Coordinator, Lara Foster, a call 304-702-6708. Your story can help more West Virginians understand how important Medicaid is to our state’s families.

West Virginians Together for Medicaid