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Having a baby without maternity coverage sucks!


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I'm 8 weeks pregnant. I just got off the phone with the receptionist at my new OBs office. There is NO WAY they will let me see the doctor to discuss care until I've completed $600 worth of blood tests! I know what my blood type is, I know I don't have AIDS and I can get my immunization record for them. Nope, that doesn't matter, have to have the tests. I'm seriously considering giving birth to this baby in a field like the pioneers did!

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We had #2 & 3 w/o maternity insurance. They just had us pay $xx/month so that their fee was covered by the 7th (I think) month. I know how you feel about the blood test. Yep, I'm xx blood type, Yep, I had measles, Yep I'm pregnant. :o

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I'm sorry! I don't know how anyone does it. We're having a surprise baby and it's crazy how much things cost even with insurance.

 

This is our 3rd. I had to be tested for HIV and a bunch of STD's when I got pregnant. And apparently there's a law in TX that says that you have to be retested AGAIN at the end of your pregnancy just incase you pick up HIV or an STD while you're pregnant. :confused:

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If they are that unfriendly at the beginning, then I would look for another dr. It is always a red flag for me when the phone/reception staff is not friendly and helpful. Most dr's will have a conference with you at the office to discuss payment arrangements and I have never had to have bloodwork before I actually get an appt.

Joy

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I will 2nd the suggestion to apply for Medicaid. Most states have some sort of special coverage for pregnant mothers, even if they won't cover you before or after your pregnancy. Pleeeease look into this. It will save a lot of headaches, not to mention your health!

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We were self-pay with #4. You can make payment arrangements with the doctor's office. I agree about the blood work. At least you know the price in advance. Mine was $400 that I didn't know about until I got the bill from the lab. For the hospital, as long as we paid in-full before discharge we were able to get a huge discount on the bill. We only had to pay 40% of what was charged. We used a credit card.

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I will 2nd the suggestion to apply for Medicaid. Most states have some sort of special coverage for pregnant mothers, even if they won't cover you before or after your pregnancy. Pleeeease look into this. It will save a lot of headaches, not to mention your health!

:iagree::iagree: I had a homebirth but if I needed a hossy, I had Medicaid just because I was pregnant. When you're not pregnant, they don't care about you :lol:, but when pg you are "disabled" and often qualify.

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I'm sorry! I don't know how anyone does it. We're having a surprise baby and it's crazy how much things cost even with insurance.

 

This is our 3rd. I had to be tested for HIV and a bunch of STD's when I got pregnant. And apparently there's a law in TX that says that you have to be retested AGAIN at the end of your pregnancy just incase you pick up HIV or an STD while you're pregnant. :confused:

 

No such law that I can find. I have had 3 kids in TX and never was tested for STDs.

 

If they are that unfriendly at the beginning, then I would look for another dr. It is always a red flag for me when the phone/reception staff is not friendly and helpful. Most dr's will have a conference with you at the office to discuss payment arrangements and I have never had to have bloodwork before I actually get an appt.

Joy

 

:iagree: I would be finding a NEW new OB. :)

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I called all the docs in my area, explained we'd be paying cash and ask what kind of deal they would give us. THEN I went to the doctor I really wanted, that had originally been the most expensive, and told them the lowest $$ I was offered. She took it! Had to pay payments and be done paying her around 7 months. Also, we didn't tell the hospital that we'd be paying cash until we showed up for birth, otherwise they wanted payments ahead of time too and there was no way we could pay doc and hospital at the same time. BEWARE! Hospital offered us a great deal if we paid a set amount before we left (about 1/2 of what we would have been charged) but if you do an epidural that adds a whole other/separate/very expensive bill. You can waive a LOT of tests but you'll have to sign a paper absolving the doctor of all responsibility if something goes wrong.

Edited by connib
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I refuse almost all of those blood tests because if I can provide previous results (immunization records, blood type, etc.) I don't see the need to be tested again. I've not had any doctor not work with me so I would definitely be looking for a new doctor if one refused to take me without the testing.

 

I wish this testing would come under better control because even with insurance paying 100% I can't imagine how many $ are spent on repetitive tests that are completely unnecessary.

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I don't need Medicaid and I doubt we would qualify anyway. We have a high deductible policy just no maternity coverage. What I need is medical care for a very common situation that a normal working family can afford! I also need a doctor who views me as an individual person and not just a checklist!!

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There are home-birth midwives but there is no way DH will go for it.

 

My DH is skeptical about homebirths, too, but he's also a numbers guy. I would get some quotes from the homebirth midwives to do a cost-comparison with the quotes you're getting from OB's and hospitals. Ask your DH is it REALLY worth paying thousands of dollars more out-of-pocket for a low-risk delivery to be in the hospital with an M.D.?

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This may sound odd, given their reputation nowadays (which is kind of sad, as that isn't what it was when I grew up...), but has it occurred to you to call Planned Parenthood to take care of your 'basic' stuff?

 

They offer all STD testing, blood work, etc., and it isn't expensive.

 

If you have valid tests, you have valid tests. A reputable physician won't stomp their foot and say "no, I'm sorry, that isn't a REAL blood test".

 

They probably also know of decent obstetricians who won't fleece people, too, as they deal with many, many women.

 

 

a

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No such law that I can find. I have had 3 kids in TX and never was tested for STDs.

 

 

Sec. 81.090. DIAGNOSTIC TESTING DURING PREGNANCY AND AFTER BIRTH. (a) A physician or other person permitted by law to attend a pregnant woman during gestation or at delivery of an infant shall:

(1) take or cause to be taken a sample of the woman's blood or other appropriate specimen at the first examination and visit;

(2) submit the sample to an appropriately certified laboratory for diagnostic testing approved by the United States Food and Drug Administration for:

(A) syphilis;

(B) HIV infection; and

© hepatitis B infection; and

(3) retain a report of each case for nine months and deliver the report to any successor in the case.

(a-1) A physician or other person permitted by law to attend a pregnant woman during gestation or at delivery of an infant shall:

(1) take or cause to be taken a sample of the woman's blood or other appropriate specimen at an examination in the third trimester of the pregnancy;

(2) submit the sample to an appropriately certified laboratory for a diagnostic test approved by the United States Food and Drug Administration for HIV infection; and

(3) retain a report of each case for nine months and deliver the report to any successor in the case.

(b) A successor is presumed to have complied with this section if the successor in good faith obtains a record that indicates compliance with Subsections (a) and (a-1), if applicable.

© A physician or other person in attendance at a delivery shall:

(1) take or cause to be taken a sample of blood or other appropriate specimen from the mother on admission for delivery; and

(2) submit the sample to an appropriately certified laboratory for diagnostic testing approved by the United States Food and Drug Administration for:

(A) syphilis; and

(B) hepatitis B infection.

(c-1) If the physician or other person in attendance at the delivery does not find in the woman's medical records results from the diagnostic test for HIV infection performed under Subsection (a-1), the physician or person shall:

(1) take or cause to be taken a sample of blood or other appropriate specimen from the mother;

(2) submit the sample to an appropriately certified laboratory for diagnostic testing approved by the United States Food and Drug Administration for HIV infection; and

(3) instruct the laboratory to expedite the processing of the test so that the results are received less than six hours after the time the sample is submitted.

(c-2) If the physician or other person in attendance at the delivery does not find in the woman's medical records results from a diagnostic test for HIV infection performed under Subsection (a-1), and the diagnostic test for HIV infection was not performed before delivery under Subsection (c-1), the physician or other person in attendance at delivery shall:

(1) take or cause to be taken a sample of blood or other appropriate specimen from the newborn child less than two hours after the time of birth;

(2) submit the sample to an appropriately certified laboratory for a diagnostic test approved by the United States Food and Drug Administration for HIV infection; and

(3) instruct the laboratory to expedite the processing of the test so that the results are received less than six hours after the time the sample is submitted.

(d) Repealed by Acts 2009, 81st Leg., R.S., Ch. 1124, Sec. 7, eff. September 1, 2009.

(e) Repealed by Acts 2009, 81st Leg., R.S., Ch. 1124, Sec. 7, eff. September 1, 2009.

(f) Repealed by Acts 2009, 81st Leg., R.S., Ch. 1124, Sec. 7, eff. September 1, 2009.

(g) Repealed by Acts 1993, 73rd Leg., ch. 30, Sec. 3, eff. Sept. 1, 1993.

(h) Repealed by Acts 2009, 81st Leg., R.S., Ch. 1124, Sec. 7, eff. September 1, 2009.

(i) Before conducting or causing to be conducted a diagnostic test for HIV infection under this section, the physician or other person shall advise the woman that the result of a test taken under this section is confidential as provided by Subchapter F, but that the test is not anonymous. The physician or other person shall explain the difference between a confidential and an anonymous test to the woman and that an anonymous test may be available from another entity. The physician or other person shall make the information available in another language, if needed, and if resources permit. The information shall be provided by the physician or another person, as needed, in a manner and in terms understandable to a person who may be illiterate if resources permit.

(j) The result of a test for HIV infection under Subsection (a)(2)(B), (a-1), (c-1), or (c-2) is a test result for purposes of Subchapter F.

(k) Before the sample is taken, the health care provider shall distribute to the patient printed materials about AIDS, HIV, hepatitis B, and syphilis. A health care provider shall verbally notify the patient that an HIV test shall be performed if the patient does not object. If the patient objects, the patient shall be referred to an anonymous testing facility or instructed about anonymous testing methods. The health care provider shall note on the medical records that the distribution of printed materials was made and that verbal notification was given. The materials shall be provided to the health care provider by the department and shall be prepared and designed to inform the patients about:

(1) the incidence and mode of transmission of AIDS, HIV, hepatitis B, and syphilis;

(2) how being infected with HIV, AIDS, hepatitis B, or syphilis could affect the health of their child;

(3) the available cure for syphilis;

(4) the available treatment to prevent maternal-infant HIV transmission; and

(5) methods to prevent the transmission of the HIV virus, hepatitis B, and syphilis.

(l) A physician or other person may not conduct a diagnostic test for HIV infection under Subsection (a)(2)(B), (a-1), or (c-1) if the woman objects. A physician or other person may not conduct a diagnostic test for HIV infection under Subsection (c-2) if a parent, managing conservator, or guardian objects.

(m) If a screening test and a confirmatory test conducted under this section show that the woman is or may be infected with HIV, hepatitis B, or syphilis, the physician or other person who submitted the sample for the test shall provide or make available to the woman disease-specific information on the disease diagnosed, including:

(1) information relating to treatment of HIV infection, acquired immune deficiency syndrome, hepatitis B, or syphilis, which must be in another language, if needed, and must be presented, as necessary, in a manner and in terms understandable to a person who may be illiterate if resources permit; and

(2) counseling under Section 81.109, if HIV infection or AIDS is diagnosed.

(n) A physician or other person may comply with the requirements of Subsection (m)(1) by referring the woman to an entity that provides treatment for individuals infected with the disease diagnosed.

(o) In this section, "HIV" has the meaning assigned by Section 81.101.

 

http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.81.htm#81.090

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I don't need Medicaid and I doubt we would qualify anyway. We have a high deductible policy just no maternity coverage. What I need is medical care for a very common situation that a normal working family can afford! I also need a doctor who views me as an individual person and not just a checklist!!

 

It sounds like you do have trouble affording it if you posibly cannot pay for the blood work or have insurance to cover pregnancy:(. IMHO I would look into Medicaid to ensure that you and the baby both have coverage just in case.:grouphug:

 

ETA: Many working families cannot afford the medical care for pregnancy and childbirth:(.

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I don't know about your state, but some states have insurance coverage specifically for children and pregnant women. You can qualify for that even if you don't qualify for Medicaid. They have higher income limits.

 

It did take me months to get the temporary emergency coverage and longer for the full approval process to happen, but it was better then nothing. I had no other insurance. I had not planned to have no insurance coverage, but had no control of DH losing his job and insurance coverage shortly after I got pregnant.

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Wow! (looking at the law quoted)

I was just going to suggest that you provide the dr. with a copy of your blood type and immunity results from previous pregnancy and refuse the std testing, but reading that law, it looks like you don't get to refuse any of this? Can they do that? It seems like they would need to pay for it if they were absolutely requiring it???

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I had four empowering, amazing homebirths that cost us under $2000 each. You are more likely to safely and naturally deliver at home than in a U.S. hospital. I would strongly advise you research your options. The countries with the best birth statistics are the ones that have higher numbers giving birth at home. So safety and finances make homebirth the best choice. Changing America's perspective on birth on the other hand is a whole other story.

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I don't need Medicaid and I doubt we would qualify anyway. We have a high deductible policy just no maternity coverage. What I need is medical care for a very common situation that a normal working family can afford! I also need a doctor who views me as an individual person and not just a checklist!!

 

I am sorry if I offended you with my suggestion. The link I provided will take you to your state's information. If you have no coverage for pregnancy, you may be eligible. I would investigate because you need access to good prenatal care without going bankrupt.

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I am sorry if I offended you with my suggestion. The link I provided will take you to your state's information. If you have no coverage for pregnancy, you may be eligible. I would investigate because you need access to good prenatal care without going bankrupt.

 

Not offended just frustrated. I refuse to rely on the government if I can at all avoid it. I think we have a solution to the problem anyway so I'm feeling much better now!

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Have you considered a homebirth? The cost for my homebirth midwife, prenatals and everything was $1800.

 

I had four empowering, amazing homebirths that cost us under $2000 each. You are more likely to safely and naturally deliver at home than in a U.S. hospital. I would strongly advise you research your options. The countries with the best birth statistics are the ones that have higher numbers giving birth at home. So safety and finances make homebirth the best choice. Changing America's perspective on birth on the other hand is a whole other story.

 

Wow. Those costs are great compared to what I'm being quoted. I'm expecting my 5th right now. We have good insurance that wouldn't cost very little out of pocket for a typical hospital birth, but I really hated my last 2 hospital experiences. I found 2 homebirth/birthcenter practices in our area. Insurance will cover one but not the other because the midwives are CPM instead of CNM. Of course, the one with CNMs that they will cover has a waiting list and I probably won't ever make it in. The other practice could take me right now, but it would cost us $3900, or $3500 if I paid in cash by 28 weeks. I'm torn. My husband is supposed to deploy around when baby is due and while he's not thrilled with paying almost $4K when we could do it for $100 in copays, he wants me to be happy since he won't be around to support. I'm having a hard time justifying the cost, even though I think I'd be much happier either staying at home or being able to leave a birth center within a few hours of delivery.

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I'm sorry! I don't know how anyone does it. We're having a surprise baby and it's crazy how much things cost even with insurance.

 

This is our 3rd. I had to be tested for HIV and a bunch of STD's when I got pregnant. And apparently there's a law in TX that says that you have to be retested AGAIN at the end of your pregnancy just incase you pick up HIV or an STD while you're pregnant. :confused:

 

FWIW, you can opt out of any of the testing.

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I'm 8 weeks pregnant. I just got off the phone with the receptionist at my new OBs office. There is NO WAY they will let me see the doctor to discuss care until I've completed $600 worth of blood tests! I know what my blood type is, I know I don't have AIDS and I can get my immunization record for them. Nope, that doesn't matter, have to have the tests. I'm seriously considering giving birth to this baby in a field like the pioneers did!

 

:grouphug:

 

I am right there with you! I'm about 7 weeks pregnant and we have no insurance. DH interviewed for a job with great benefits but he didn't get it. :(

He's been applying for jobs with the state, but because he's been self-employed for so long, I don't know if he's going to get one. We had a homebirth with kid #3 and we're planning on doing that again, but we're kind of waiting to see if he gets any of these jobs before I make an appointment with a midwife. (BTW, with a midwife, at least the ones I know, you don't have to take any test you don't want to.)

 

I ended up skipping all of the tests with kid #3, but I'll be 38 when I deliver this time around, and reading about all of the statistics about maternal age and birth defects has me a bit scared. If we end up with no insurance I'll probably skip all of the tests and hope for the best. We've even discussed doing an unassisted homebirth (my deliveries have all been quick and uneventful) but I really would like somebody there just in case.

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Woman posts that something is expensive. People immediately advise that she go for government money. :confused:

 

As someone else mentioned, you can negotiate way down if you're a cash customer. Avoiding heaps of insurance paperwork saves the hospital a lot of money. I don't know about the lab tests though. Those are usually farmed out, so you'd have to find someone with the power to negotiate with you. You could see if the prices at a place like http://www.walkinlab.com/ are lower. (I have no idea whether or not they are.)

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I don't need Medicaid and I doubt we would qualify anyway. We have a high deductible policy just no maternity coverage. What I need is medical care for a very common situation that a normal working family can afford! I also need a doctor who views me as an individual person and not just a checklist!!

 

No kidding....this is why we cancelled our private insurance plan 5 years ago. Our premiums kept going up and we still had to pay for every little test. Our plan didn't cover anything. We finally penciled it all out and decided we'd just pay out of pocket when things came up. We only go to the doctor when something is really wrong with us. No check-ups or anything.

 

DH is only looking into jobs with truly excellent benefits. Otherwise, it's not worth it...he'll stay self-employed and we'll pay out of pocket. Health insurance is such a racket. :glare:

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We have had 2 children without maternity coverage - when you are self-employed it's difficult to get, and expensive to have maternity coverage. We negotiated rates with all providers and usually got about a 50% discount....for those suggesting Medicaid, a lot of people who buy their own insurance don't qualify - and depending on the state you are in, there aren't plans covering pregnant women....we always just asked for "cash" discounts, etc. Most places were willing to work with us. And I called around to different labs to find which one would give us the best rates - I had CPC codes and everything so they could give exact pricing....

 

Best wishes,

Melody

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Woman posts that something is expensive. People immediately advise that she go for government money. :confused:

 

Actually I was attempting to assist with a gap in her health coverage. Letting her know about government services she is entitled to or may qualify for seemed legitimate, just as I would advise a starving person to consider a food bank or food stamps. That's not "going for government money." She wouldn't be getting a dime of cash assistance. She would get help receiving the health care she needs.

 

Babies born to a mother on medicaid will be covered at birth. This is helpful in case there is a need. Many private insurances have had a field day denying anyone coverage, including newborns with health problems.

 

I was trying to help. Obviously those inelligible or opposed to government assistance can skip my advice, but I honestly can't understand why you would be nasty.

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Wow. Those costs are great compared to what I'm being quoted. I'm expecting my 5th right now. We have good insurance that wouldn't cost very little out of pocket for a typical hospital birth, but I really hated my last 2 hospital experiences. I found 2 homebirth/birthcenter practices in our area. Insurance will cover one but not the other because the midwives are CPM instead of CNM. Of course, the one with CNMs that they will cover has a waiting list and I probably won't ever make it in. The other practice could take me right now, but it would cost us $3900, or $3500 if I paid in cash by 28 weeks. I'm torn. My husband is supposed to deploy around when baby is due and while he's not thrilled with paying almost $4K when we could do it for $100 in copays, he wants me to be happy since he won't be around to support. I'm having a hard time justifying the cost, even though I think I'd be much happier either staying at home or being able to leave a birth center within a few hours of delivery.

 

We use a lay midwife. The CPMs and CNMs in my area are around $3500 I believe. I love my lay midwife. She learned birthing through experience as an apprentice to a senior midwife. She knows more about birth than any other doctor or midwife I've ever come across. Good luck mama. An enjoyable birth is something I would make many sacrifices for. It makes a huge difference in your life.

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I will 2nd the suggestion to apply for Medicaid. Most states have some sort of special coverage for pregnant mothers, even if they won't cover you before or after your pregnancy. Pleeeease look into this. It will save a lot of headaches, not to mention your health!

:iagree:Absolutely. This is how I had insurance for both of my pregnancies. In my state, I believe anyone who is preg. and has no insurance can get some coverage.

 

You don't need the extra stress right now and you never know what might come up in a pregnancy.

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I had four empowering, amazing homebirths that cost us under $2000 each. You are more likely to safely and naturally deliver at home than in a U.S. hospital. I would strongly advise you research your options. The countries with the best birth statistics are the ones that have higher numbers giving birth at home. So safety and finances make homebirth the best choice. Changing America's perspective on birth on the other hand is a whole other story.

:iagree::iagree::iagree:

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I'm 8 weeks pregnant. I just got off the phone with the receptionist at my new OBs office. There is NO WAY they will let me see the doctor to discuss care until I've completed $600 worth of blood tests! I know what my blood type is, I know I don't have AIDS and I can get my immunization record for them. Nope, that doesn't matter, have to have the tests. I'm seriously considering giving birth to this baby in a field like the pioneers did!

 

dependinig upon your income, you should now be eligable for your state's health insurance pool. Have you talked to your state rep? social and health services?

 

the coverage is retroactive three months prior to the pregnancy, and three months after delivery.

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Another option . . . Could you take $1000 or so and invest in a doula or lay midwife to attend help you during the entire birth? If she came to your home in early labor, you could delay going to the hospital until as late as possible. Then she could help you at the hospital, run interference, and be your advocate/helper.

 

That would be a lot cheaper than paying OOP for the entire birth, but might solve a lot of your concerns, as well as give you a substitute coach since dh won't be there.

 

HTH

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Woman posts that something is expensive. People immediately advise that she go for government money. :confused:

 

As someone else mentioned, you can negotiate way down if you're a cash customer. Avoiding heaps of insurance paperwork saves the hospital a lot of money. I don't know about the lab tests though. Those are usually farmed out, so you'd have to find someone with the power to negotiate with you. You could see if the prices at a place like http://www.walkinlab.com/ are lower. (I have no idea whether or not they are.)

 

 

With so many people suffering chronic unemployment and lack of health insurance, I don't think it is :confused: to suggest looking into govt. assistance programs. It is many people's everyday reality in these difficult economic times.

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With so many people suffering chronic unemployment and lack of health insurance, I don't think it is :confused: to suggest looking into govt. assistance programs. It is many people's everyday reality in these difficult economic times.

 

Yep. We did not go on any state assistance until we absolutely needed to, but I am so thankful it was there when we needed it. Chronic unemployment here and lack of health insurance coupled with a surprise pregnancy...

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