woman speaking with caption 'Finding out my insurance didn't cover maternity at 25 weeks pregnant' (l) pregnant woman with clipboard reading 'Insurance' on table (c) woman speaking (r)

Inthon Maitrisamphan/Shutterstock @florble/TikTok (Licensed)

Woman says she found out her insurance doesn’t cover maternity at 25 weeks pregnant

'American Healthcare is a bigger scam than MLMs.'


Rachel Kiley


Posted on Jan 12, 2023

A TikToker said she discovered over halfway through her pregnancy that it was not covered by her insurance.

“I’m 36 weeks pregnant,” @florble told her viewers. “I’ve had a very, very, very health pregnancy, but the worst thing that I’ve had to deal with was my fucking insurance.”

Immediately after discovering she was pregnant via an at-home test, the mother-to-be said she started calling around town to find an OB/GYN that took her insurance. After she did, and they confirmed her coverage with her insurance provider, they gave her financial information regarding what she would owe, she said.

But things took a turn when she said she was to referred to a specialist by her OB/GYN, and subsequently received an unexpected bill for $2,000 for the visit.

“I’m 25 years old, and I’ve been staying on my parents’ health insurance because it’s been really good. But we found out that my 63-year-old mother is the only one covered on that plan for maternity,” she explained. “So what had happened was my OB had contacted my health insurance, they said, ‘Oh yeah, you’re good,’ because they see maternity somewhere on the plan, not realizing that it’s only for my mom, until someone finally caught their mistake when I went to the specialist.”

@florble Insurance nightmare #pregnant #pregnancy #insurance #insurancehorrorstories ♬ original sound – Florble

The TikToker said she had numerous conversations with her OB/GYN and the insurance company but said a clause in the agreement absolved them of any responsibility for the mistake, meaning not only would her impending visits and birth not be covered but she may be held financially responsible for all the past visits to her OB that insurance had been mistakenly covering.

This caused a scramble to try to figure out her options. She said she considered running down to the courthouse to marry her fiancé early to get on his insurance, but was under the impression her pregnancy wouldn’t be covered since she was already so far along.

Ultimately, she notedthere was only one solution: Medicaid.

“Luckily, in the state of Georgia, we find out that there’s specific insurance for women who are already pregnant, and my OB takes them,” she said. “And luckily enough, I didn’t go back to work when I found out I was pregnant. And even luckier, my fiancé and I didn’t run down to the courthouse and go get married, just so that we would be married on paperwork for this baby.”

@florble Replying to @florble part 2 of the insurance nightmare #pregnant #pregnancy #insurance #insurancenightmare ♬ original sound – Florble

Medicaid is generally only available to low-income households that meet certain additional qualifications, which, in Georgia, includes pregnancy. So if @florble had gone back to work, she likely wouldn’t have qualified.

@florble was approved for Medicaid and said Medicaid will go back and cover the past three months of expenses.

Viewers were empathetic with @florble’s situation, although many fellow Americans seemed resigned in their horror, having dealt with the frustration and confusion of insurance themselves time and time again.

“THE SAME THING HAPPENED TO ME!!” wrote @haileymadison__. “I had to get emergency medicaid and everything was covered.”

“Everytime i see this i feel like this is so mental… america you need public health insurance!” @eierpfannkuchen said, while @fruit.loop333 posited that “American Healthcare is a bigger scam than MLMs.”

“My entire pregnancy was covered under medicaid,” another viewer added. “I wish Healthcare was universal at this point. i shouldn’t be ‘lucky’ to be so poor that meds are free.”

The Daily Dot has reached out to @florble via TikTok comment.

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*First Published: Jan 12, 2023, 3:42 pm CST