There is no such thing as stand-alone maternity health insurance. Rather, maternity coverage is either included under the normal benefits of a major medical health insurance plan or as an option in other plans.
To find health insurance rates on plans that include maternity coverage, enter your zip code in the box now.
According to the American Pregnancy Association, approximately 13% of women who become pregnant each year are uninsured. With an estimated cost of delivery between $6,000 and $8,000, the lack of maternity benefits can cause financial strain on new parents. The best time to shop for a health insurance plan that includes maternity benefits is before becoming pregnant. Although it is against federal law, some companies consider pregnancy a pre-existing condition.
I plan to have a baby in the future, what coverage do I need?
If you are planning to become pregnant, and are covered under a group health insurance plan through your employer, you will want to review your summary plan description or talk to someone in the benefits department at your company and ensure that your plan will cover your maternity expenses. Most group plans include maternity as standard, but there are exceptions.
If you are covered by an individual health insurance policy, you should pay special attention to what that plan covers. Most individual health insurance plans offer maternity coverage as an add-on, or a rider, to the normal coverage. A rider however, will increase your premium.
Some private insurance companies do not offer maternity health care coverage. The Health Care Reform Act addresses this issue. Beginning in 2014, all private insurance companies will be required to offer maternity coverage.
What are my options if I am not eligible for a group plan and cannot afford an individual policy?
Medicaid, a federal benefits program, is available to individuals and families with low income. Medicaid will cover the costs for any healthcare directly related to maternity. Although a federal program, Medicaid is managed on a state basis with each state applying its own regulations. Women who are pregnant and experiencing financial difficulty are eligible for Medicaid.
Another product of the Health Care Reform Act is the high-risk pool. This act calls for states to offer temporary insurance plans for anyone with pre-existing conditions that have been uninsured for at least six months.
Unlike Medicaid, high-risk pools do include income limitations. Contact your state to determine what specific rules apply.
Is it worth the extra cost to elect a maternity health rider?
Until Health Care Reform completely kicks in, there are some things to consider when deciding if it is worth the additional cost to purchase a maternity health insurance rider.
Because most companies require the covered individual to have had coverage for a certain period prior to becoming pregnant and because of postpartum care, etc., it may be necessary to pay the additional premium across a two benefit plan years.
Each individual has to look carefully at her situation. A maternity health insurance rider can cost as much as $400 a month. If you pay for additional coverage for two plan years, you will spend an additional $9,600 in premium alone. Considering deductibles and other costs, your out-of-pocket expenses will be even more. Assuming the average maternity costs are between $6,000 and $8,000, paying for a rider would be a waste of money.
Are there any exceptions to my care and the care of my baby if I do not have maternity health coverage?
You may be enrolled in a medical plan that does not include, or under which you did not elect, maternity benefits. However, most states mandate that insurance companies cover any expenses that result from pregnancy complications – regardless of whether you have maternity coverage or not.
Additionally, if you are enrolled in a medical plan and do not have the additional maternity coverage, your baby will automatically be covered under that plan for a period of 31 days and can be added permanently to the plan at any time during that period.
Most people feel that having maternity health insurance coverage provides peace of mind. If you are already covered under a plan and your pregnancy will not affect your premium, you are in a good position. However, if you have to decide if it is worthwhile to pay the additional cost for a maternity benefit rider, you have a lot to consider. In either case, your best defense is to equip yourself with knowledge and to become as familiar as possible with your plan or proposed plan.
If you are considering becoming pregnant in the near future, you can enter your zip code in the box provided to best rates possible from online health insurance providers.