Thursday, May 9, 2013

Finding Maternity Insurance

There is no such thing as maternity insurance.

Believe it or not, that is true. The term maternity insurance is used by various web sites because that is what many of you search on. But, there is no such product as a standalone maternity insurance plan.

How Do People Afford To Have Babies?

We get asked the same question almost every day. "How can anyone afford to have a baby?" Somehow or another, babies keep getting born with or without maternity coverage. But, the expenses can be a burden.

There are a number of options available to you, although none of them are perfect.


  1. Consider paying the maternity expenses out of your own pocket. If you call your local hospital and pre-negotiate a fixed rate and do likewise with your doctor, you can expect to spend somewhere between $6,000 and $8,000 for a normal delivery. A c-section might run between $10,000 and $15,000. Keep in mind, this is just an estimate.

  2. You can use an advocacy service. They will negotiate with your hospital and doctor for you. In certain instances, they have already established relationships at rates that are lower than you could negotiate on your own. We have found them to be very effective.

  3. You can purchase health insurance with a maternity rider. Keep in mind that this means a new insurance plan. You cannot buy maternity insurance by itself. Be aware that if you have had a complication to pregnancy in the past, you probably will not be able to purchase a maternity rider.

  4. If you are employed and there is a group health insurance plan available to you, it will most likely include maternity coverage.

  5. If you are self-employed and live in any one of the following states, we might be able to provide you with a small group plan that will completely cover your maternity expenses. Presently, we can offer these services in Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Nevada, West Virginia, and soon in Florida, Nebraska and Texas.

For option one you can call the hospital yourself. For number two, you can call the advocacy service at 800-460-9178. For options 3 and 5, you can call me. My information is at the bottom of this article. For number four, you need to read your plan benefit book or talk with your human resource person.

If you happen to live in Southeast Florida, we have pre-negotiated rates with a number of hospitals and doctors. Again, call us for details.

"I am already pregnant and I need insurance."

If you are already pregnant use the advocacy service we just mentioned. You can call them directly at 800-460-9178.

If you have a group health insurance plan available to you, pregnancy cannot be considered a pre-existing condition. Once you are on the plan, it will cover the remainder of your pregnancy. Otherwise, there is little else you can do.

Why is it so difficult to find health insurance with maternity coverage?

First of all, let me assure you that it has nothing to do with a zero population growth movement. It is purely a matter of insurance economics.

If you are willing to pay extra for a maternity rider, then clearly you are planning on becoming pregnant. The probability of a claim is very high. In many instances the carrier will pay out more than they take in. Consequently, many companies that sell non-group health insurance plans have discontinued maternity options. Those that maintain this option generally have limited the payout. You end up paying as much or possibly more than you get back in benefits.

Group health insurance on the other hand, typically has maternity coverage as a state mandated benefit. They build the costs into the premium.

On most individual plans, complications to pregnancy are covered even though a normal delivery is not.

I urge you to read your policy carefully. In almost all instances, you will find that complications to a pregnancy are covered the same as any other illness. This means that unless you have had a complication in the past, any future complications will be covered.

You must do the math.

Since complications to pregnancy are usually covered, you only need to plan for a normal delivery. If your carrier tells you that a complete maternity rider will add $250 a month to the cost of your plan, and there is a 12 month wait before you can become pregnant, it is hardly worth it. You would be better off using an advocacy service and paying for the pregnancy out of your own pocket.


In addition to the options outlined in this article, in certain parts of the country there are local and state agencies that can provide prenatal services and sliding scale fees for delivery. Be sure to investigate all available resources.

I invite you to call me if you have questions. My information is at the bottom of this article. Or, if it is missing, we are available 9AM to 8 PM EST at 800-272-0512.

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