Maternity Insurance In The US
When we discuss finding maternity coverage, we know that we are probably attracting two groups of people. One group is planning ahead for the time when they would like to have a baby. In this case, no family member is actually pregnant yet. This is, of course, a much better time to find maternity coverage. The other group of people who are reading this article already has a pregnant family member. In this case, they are probably scrambling to find some help covering all of the bills associated with having a healthy baby. This will be a little tougher, but there are still some options.
If You Are Planning Ahead For Pregnancy.
If nobody in the family is pregnant yet, but you plan on having a baby in the future, here are some common ways to find maternity health insurance. Some of these options, like payment plans or group health, may still work if you are already pregnant too.
Group Health Insurance - A work related health plan usually covers pregnancy. This is probably the easiest and most common way to find maternity coverage. If your current employer does not offer this, it may be time look for for one who does.
A pregnant woman may still be covered on her parent's insurance if she is young enough. There could be other qualifications like she must be unmarried or a student too. A wife should be covered by her husband's policy if they opted into that coverage. And of course, she would be covered by her own employer's plan if it covers maternity.
Individual Health Insurance - I am not an expert on the private health plan market in every state. In my own state, I can tell you that most family or individual plans do not cover normal maternity costs, or they cover them with a very high deductible. The basic health plan should cover complications of pregnancy. So a C section should be covered. However a basic private health plan probably does not cover office visits, tests, or a normal delivery.
The only health insurance company that I know of that offers a maternity rider (option) is Time. This will vary by state, and it is an extra option with an extra premium. It also has a waiting period before it will pay benefits. If you think that you need this benefit, you must take it well before anybody gets pregnant!
HSA Health Insurance - In some states, there is an individual HSA (health savings account) major medical plan with a maternity rider (option). The health savings account part of the plan is a tax deductible account you must contribute to before you need it. The major medical has a maternity option you can choose. Keep in mind that this option will have a waiting period before it will pay any benefits so this will only work if you plan ahead. But if you do plan ahead, your HSA balance should help you defray the costs of the higher deductible.
Your HSA, on its own, can be helpful even if the major medical plan does not cover maternity. You could use your cash balance, for instance, to pay for prenatal care.
Supplemental Insurance - Some disability policies may cover time lost from work because of a pregnancy. I have also seen some supplemental hospital or illness policies that will pay in case of maternity. These plans are unlikely to accept anybody who is already pregnant though, and I have never seen one that would cover the whole cost of maternity.
Save Money - If you can afford it, and you have no maternity coverage, or you do not have much maternity coverage, you can save for it like you save for a down payment on a house or new car.
If You Are Already Pregnant Without Maternity Insurance
Public Health Insurance - CHIPS is the federal and state children's health insurance plan. It also covers pregnant women. Your income must be less than the guidelines, but it is a good option for people with moderate incomes. You will be restricted to using the doctors on hospitals that participate, but you should be able to find medical care in your area. Very low income people with few assets may qualify for Medicaid.
You may also be able to find low cost clinics and hospital systems in your area. Visit PPARX.org because they have a search by zip code.
Your local Department of Health and Human Services is another public resource. Again, these options are probably going to work the best for people with limited incomes.
Payment Plans - Some OB-Gyns and hospitals have payment plans for the normal cost of maternity. You may need this if you lack coverage, or if your own health insurance will not cover the bulk of the cost. It would actually be better to check this option out before you are pregant, but if you are pregnant, it is an option to research. Try asking your current doctor or a nearby hospital. You might also search online for maternity payment plans in your area.
Private Loans - Many maternity doctors will give you a fee schedule for normal deliveries. Even if they have a payment plan, you may do better with your own financing. I hesitate to advise anybody to go into debt, but when you are safeguarding the health of a mother and baby, this may be something to consider.
Are You Pregnant or Planning To Get Pregnant?
Keep in mind that a normal US delivery costs $5,000 - $10,000. This cost will be multiplied if there are any major complications. In a perfect world, this would all be planned for before conception. I am not writing this to preach because I am aware that this does not always happen because we are humans living in an imperfect world. The most important thing is to make sure that the mother and baby have the best possible health care.
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