Maternity Insurance Made Simple

Why Can't I Find Maternity Insurance?

Unless you happen to live in one of the five guaranteed issue health insurance states (NY, NH, MA, VT and ME) or you currently have a group health insurance plan, finding maternity insurance coverage will be like looking for a needle in a haystack. Most major carriers have eliminated the option to add maternity coverage. Those that did not eliminate this feature, charge $200 to $300 a month extra for this add-on. Plus, there is a waiting period before you can become pregnant of up to 12 months.

To add insult to injury, the plans still have out of pocket deductibles and coinsurance. A few plans make you think they have a maternity option and charge you a nominal amount for it (around $100) but you later find that the benefit was extremely limited and you are generally getting back what you paid them or less. Hold on, I am not through with my ranting yet.

If you have had a prior c-section or a complication to pregnancy, they will not sell you the maternity rider at any price.

Does It Pay To Have Maternity Insurance Coverage?

Once you sit down and do the math, you start to wonder if maternity coverage is worth the bother. Let us say that you buy a plan and it costs you an additional $200 a month. They tell you that you have to wait 12 months before you can become pregnant. Let us further suppose that after waiting 12 months it takes you three more months to conceive. Afterward, assuming you are human, we have another 9 months of pregnancy. There is a total of 24 months that you paid $4,800 extra for in premiums. The plan might have deductibles and coinsurance of another $2,500 to $5,000. The cost for having a baby with health insurance is $7,300 to $9,800. If it takes longer to conceive, the bill goes up.

What most people do not know is that complications to pregnancy are covered by most health insurance plans even if you do not have maternity coverage. So, the hospital portion of a c-section is covered regardless. Look at all of the restrictions maternity insurance coverage puts upon you:

• You cannot become pregnant for up to a year and if you do you forfeit the maternity coverage.


• You still pay somewhere between $7,000 and $10,000 out of pocket with the coverage.


• You have to choose one of the few companies that offer this rider. This might mean that you are paying more for your other health insurance with less coverage.

Alternatives to Maternity Insurance

Instead of purchasing maternity insurance there are other plans available that can reduce your maternity expenses. Remember that complications to pregnancy are probably covered regardless. You can always contact the author for more information.

Advocacy Services - Over time, we have found that this service can negotiate extremely low rates for both pre-natal and delivery services, including lab fees. They do this day in and day out and have done this tens of thousands of times. This is the only alternative for someone who is already pregnant (other than group health insurance).

Limited Benefit Plans - These are guaranteed issue health insurance plans that cover maternity the same way they cover having your tonsils out. They provide a certain dollar amount for doctor visits and hospital costs. The operative word is limited. These plans are not available in all states. However, they can provide a great alternative to maternity insurance. There are a number of these plans at different price points.

Recently, we found a plan that will pay close to $7,000 for a two day hospital stay for maternity. The catch is, you must be employed when the plan begins. You do not have to remain employed, however, and your spouse can take the plan and put you on it as a dependent. It is very cost effective.

Group Health Insurance - Just about all group health insurance plans cover maternity. If you are self-employed it can be difficult to find a true group health insurance plan. We do have information for Group of One health insurance plans that are available in about 15 states. They cover maternity and, if you currently have health insurance, will cover you even if you are already pregnant.

The Maternity Insurance You Want and the Maternity Insurance You Can Get

What most of you reading this article would like to find is a plan that pays all or most of the medical costs associated with having a baby. But, unless you are fortunate enough to have a fantastic group health insurance plan, it is highly unlikely. I urge you to consider some of the techniques I described in this article.