Pregnancy and Health Insurance; or What to do without Maternity Coverage

A lot has changed in the health insurance world as a result of the health reform bill Congress signed last year and the continual rise of healthcare prices! To get straight to the point, unfortunately there is no carrier we know of that is offering a maternity coverage option on individual health insurance. There were only 3-4 doing so a year ago, but they have dropped that option. So if you’re wanting to have a baby, here’s what we suggest:
* If you have access to an employer-sponsored group health insurance plan, try to get on it. These plans are required to have maternity coverage. (That’s one reason the price is high! Even when individual maternity was available, the price was high.)
Easy, right? But if that’s not an option…
* You’ll want to get an individual health insurance policy. While they don’t cover normal maternity expenses, they do cover complications of pregnancy, which could be important because that stuff can get crazy expensive. Additionally, you will have the opportunity to add your baby to the policy within 30 days of birth regardless of the baby’s health. (This is very important because there are no child-only policies on the market anymore, which is a consequence of the new health bill last year.) But, once you are pregnant, you will not be able to get individual health insurance at all (largely for those reasons).
* If/when you do get pregnant, you need to talk to the doctor’s office and the hospital where you plan to deliver very early in the process. You can shop for these services like you shop for anything else – in order to get the best deal for your money. And these providers want your business. You can simply tell them that you don’t have maternity insurance and would like them to give you the same price they give to Blue Cross and Blue Shield members (or better – but that would be the baseline I’d ask for first). People with maternity benefits are getting a “network discount” just like you would get on any other insurance claim – that’s the point of the network – the medical providers have agreed to discounted pricing in order to get Blue Cross (or whoever) customers. You can ask for that upfront (get it in writing!) and they may well give it to you.
One final suggestion:
* If/when you sign up for an individual health insurance plan, I’d suggest getting one that qualifies you to open a Health Savings Account (HSA). You can save money in an HSA tax free (that is, the money you put in there, up to around $3k/year for single coverage or $6k/year for family coverage, is money you won’t pay any income tax on). Then begin saving money there (as much as you can up to the annual limit) to pay for the pregnancy stuff.
Children are a blessing and a lot of fun. But they are expensive! And that starts immediately. With some foresight and planning, however, you can help mitigate these costs. We’re happy to help you in any way we can, so please contact us!