Health Insurance Plans with Maternity Coverage
Many families are in search of affordable health insurance that will provide maternity or pregnancy benefits. Health carriers offer such plans, but they vary in the amount of coverage provided. In Ohio, most insurers provide no benefits for nine months and at least one insurance company will not cover a pregnancy for 18 months.(If you are interested in learning your options concerning a maternity plan, please click here.)
As with all things insurance related, you must plan ahead. Occasionally, people call our agency once they are pregnant and are disappointed to learn insurance cannot be purchased to cover the pregnant spouse. Insurers simply will not take on this risk. However, a health plan can be purchased for a healthy mother and child after delivery.
When is My Pregnancy Covered?
Generally, policies will provide benefits for maternity after the insurance has been in force for at least nine months. If you were to purchase a plan, then shortly thereafter conceive a child, and the child was delivered before the policy had been in force for nine months, then your pregnancy would not be covered. Again, it is prudent to plan ahead and purchase a policy with a maternity rider some months before conception.
It might be helpful to look at this from the insurance provider’s point of view. Typically, when a couple desires and pays for a maternity plan, then they are likely to use it. The insurance company is relatively certain that a claim will come in the near future. Thus, they will build the cost into the premium for the insured (you) and mandate a waiting period. That being said, some companies are offering plans that are more attractive than others.
A Popular HSA Maternity Plan with a Reasonable Deductible
One insurance company offers a Health Savings Account (or HSA) maternity plan with a $1,500 individual deductible. Once the deductible has been reached and the nine month waiting period has been satisfied, the plan would cover the balance of the pregnancy. In this example, you could fund the HSA account with at least the $1,500 and write that off against your income. The $1,500 could be withdrawn tax free to satisfy the deductible and then the policy benefits would kick in. Currently, this HSA plan is one of the more popular policies available.
Another popular plan has no waiting period and provides more benefits the longer the policy is held. The maternity rider will cover $2,000 toward a pregnancy in the first two years. During years three and four, the policy will pay up to $4,000 and years five and on the policy provides coverage up to $6,000.
At this point, clients often ask about prenatal care and doctor’s office visits. Fortunately, most Obstetricians do not charge as you go. Doctor’s visits, prenatal care and delivery are all included as part of the pregnancy and usually subject to one, predetermined charge. Thus, the final bill can be run through your insurance company (assuming you purchased a maternity rider) and then settled up.
The bottom line with health insurance policies and especially one that covers pregnancy is to plan ahead. There are several options available, but you will get the most from your policy if you research and purchase it ahead of time. Contact us today for more information or a quote.
