Health Insurance Blog

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. Many insurers will not provide benefits to the insured for at least nine months.

As with all things insurance related, you must plan ahead. Occasionally, consumers are interested in maternity policies once they are already pregnant. They are disappointed to learn insurance cannot be purchased to cover a pregnant spouse – pregnancy is a preexisting condition. 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 nine months, but some carriers offer plan with limited benefits that begin day one. However, if you were to purchase a plan with a nine month waiting period, your pregnancy would not be covered if the child was delivered before the nine month window had expired. 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) with a maternity rider and a low $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 The $1,500 could be withdrawn tax free to satisfy the deductible and then the policy benefits would kick in.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.

Another option is to simply self insure for a pregnancy. Many consumers will purchase traditional health insurance or possibly an HSA qualified plan and save each month in order to cover maternity expenses.

How are Pregnancies Billed?

At this point, clients often ask about pre-natal care and doctor’s office visits. Fortunately, most Obstetricians do not charge as you go. Doctor’s visits, pre-natal care and delivery are all included as part of the pregnancy and usually subject to one, pre-determined charge. Thus, the final bill can be run through your insurance company (assuming you purchased a maternity rider) and then settled up.

When purchasing health insurance policies covering pregnancy, you must plan ahead. There are several options available, but you will get the most from your policy if you do your due diligence and purchase the policy ahead of time.

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