FAQ

Best Health Insurance Options for Pregnant Women – ValuePenguin

Maternity coverage has improved a lot in recent years, as the Affordable Care Act (ACA) requires health care plans to cover pregnancy services. The best health insurance will provide coverage for all the costs of pregnancy, including prenatal tests, blood tests, ultrasounds, monthly or weekly doctor visits, and labor and delivery of the baby. These medical bills can add up quickly, with the average pregnancy cost ranging from $9,000 to $200,000 without insurance. More affordable plans, such as hospital indemnity policies, are also available, but they don’t include as many benefits as other maternity coverage.

Is pregnancy a pre-existing condition?

pregnancy is considered a pre-existing condition, but recent laws require that all marketplace, employer-provided, and medicaid plans must cover maternity and newborn care. prior to this legislation, you could be denied coverage because of your pregnancy. Today, pregnancy is considered an essential health benefit that must be covered by health insurance companies. Some typical pregnancy expenses include:

Reading: What health insurance covers pregnancy

Many medical bills from pregnancy can be very expensive if you don’t have health insurance, which makes finding an affordable policy crucial.

considerations for maternity health insurance

The best health insurance for you will depend on whether you are currently pregnant or planning to conceive in the future. In many situations, you’ll be able to get the best possible health insurance if you plan ahead, as you’ll have more options for maternity coverage. For example, if you don’t currently have health insurance from an employer, you should plan to purchase a policy during the open enrollment period, which typically occurs from early November to late December.

Even when pregnancy is a surprise, there are still great health insurance options if you don’t have coverage when you get pregnant. These can include options like Medicaid or off-market health insurance policies, which can be purchased at any time during the year.

Does the insurance cover surrogacy?

If you are currently using a surrogate for pregnancy, then there are health insurance implications to consider. Intended parents are always required to provide health insurance for a surrogate. In addition, the surrogate mother’s health insurance will not provide pregnancy coverage. therefore, you will need to use your own health insurance to cover maternity and newborn expenses during the surrogate’s pregnancy.

There are no limitations or differences in what is covered by health insurance policies for surrogate mothers. all of the policies highlighted below would offer the same coverage whether you are pregnant or have a surrogate ride for you.

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change insurance or job during pregnancy

If you’re pregnant and signed up through an employer’s health plan, but then change jobs, you may need to wait before joining the new health plan. this may not be a problem if you are early in your pregnancy, but it could be more serious if you are further along. To close this gap, you can enroll in your former employer’s Cobra plan, in which you would receive all of the same pregnancy benefits from your previous health insurance. insurance collects is expensive, but would provide the necessary coverage for your medical bills.

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We do not recommend changing insurance plans during pregnancy, as your coverage options may be limited. It’s usually more difficult to find a full pregnancy benefits policy while you’re pregnant compared to planning ahead and buying a plan before you conceive. That’s because pregnancy is classified as a pre-existing condition.

will short-term health insurance cover pregnancy?

Because pregnancy is considered a pre-existing condition, short-term health insurance plans generally do not provide maternity coverage. If you currently have a short-term plan and are considering having a child, we recommend purchasing a private health insurance policy that provides coverage for all pregnancy expenses.

best health insurance for pregnancy

The best pregnancy health insurance will be determined by your income and whether your (or your spouse’s) employer provides health insurance. There are three types of health insurance plans that offer the best affordable options for pregnancy: employer-provided coverage, ACA plans, and Medicaid.

employer-sponsored health care

The easiest health insurance option for pregnant women is employer-provided coverage, either through the mother or her spouse. This can be especially helpful if your employer pays a portion of your health insurance premiums, thus lowering your payments. It is important to note that some employer health plans will have a waiting period, usually three months from the date your coverage begins, during which benefits will not be provided. this is to prevent sick people from applying for health insurance only after they’ve gotten sick.

Under the Health Insurance Portability and Accountability Act (HIPAA), the birth of a child qualifies you for a special enrollment period where you can enroll in a plan, but getting pregnant doesn’t.

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Adult children who are classified as dependents under an employer’s health plan are not eligible for coverage for pregnancy or their children. this can become a problem because you are allowed to stay on your parents’ plan until age 26. In this case, the best health insurance option might be to look for Medicaid or Marketplace health insurance.

market medical insurance

Marketplace health insurance provides maternity care and must cover all essential health benefits listed in the ACA. Plus, the insurer can’t deny coverage for a pre-existing condition, and you won’t need to go through a waiting period.

Usually, a Marketplace policy can only be purchased during your state’s open enrollment period, which requires you to plan ahead. ACA plans can also be purchased if you experience a qualifying life event, which then triggers a special enrollment period. this can include events like getting married or losing your job. however, becoming pregnant is not a qualifying life event and therefore would not open a special enrollment period. on the other hand, giving birth is a qualifying life event.

Marketplace plans with a higher monthly premium and lower deductible provide the most coinsurance and can help you save on out-of-pocket costs. Check out your state’s silver, gold, or platinum health plans and find out what works best for you.

medicaid and chip

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Depending on your income level, you may be eligible for coverage through Medicaid. Because Medicaid is regulated by the ACA and the federal government, it must provide the same maternity, prenatal, and newborn insurance coverage as marketplace and employer policies. Plus, Medicaid doesn’t have designated waiting or enrollment periods, which means you can apply for coverage at any time during the year.

The Medicaid program allows low-income people to enroll in a plan and receive health care benefits if their household income is below certain limits. Most states have passed the expanded version of Medicaid, which allows anyone with a family income of less than 138% of the federal poverty level to be eligible. however, you should check to see if your state has adopted expanded medicaid.

Children’s Health Insurance Program (CHIP) is a separate health insurance program that provides coverage for children under the age of 19 and pregnant women. The policy is similar to Medicaid in that it is a low-income insurance plan designed for families and individuals.

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chip health coverage can provide a critical safeguard for women who earn too much for medicaid coverage and can’t afford an aca plan. The following states provide full pregnancy benefits with no premiums or coinsurance under the chip:

Other states that have adopted this legislation may require a pregnant woman to pay part of the premium and use coinsurance for pregnancy coverage. For this reason, she should verify the services provided by Chip of her status before relying on this plan to obtain health insurance during pregnancy.

what is complementary insurance for pregnancy?

Supplemental maternity insurance coverage is a health insurance policy that makes cash payments directly to you instead of paying the gynecologist, hospital, or other health care providers. There are two main forms of additional insurance you can purchase for pregnancy: short-term disability and hospital indemnity. however, both policies must be purchased prior to conception, as they do not include coverage for pre-existing conditions.

pregnancy disability insurance

A short-term disability or maternity leave insurance plan is designed to replace a mother’s income during maternity leave and if her doctor orders bed rest. Some employers will pay the full amount of salary when a woman goes on maternity leave, but not all companies do. For this reason, you should check with her employer for their maternity leave policy. If it doesn’t support maternity leave or only provides a few weeks’ pay, then purchasing a short-term disability plan might be the best option.

hospital compensation

Another pregnancy policy that may be helpful for your situation is a hospital indemnity plan. this is not a full coverage policy like other health insurance plans. instead, it’s considered a substitute health care plan if you can’t afford a typical health insurance policy.

The hospital indemnity plan covers all the costs of your child’s hospital admission and delivery, but does not provide coverage or prenatal therapy. In addition, the indemnity plan may provide additional benefits if your baby is born prematurely and needs to be admitted to the neonatal intensive care unit (NICU).

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