Health insurance plans that provide maternity coverage will generally cover the standard medical costs associated with a healthy pregnancy. This includes visits to an OB-GYN and the cost of inpatient delivery of your child. A plan that does not provide maternity coverage will not pay for these costs, however most will pay for medical complications that may arise.
Finding Health Insurance With Maternity Coverage
You can’t buy stand alone maternity insurance, coverage must be offered as part of a general health care plan. Most insurance companies in most states will not cover maternity under their standard benefits and all consider it a pre-existing condition. Some states have made it a requirement that all health plans include maternity coverage and there are still a few providers that offer it in states that don’t. Keep in mind though that your pregnancy costs will count towards your deductible and coinsurance. Even if you have pregnancy insurance, it is likely that you will still realize substantial out of pocket costs.
When searching for health care plans, I recommend you start with eHealthInsurance. They allow you to sort through the available plans by both maternity coverage and optional maternity riders. Use the menu on the left hand side of their quotes result page (pictured on right) to sort the available plans. You do not have to give them an personal info or contact information for these quotes.
The Maternity Rider Option
While most plans will not cover delivery or OB-GYN visits under their terms, some will offer an add-on Maternity Rider. If you purchase a maternity rider, normal costs associated with pregnancy will be covered up to a set amount. However, the monthly cost of the rider is often quite high, sometimes much more then your premium. The costs of a rider make this more of a pre-paid option rather then insurance. You may even pay more for the rider then you would pay for your pregnancy on your own.
Maternity riders usually come with a waiting period and are meant only for women who hope to get pregnant but are not there yet. If you become pregnant within the waiting period, you will not get coverage for that pregnancy.
Make sure you do the math on the total cost of riders. The sum of all the monthly payments can be substantial and may be more then the cost of paying out of pocket.
I Can’t Find a Good Plan that Covers Pregnancy
Many insurers do not cover pregnancy, or if they do the premiums are very high. Don’t worry, there are other options. If you are already pregnant, and have no coverage, you may consider looking for insurance through your state’s high risk pool or through the federal government’s Pre-Existing Condition Insurance Plan, or PCIP.
Another option is to pay for your pregnancy and delivery costs through a health savings account. This is best for women who are not yet pregnant yet and can begin saving towards their costs. Many hospitals have flat fee rates for delivery which can vary greatly. By shopping around you can literally save thousands of dollars. Additionally, your maternity costs can be paid out of your HSA, in pre-tax dollars, also potentially saving you thousands of dollars. A health savings account must be paired with a high deductible health plan which will also result in a lower monthly premium, making it easier to add to your savings.
Of course, joining an employer’s group plan is the easiest way to get health insurance with maternity coverage. If you are pregnant or expect to be pregnant and can not qualify for private insurance and can not afford the costs of a pregnancy, finding a job with benefits is your best bet. However, many employer plans are shifting a greater percentage of the cost of care onto employees, so even this option isn’t cost free.