Baby Steps to Learning About Maternity Insurance
With four little ones of my own, I can attest to the fact that being a mother is an incredible thing. Bringing those precious babies into the world is nothing short of a miracle.
The medical bills — not so much a miracle. And certainly not incredible. Insane, frightening, astounding — yes. Miraculous — no. One doctor's visit alone can run you hundreds or thousands of dollars. And don't even think about the actual birth and hospital stay.
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Altogether, you can expect prenatal care, postnatal care, and the actual delivery to run at least $30,000 — not something to sneeze at. Having maternity insurance is the best way to combat these high prices. Unfortunately, millions of women go without the proper maternity insurance — if they have any at all.
We're here to help, though. Below you'll find information on maternity coverage, how to know if you have it, and how to find it if you don't.
What Exactly Is Maternity Insurance?
Maternity insurance is a type of insurance coverage intended to take care of the medical costs of pregnancy and childbirth.
This typically includes:
- Prenatal doctor visits, usually including any lab work, ultrasounds, and other testing or procedures
- Hospital stays
- Newborn care
- Lactation devices and counseling
Is Maternity Covered In Regular Health Insurance?
Okay, so here's where it gets a little dicey. Yes, some health plans do cover maternity costs, but not all. Many women have been surprised to learn that plans they think cover them actually don't.
For example, many young women choose to stay covered on their parents' plan, even when first married. It helps ensure they have coverage while they are working out the kinks of becoming an adult and living on their own — or so they think. For many, that coverage takes care of regular doctor visits, broken bones, and even the first prenatal appointment. However, that's where the coverage ends. The insurers do not offer coverage for pregnant adult children.
Many also mistakenly assume that their insurance through work or another source automatically cover their maternity expenses. This too often leads to undue stress during pregnancy. The mother-to-be is scrambling to determine how to cover pregnancy costs — even after she's paid all her insurance premiums.
Maternity Insurance and the Law
Employers who have more than 50 employees have long been required to offer insurance coverage to full-time employees, including maternity care. Since the Affordable Care Act (ACA) in 2014, requirements have extended a bit.
The ACA requires that any new or renewed small group health insurance policies or individual policies must cover maternity.
Businesses with fewer than 49 employees are not required to offer insurance coverage. However, if they choose to offer any health insurance, it must include maternity care.
These changes have — of course — helped many women. Unfortunately, there are still plans out there that do not cover pregnancy and childbirth. You have to understand that not all insurers are regulated by the Affordable Care Act or any insurance department. If they are not regulated, they are not required to offer maternity care.
For example, there are some individual groups out there that provide a healthcare cost-sharing program, like some ministries. These are not regulated and can choose what they cover. Additionally, supplemental coverage, short-term policies, and similar “excepted benefits” are not regulated.
The bottom line is that not all women with some form of insurance coverage are covered for maternity and childbirth. To determine if you are, you need to go directly to the source. Reach out to your insurance company and ask the following questions:
Am I covered for pregnancy and childbirth?
If so, what all costs do you cover? Is anything left out?
How much of the cost am I responsible for?
Do I need a referral from my doctor for my coverage to pay for the OB/GYN and related costs?
When my baby is born, how long of a hospital stay does my insurance cover?
Do you cover private rooms, or does it have to be a shared room?
Does my plan cover other types of birth costs, like if I want a home birth or a midwife?
After this discussion, you should have a thorough understanding of whether you have enough coverage for your maternity and childbirth needs. If you're set, congratulations! If not, don't fret. There are ways to take care of this.
What If I'm Not Covered?
Not having medical coverage for anything is stressful — even more so when pregnancy is involved. I'll be honest. When I found out I was pregnant with my third baby, I did not have insurance. And I was having no luck finding any. I cannot begin to describe the agonizing hours I spent trying to figure out what to do. How would we bring a healthy baby into the world when I could not even get to the doctor?
I cried — not just because of the pregnancy hormones, either. I was scared and overwhelmed. I had absolutely no clue what steps to take. It seemed as though we were going to be working double shifts for the next nine months, hoping and praying that would make it work.
Fortunately, after a few excruciating weeks, I had a resurge of motivation and started looking for solutions again. I found a few, and I'm going to share those with you in a moment.
Can I Get Insurance If I'm Already Pregnant?
Did you know that there was a time not too long ago that insurance companies would not cover maternity if you were already pregnant? It was considered a pre-existing condition — like cancer or a heart condition. You would only be covered if you got pregnant while already on insurance.
If you did not plan your pregnancy and make sure you had insurance that covered you, you would be on your own for maternity costs. This always seemed absolutely insane to me, especially considering nearly half of pregnancies in the U.S. are unplanned. However, insurers could do what they chose at the time.
Fortunately, this is no longer the case. Insurers can not turn you down because you are already pregnant or increase your premiums due to pregnancy. However, let's keep in mind that we are still referring to regulated insurers and insurance plans. Those not regulated still have the freedom to make those choices.
Maternity Insurance Options
The following are some of the most common insurance options to consider when pregnant.
Medicaid
Medicaid is an incredibly helpful resource for many people. Sadly, not everyone who is eligible takes advantage for a couple of reasons. The first is that they are unaware that they are eligible because it's for low-income households.
Income requirements vary by state and your household size, but you would be surprised how much you can make and still qualify. Even if you make too much, there are other Medicaid-based plans that are low-cost compared to many other insurance options.
The second reason many people avoid applying for Medicaid is due to shame and misconception. There have been people in the past who made statements that those on Medicaid do not get quality treatment.
I can personally attest to this being incorrect. Like any other insurance, Medicaid provides a list of doctors in their network for you to choose from. You can pick the OB/GYN you are comfortable with and that you feel treats you well.
Another part of that misconception is that many feel as though they will be looked down on for using Medicaid. Let me start by saying that more people are on government-regulated programs than you know, even if they do not admit it. There is no shame in getting help when you need it.
And anyway, you do not have to tell anyone if you don't want to. Do what you need to make sure you have a healthy pregnancy and birth. No one's opinion is worth more than that.
Employer-Sponsored Plans
If your employer offers health insurance, this may be your best option. I say "may" be your best option because those plans can get expensive. However, it's always worth looking into. If the premiums are not too high, or if your employer pays a portion of the premiums, it might be worth it.
Private Plans
There are also many private insurers available that offer health insurance. Remember, though, that if they are not regulated, they may not cover maternity expenses.
To find the best insurance plan for you, it's important to look for several options and ask the questions from the above "Maternity Insurance and the Law" section. Then, compare premiums so you can choose one that suits your budget.
Marketplace Health Insurance Options
The Affordable Care Act brought some good things with it. The health insurance marketplace is one of them. It made insurance accessible to many people who could not normally get it. As the health insurance plans in the marketplace are regulated, you can find maternity insurance there.
Let me be honest, though, in saying that the word "affordable" is a bit of a stretch for some people. When the marketplace first came to be, I tried looking into insurance for myself and my husband. At the time, my children had coverage, so we were the only two that needed it.
I'm not kidding when I say my jaw literally dropped as soon as my monthly premiums popped in front of me. They were more than my rent and car payment. And, quite frankly, they were more than any amount the two of us spend going to the doctor each year.
What's worse is that I found out I was not alone. Others that I knew personally were struggling with the same thing.
I'm not saying that you can't find affordable insurance there. I am just saying that, like shopping for anything else, it's imperative that you look at several options and compare rates.
What If I Still Can't Find Coverage?
In some cases — despite your efforts — you might still have difficulty finding coverage you can afford. If that happens, there are still a few routes to try.
Self-Pay
One of the options that I found that surprised me was that some OB/GYNs offer payment plans. I talked to a few that spread maternity and childbirth costs out over the full nine months. You would pay a few hundred per month right up until the last payment. It would be the same amount each month, regardless of how many appointments you needed.
For example, at the beginning of pregnancy, most mommas only need to see the doctor monthly. The closer you get to birth, the more frequently you need to see the doctor. Regardless, many self-pay doctors require the same monthly payment throughout your maternity.
I actually found another doctor that did not require payment during pregnancy. Instead, you would get the bill when it was all over. Of course, you could pay what you could every month to help pay down the balance. He simply did not believe in causing undue stress during pregnancy and, therefore, gave mommas some breathing room.
If you absolutely cannot find insurance coverage, call around to doctors in your area. Most likely, you can find one or two that will work with you on a self-pay plan.
Charity
Charity services vary according to the actual charity, the location, and more. However, some charities can help you either locate maternity care services or even provide them. Sometimes they team with doctors that help provide services.
You'll need to call around to charities in your area. You can also ask local churches and government agencies, as they may know just where to send you.
Community Services
Most states have free — or deeply discounted — medical services. In my area, it's referred to as the “health department,” but it might be called something different in your state or county.
No matter what it's called, they can often help with things like pregnancy tests, maternity care, newborn care, and more. I know that ours is geared towards moms and little ones, even though others can get assistance, too. Locate your community health clinic and give them a call to find out how they can help you.
Conclusion
Though it can be difficult, you can find maternity insurance to help cover pregnancy and childbirth expenses. For help, take a look at the Insurry store to learn about opportunities and compare options.
Insurry is a part of the Goalry Mall, which is dedicated to helping you get your financial life on the track you want. In addition to finding insurance coverage, you can set savings goals for your baby's college education, set your monthly budget to prepare for your new arrival, and much more. Take a look to learn how the Goalry Mall can put you on a path toward financial success for you and your entire family — even members that have yet to arrive.