Supplemental maternity insurance coverage is an important benefit for families planning a pregnancy or trying to conceive.
The policies fill two huge gaps most families face: lack of paid leave, and large cost-sharing requirements in traditional healthcare plans.
Supplemental health insurance policies for pregnancy make cash payments directly to you rather than gynecologists, hospitals or other healthcare providers.
- How the plans work during pregnancy and maternity leave
- Coverage with no waiting periods
Supplemental Maternity Insurance Plans
Most employers do not provide paid maternity leave benefits so families must find a way to cope with one less income, while medical expenses are rising – unless they purchase supplemental insurance to cover maternity leave. Learn how to get supplemental health insurance to cover pregnancy.
Two plans provide maternity leave benefits for normal childbirth, short-term disability, and hospital indemnity.
Supplemental short-term disability is the first component of supplemental maternity insurance coverage. Replacing mom’s income while she is out of work is a vital aspect of protecting your family finances. She may lose income prior to delivery if the doctor orders bed rest. C-section delivery requires a longer recovery, and postpartum bleeding may delay a return to work.
Supplemental hospital indemnity is the second component of supplemental maternity insurance coverage. Not only is your admission for normal delivery covered, but also extra benefits may be paid when your infant(s) is born prematurely. Many couples undergoing infertility treatments have a much higher chance of conceiving multiples, which are often born pre-term. Hospital indemnity may pay an additional benefit for each child confined to the NICU.
Supplemental Health Insurance during Pregnancy
Supplemental health insurance during pregnancy bed rest can prove invaluable. Complications of pregnancy can happen to anyone, but those undergoing infertility treatments face this problem more often.
Most infertility treatments are not covered, meaning couples pay out-of-pocket for expensive infertility treatments before getting pregnant. Couples may deplete savings, or take out loans to finance IVF and other costs for artificial reproductive techniques.
The resulting pregnancies are often high-risk. Many women have underlying medical conditions, or they may have delayed starting a family. High-risk pregnancies are more likely to experience complications that require mom to miss work prior to delivery. This results in unplanned lost income. High-risk pregnancies may also mean an unplanned hospital stay during pregnancy. This may result in unplanned expenses for hospital deductibles and other costs.
The two supplemental maternity insurance policies may replace mom’s income during a pregnancy bed rest, and may make incremental cash payments for each day she spends in the hospital. The coverage is perhaps the most sought after supplemental health insurance for families. The reason is simple: people expect to utilize the benefits, and they know they have big holes in existing coverage.
When Already Pregnant
Many site visitors ask about purchasing supplemental maternity insurance when already pregnant. While the Affordable Care Act stipulates that preexisting conditions must be covered with no waiting period or increase in costs, the law does not apply to supplemental health insurance policies. Pregnancy is a preexisting condition, and your policy must begin prior to conception in order to qualify.
If you are already pregnant and needing insurance, there may be more options than you think. The Affordable Care Act plans are available for purchase during any open enrollment period. There may be premium and cost sharing subsidies based upon your income. In addition, state disability plans can help with income replacement.
How Supplemental Maternity Insurance Coverage Works
Supplemental maternity insurance coverage works by replacing a portion of mom’s income during the time she is unable to work, and by making cash payments to the policyholder upon admission to the hospital.
There is no waiting period before coverage begins, but the concept works differently from plans governed by the Affordable Care Act. Couples undergoing infertility treatments such as In Vitro Fertilization benefit most.
No Waiting Period
Supplemental maternity insurance has no waiting periods before coverage begins. The policy begins immediately for losses caused by accidents and illnesses. There may be a nine-month exclusion for normal childbirth, which rarely causes a problem for people purchasing the plans prior to conception. You may not have to wait for your employer’s open enrollment to get started.
Maternity insurance under Obamacare works differently with waiting periods and other factors. Preexisting conditions are covered with no waiting period, but start times must comply with open enrollment dates.
The Affordable Care Act leaves two other big holes. First, the new law does not address the lack of paid maternity leave. Second, many of the plans still have very big cost sharing components. Families still face big deductibles and copayments. These cost-sharing components grow in importance when people utilize the benefit – as most pregnancies do.
Coverage for IVF Multiple Birth Exposure
Supplemental maternity insurance coverage is crucial for couples trying to conceive through In Vitro Fertilization. High order multiples are far more common with families undergoing infertility treatments such as IVF. Multiple pregnancies often deliver pre-term, and the infants often experience a long NICU confinement.
This often results in significant medical expenses associated with the hospital stay that can catch couples by surprise. Hospital co-pays, co-insurance, and deductibles have become very common. They boost your baby delivery costs. If your plan has a deductible, you may be charged for each infant confined the NICU. You might have planned paying this only once.
The nastiest surprise for many couples is out-of-network fees. You might have planned to deliver at your local in-network hospital, only to be transported to a center specializing in premature delivery. If this facility is not in-network, you may be responsible to pay the amounts over the carriers “allowed charges.” These fees can be hefty.