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 it works to fill gaps
- High-risk pregnancy and preterm deliveries
- Covering maternity leave
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. Learn how to get supplemental health insurance to cover pregnancy.
Holes in ObamaCare
The Affordable Care Act allows families to purchase health insurance covering maternity, newborn care, and hospitalization beginning January of 2014. This present a new opportunity for families that previously could only purchase individual plans with maternity riders. These riders came with long waiting periods, or large deductible.
Maternity insurance under ObamaCare still leaves two 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.
Multiple Birth Exposure
Supplemental maternity insurance coverage is crucial for couples trying to conceive. High order multiples are far more common with families undergoing infertility treatments. 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, and boost your baby delivery costs. If your plan has an individual deductible you may be charged for each infant confined the 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 on delivering at your local in-network hospital, only to be transported to 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 pretty hefty.
Supplemental Insurance to Cover Maternity Leave
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. There are two policies that 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 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 scenarios 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.
High Risk Pregnancies
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 considered 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. Also, state disability plans can help with income replacement.