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 the 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. The extra cash arrives in the mail when you need it the most.
- When and where to buy your policies
- How the plans work for pregnancy and maternity leave
- Coverage with no waiting periods
Supplemental Health Insurance for Pregnancy
Supplemental health insurance for pregnancy can prove invaluable. They may replace a portion of your income during pregnancy bed rest, and while on maternity leave, and reduce your out-of-pocket expenses for a hospital stay.
However, you must purchase the two policies at the right time and in the right place.
When Already Pregnant
Many site visitors ask about purchasing supplemental maternity insurance when already pregnant. While the Affordable Care Act stipulates that carriers must cover pre-existing conditions with no waiting period or increase in costs for primary medical plans, the law does not apply to supplemental health insurance policies.
Pregnancy is a pre-existing condition.
Secondary policies must begin prior to conception in order to qualify for benefits.
- Request a maternity leave loan to fund your leave from work, and increase your resources needed to pay leftover hospital bills from your delivery. Repay the note with convenient monthly payments.
- Request a primary medical insurance quote to optimize your plan for labor and delivery. 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.
The ideal time to purchase supplemental health insurance for pregnancy is prior to conception. Both policies contain a nine-month exclusion for normal labor and delivery. They both also exclude coverage for any preexisting condition for twelve months.
Your employer is the best place to purchase these policies. Carriers do not sell policies covering normal childbirth privately to individuals. You can take advantage of the program during open enrollment if your employer agrees to offer voluntary employee benefits. Apply for benefits after pregnancy complications or your normal delivery.
Obtain the coverage during your employer’s open enrollment period. If you introduce one of our agents to your employer, they will establish a special one-time enrollment for the new options. After that, you can begin a new policy during your employer’s annual session.
You can purchase the disability policies directly as an individual any time of year. However, policies obtained through this more convenient channel are less appealing. They do not cover normal childbirth.
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.
Two plans provide maternity leave benefits for normal childbirth, short-term disability, and hospital indemnity; however, you must purchase coverage prior to conception. This one stipulation rules out the majority of site visitors.
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.
Quotes and Rates
Requesting online quotes is an exercise in futility for many site visitors. The monthly premium costs compared to the projected benefit payment for normal delivery is very appealing. However, since you can only buy the policies if your employer offers the benefit first, your focus should be on getting your employer motivated to give you a voluntary option.
Request an online quote for an individual policy if your employer does not offer you an option. Buying directly outside of your employer minimizes the value of the program. You must start the policy prior to conception.
Applying for Benefits
Apply for benefits after pregnancy complications stop you from working, or after giving birth. Use the claims form provided by the carrier you purchased your policy from prior to conception. Your doctor and employer may need to help complete the paperwork.
Utilize your hospital’s UB04 form to document your admission.
Hospital indemnity is the second component of supplemental maternity insurance coverage. Not only is your admission for normal delivery covered, but also you may receive extra benefits 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.
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 her 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. Carriers cover preexisting conditions 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 copays, co-insurance, and deductibles have become very common. They boost your baby delivery costs. If your plan has a deductible, the hospital may charge you for each infant confined the NICU. You might have planned to pay 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 need emergency transportation to a center specializing in premature delivery. If this facility is not in-network, you may be responsible for paying the amounts over the carriers “allowed charges.” These fees can be hefty.