Two supplemental health insurance plans offer critical coverage for families planning a pregnancy or trying to conceive. The policies fill huge gaps most new parents face.
First, your primary healthcare plan includes cost-sharing components that make pregnancy and childbirth challenging to afford: hefty deductibles and copayments.
Second, most new parents take unpaid maternity leave because their state does not require the program or their employer does not offer a benefit.
The combination of extra expenses and lost income is devastating. Enroll before conception to avoid this calamity, and spend quality time bonding with your baby without worrying about unpaid medical bills.
Supplemental Pregnancy Insurance
Supplemental insurance for pregnancy is auxiliary coverage that women can purchase to minimize their out-of-pocket costs for prenatal care, plus labor and delivery in a hospital.
It is not a substitute for a traditional healthcare plan, and you should have this coverage in force before looking for something extra. Plus, you must purchase a supplemental plan before conception.
- Supplemental Pregnancy Insurance
- Supplemental Maternity Leave Insurance
- Final Thoughts
Pregnancy Health Insurance
Before buying supplemental pregnancy insurance, it is critical to understand the possible holes in your base healthcare plan and your options after you conceive.
During pregnancy, the best health insurance minimizes your unreimbursed medical expenses. You over-utilize services for at least nine months.
- Individual and family deductible
- One for mom
- One for baby
- Coinsurance and copayments
- Balance billing from out-of-network doctors
You can buy pregnancy health insurance without waiting periods before benefits begin (even if you already conceived). However, you might have to delay until the annual open enrollment – depending on your household income.
Hospital Indemnity Insurance
Supplemental insurance for pregnancy has an alternate name: hospital indemnity, which pays a fixed benefit for specified services, thereby filling many of the holes noted above (deductibles, copayments, and balance billing).
You must buy this extra coverage before conception to qualify for any pregnancy-related benefits.
Supplemental hospital indemnity insurance might pay a significant fixed benefit for the most expensive part of your pregnancy journey: childbirth.
- Mom’s confinement after labor and delivery: 1X
- Sick or premature infant confined to Neonatal Intensive Care (NICU)
- Singleton: 2X
- Twins: 3X
- Triplets: 4X
Couples who are undergoing infertility treatment and IVF frequently conceive twins and triplets, often delivering preterm and beginning life in the NICU. This extra coverage proves invaluable in these scenarios.
Supplemental hospital indemnity insurance could make smaller fixed claim payments for any of these common scenarios affecting prenatal women.
- Fasting blood glucose testing to monitor pregnancy diabetes
- Outpatient gynecological surgical procedures
- Dilation & Curettage (D&C)
- Endometrial ablation
- Lysis of adhesions
- Gynecological diagnostic procedures
- Cervical biopsy
- Cone biopsy
- Endometrial biopsy
- Loop Electrosurgical Excisional Procedure (LEEP)
- Emergency room visits for false labor
- Doctor office visits for prenatal care
Secondary Insurance for Pregnancy
It is also critical to understand the distinction between supplemental and secondary insurance for pregnancy. The two words sound like synonyms but work like antonyms when the time comes to file a claim.
- Supplemental plans (hospital indemnity) complement the primary coverage by paying a fixed amount according to a pre-published schedule that does not vary
- Costs less
- Pays more
- Secondary plans (healthcare) duplicate the primary coverage and coordinate benefits (cover unreimbursed expenses: deductible, coinsurance, etc.) in varying amounts
- Cost more
- Pays less
Supplemental Maternity Leave Insurance
Supplemental maternity leave insurance is a different form of auxiliary coverage that women can purchase to fill holes in employer policies and state-mandated programs that replace a portion of income while mom is absent from work.
As before, you must purchase the supplemental coverage before conception if you want to enjoy extra income support during your job absence.
Maternity Leave Insurance
Before buying a supplemental policy, you must understand what maternity leave insurance you might already have and how the rules can leave you with gaping holes to fill.
State-mandated maternity leave benefits apply in the state where you work rather than where you live, affecting commuters crossing borders. Two programs come into play.
State Disability Insurance
State-required temporary disability insurance replaces a portion of income during maternity leave when mom is physically unable to work, but in only seven regions, with varying benefit levels.
|State||Percent Limit||Weekly Maximum|
Paid Family Leave Insurance
State-required paid family leave insurance replaces a portion of income while mom and dad bond with their newborn baby, but in only seven regions, and again with varying benefit levels.
Finally, a minority of employers offer paid maternity leave voluntarily to attract and retain a competitive workforce. For example, many technologies companies such as Google, Microsoft, IBM, Amazon, and others provide this benefit.
However, most large employers offer unpaid maternity leave as required by FMLA: 12 weeks of legal job protections without monetary compensation. Plus, small businesses do not have to comply with FMLA rules.
Supplemental maternity insurance also has an alternate name: short-term disability, which pays a fixed dollar amount during each day that mom cannot perform her regular job duties because of a covered health problem.
- Medical complications of pregnancy before birth
- Recovery from childbirth (labor & delivery)
- Postpartum medical complications that delay return to work
Get a short-term disability quote to see what it might cost to fill the many holes in the paid maternity leave programs noted above.
- Increase the amount above the measly $170 offered in NY State
- Extend the duration past the brief 12-week period in Washington State
- Establish benefits where no programs exist at all
- 43 states without mandatory temporary disability
- Employers that do not offer paid family leave
Supplemental health insurance can make your pregnancy and maternity leave more affordable by filling cavernous holes in their primary coverage. However, you must purchase the two auxiliary policies before conception to qualify.
Hospital indemnity acts as supplemental pregnancy insurance by paying a small fixed benefit for many prenatal care services and more significant amounts for mom’s confinement and her infant(s) admission to Neonatal Intensive Care.
Short-term disability works as maternity leave insurance by replacing a portion of mom’s income when she is unable to work because of a covered medical condition: pregnancy complications, childbirth, and postpartum disorders.