Maternity Insurance And Your Pregnancy
Insurance during pregnancy is a real issue in today’s hard economic times. It is important that a pregnant women has maternity insurance so that they can receive all of the necessary medical visits before they have their baby to insure a healthy pregnancy. And maternity insurance will also help pay for the cost of the baby’s delivery. It is also extremely important to have maternity health insurance coverage after a baby is born, so that they can continue to receive continued wellness care.
Under federal law, it is illegal for group insurance plans that cover maternity to consider pregnancy a pre-existing condition. In other words, if you change from one group health insurance plan to another group health insurance plan while you are pregnant, the new health insurance prvider cannot deny any claims that are related to your pregnancy. However, because of certain loopholes, some pregnant women could find they are lacking the amount of insurance coverage that is needed to cover the cost of their prenatal care. Remember, it is very important for a pregnant woman to plan out her pregnancy as much as possible.
As we mentioned, a group health insurance company cannot consider pregnancy to be a pre-existing condition. This is because of a federal law known as HIPAA. This means that grou phealth insurers cannot exclude coverage for prenatal care or for your baby’s delivery. Your employment or health insurance history does not have a bearing on this. Please remember that this is only the case if the plan you have in place already includes maternity insurance coverage.
HIPAA applies primarily to group health plans not individual health insurance plans. If you change from one individual insurance health plan to another individual health insurance plan, or from a group insurance plan to an individual insurance plan, you run the risk of not receive maternity health insurance coverage. In other words and in many cases, if you are already pregnant and you are considering changing health insurance, you might find that supplemental maternity insurance coverage is too expensive or that it is not available at all.
In most cases with individual health insuranec plans, there is a waiting period before maternity insurance coverage begins. This may be true even if you are eligible for maternity health insurance coverage under HIPAA. For example, if you are pregnant and have group health insurance, but then switch jobs, your new group health insurance plan might have a standard one to three month eligibility period before you can join. In this case, your pregnancy would not be covered until the plan goes into effect. If you are still in the very early stages of your pregnancy, this might not be a problem considering that you might be able to afford the costs for obstetrician visits on your own. But in the later stages of your pregnancy there could be significant out-of-pocket costs. Make sure that you plan for these costs if you are considering changing employment during your pregnancy. In order to have health insurance coverage during this waiting period, you might consider enrolling in your former employer’s COBRA plan. But please be aware that in many cases employers are not required by law to offer COBRA unless they have at least 20 employees on staff. You could end up paying quite a bit more in premiums with a COBRA plan as well. Sometimes up to 100 percent more than the full premium due to administrative fees. If you need help sorting through these options please let us help by clicking on one of the links at the beginning or the end of this article.
Another option to consider as long as you have had at least 18 months of group coverage is to buy a “guarantee issue” or “guaranteed acceptance” individual health insurance policy. These types of health insurance plans are offered without rejecting you because of pre-existing conditions. However, in some states you could be forced to join a high-risk pool. High-risk pools are notoriously known for high health insurance premiums.
You could be eligible for maternity insurance help from the government through Medicaid. However, to qualify for Medicaid, the government insurance program that was designed for the economically challenged, you will have to meet very strict income requirements. You could also qualify for WIC, the Special Supplemental Nutrition Program for Women, Infants, and Children run by the federal government. In order to be eligible for this program, you must be considered a “nutritional risk” by a health care professional. In any case, there are resources available through various non-profit orginizations that can assist women through their pregnancy.
In summary, if you are already pregnant and you have group health insurance that includes maternity insurance, then try to stay with that particular health insurance plan until you have completed your pregnancy and your new baby has received all of the well-baby care that is needed. If you are pregnant and have an individual health insurance plan that includes maternity health insurance coverage, then keep that coverage in place until your well-baby visits are complete. If you are pregnant and without maternity insurance, you may have to pay the full cost of your pregnancy. It is suggested to plan your pregnancy and make sure that you have adequate maternity insurance coverage in place before you decide to get pregnant. We have professionals that are available to assist you in making the right choice about your mternity health insurance. Visit us today by clicking on the previous link.
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