Look at your Health Insurance before you get pregnant

by AdminJ on July 13, 2010

Finally decideing you are ready for a baby there are millions of things going through your mind of what you need to do to get ready, a major item to think about is if your current Health Insurance is the right plan for you when you give birth? Does your Insurance Plan have maternity coverage? A few important questions any one should ask before they get pregnant and preparing for a baby.

1. Does Your Current Insurance Plan have maternity coverage?
Seems like a dumb and obvious question but not all Health Insurance Plans cover maternity coverage, espically individual plans. If your current plan does not cover maternity coverage that means it will not pay for any doctors visit, ultra sound, prenatal visits, prenatal testing, giving birth etc. Anything that has to do with your pregnancy and baby. One should check their current plan.

2. Is your OBGYN In-Network?
Most woman already have an OBGYN or have figured out who will deliver your baby, you need to make sure that your doctor and the hospital your doctor is affiliated with are In-Network with your Health Insurance Carrier.
If you have a PPO, you will have the option of going in and Out-of-Network, which is nice because you do have flexibility but when you do go Out-Of-Network your percent of the cost is much higher then staying In-Network.
My advise is to always try and stay with doctors and facilities that are In-Network to pay the least amount possible.

If you have an HMO, no need to worry. Your PCP will have referred you to a OBGYN that is in your Network.

3. What is your total Cost of Birth?
The total cost of the birth does differs from plan, person and kind of birth.
Every Health Insurance Plan has a Out-of-Pocket Maximum. That is the most one will spend in one calendar year on all medical bills. Once this amount is met, you will not longer be charged for any service and the Insurance Carrier will pay 100%.

The Out-of-Pocket max can be as low as $2,500 on PPO plans to $10,000. On HMO plans they tend to be less.
When you think about all the doctors visits, ultra sounds and tests you have before you even give birth you may already hit your Out-of-Pocket MAX.

4. Be sure you have Maternity Coverage!
If you do get pregnant and do not have maternity coverage, you will not be able to get your own individual plan. Being pregnant is a pre-existing condition. Another option would be to join group coverage (from an employer) or to try Medical depending on your income.

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