What maternity health insurance plan?
June 3, 2010 9:17 AM   Subscribe

What options are available for maternity health insurance?

My wife and I want to start trying for a second child. I am an independent contractor, living in Utah, and we have private insurance through Humana.

We had our first child while my wife worked for the state so we are new to the private health industry. We are trying to figure out our options and we are overwhelmed with the information and plans out there. We are not eligible for most grants or other government funded programs. Although, we are applying for a lot of them just to make sure.

Does anyone have any advice on where to look or what plans might be good? Any advice on supplemental insurance? Really, any advice at all is welcomed.

Also, I am a Canadian citizen and we have the option to send my wife up to Canada for the last trimester. If she is there for three months before having the child we will have full coverage. She can stay at my family's home during that phase. Does anyone have any experience with doing this?

posted by birdlips to Health & Fitness (4 answers total)
Contact a local life/health broker. He'll be able to walk you through your options.
posted by valkyryn at 10:29 AM on June 3, 2010

Before the major individual market reforms kick in on January 1, 2014, you might be pretty much out of luck. There's only a few states that require providers in the individual market (that is, policies you buy directly rather than through your employer) to include maternity coverage or even to offer it as a rider. Utah isn't one of them.

You should talk to a health insurance broker about whether any insurance companies in your area offer maternity riders on their health insurance policies. In many states it's just not available at all, but I don't know about Utah specifically. If it is offered, it might be very expensive (on the order of $200 - $1,000 additional in premiums per month) and it might not cover any pregnancies that start within a certain period of time after purchasing the rider (for example, any pregnancy that starts within a year isn't covered). You also want to make sure that if you find a policy covering pregnancy / delivery, that it is a comprehensive benefit. Make sure there's nothing hinky like a maximum benefit of a few thousand dollars, or only covering hospitalization after the first day (all the expensive stuff happens on the first day!).

There's a reason that nearly half of all births in the United States are covered by Medicaid: if you don't have health insurance through an employer, it's very very difficult to get maternity coverage in any other way. Utah is, unfortunately, not known for extending Medicaid eligibility very far up the income ladder (although this is of course very worth checking for--the income limits for pregnant women are different than for parents in general, so make sure you're getting information Medicaid specifically for pregnant women).

Honestly, I wouldn't be surprised if sending your wife up to Canada during the last trimester ends up being your best/most affordable option.
posted by iminurmefi at 11:19 AM on June 3, 2010

Besides working through a reputable broker, another option is to save up the cash and negotiate a deal with your wife's obstetrician and the hospital/birthing center she plans to deliver at.

Make sure your major medical will cover complications of pregnancy (I have never seen a policy that wouldn't but I am not in Utah and don't know Utah specs on this) and that you would be able to add your newborn right away to your existing major medical policy.

Any maternity rider will definitely have a waiting period and it will probably be a wash in the benefits you receive vs. the premiums you pay--because the only people who buy maternity riders in the individual market are the people who intend to get pregnant. You might be better off putting that cash aside in an interest-bearing account so you can at least earn a little bit on it.

And now, an aside. As a previously pregnant woman whose condition deteriorated very quickly, personally I would not be comfortable with the thought of being away from my own personal physician in a foreign country in the last trimester.
posted by FergieBelle at 12:36 PM on June 3, 2010

Response by poster: I wanted to reply to report my experience.

I took the advice and contacted an insurance broker. They were super easy to work with and really helped us out.

As it turns out there is only one option in the state of Utah. It is a supplemental insurance through Humana One. The program has only been going for three weeks and we were only the second people to apply through this firm.

Basically the coverage offers up to $2600 (I know, that's all, but better than nothing) towards the cost of delivery. It costs about $52/month and you have to have it for at least 10 months before you deliver. My regular insurance covers any complications before and after delivery but we will certainly be paying a lot of money out of pocket even if things go well.

Got to love health care in America!
posted by birdlips at 1:33 PM on June 7, 2010 [1 favorite]

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