States Where Maternity Insurance Is A Mandate To Be A Part Of Health Insurance Coverage.
As of now states where maternity coverage is a mandate for individual and family health coverage are:
Washington | New York | Vermont | Colorado | New Jersey | Montana | Massachusetts
If you reside in California, there is good news for you. Effective July 1st 2012, it is mandatory for health insurance plans to provide inbuilt maternity coverage in the state of California. Also, if you live in CA, you can also check another good program called Access For Infants and Mothers (AIM). This program is specially for uninsured women who are pregnant. One condition is, you should be within 28 or 30 months of your pregnancy for approval. This program covers everything.
Although The Affordable Care Act (Obamacare) has made purchasing health insurance much more simpler however we may not see any significant change until 2014 when the law actually comes in effect. Post 2014, maternity coverage and new born care and treatment will become a part of essential health benefits and hence will be offered by individual health plan providers and also by the health insurance exchanges which will be functional by then. Large group health insurance plans are for now excluded from this mandate.
Maternity Insurance Coverage Options Right Now
Individual Health Insurance Plan With Maternity Coverage
- First and foremost, if you are already pregnant, then you will not be able to purchase individual health insurance plan with maternity coverage. One exception to this is, if you qualify for the guaranteed issue HIPAA sanctioned health insurance plan. Guaranteed Issue policies can only be bought if you have group coverage for 18 months at a stretch.
As per the recent study which was conducted by National Women’s Law Center Washington D.C. on around 3,300 individual health insurance policies the results were quite shocking. Only 12% of those had maternity coverage.
- Everything boils down to planning. If you already have an individual health insurance plan then you can add maternity insurance as a supplemental coverage. Commonly known as a rider. However, their is a waiting period attached to it. You might have to wait for 6 to 12 months before you get full maternity insurance benefits.
- Mostly all health insurance companies offer maternity coverage on their health insurance plans as an extra add on. Before buying, compare plans through at least 3 insurance companies.
- Just to guide you in the right direction, always purchase your health plan with maternity coverage much before planning your baby. There have been instances wherein expecting mothers have been denied coverage from their current health insurance providers for the reason which goes like this,” We cannot cover you because, you took out the policy before conceiving your baby” I know this atrocious and absolutely absurd but this practical example is mentioned so that you are well prepared in advance.
- Even when you are covered for maternity insurance through your employer’s group plan, the stage of your pregnancy and the waiting period of your maternity coverage plays a major role. What if you are in the 8th or 9th month of your pregnancy and there is a waiting period of at least 2 months before your cover kicks in?
- COBRA plan (specific to your state) can be used to cover this drawback of waiting period. You can enroll yourself in your former employees COBRA plan in the meantime and avail maternity insurance. As states have adapted their own COBRA laws, at times they are also referred as “Mini COBRA Laws”. Keep in mind that this can be an expensive alternative in terms of premium and deductible amount and opt for it only when it is necessary.
Planning Is The Key…. Plan Your Baby and Your Maternity To Avoid Any Waiting Period Hassle…
Pre-Existing Condition Insurance Plan (PCIP) Alternative:
- This can be a good option for maternity insurance if you qualify for it. You need to be a US citizen and should be without any insurance coverage for at least 6 months.
Medicaid and Special Supplemental Nutrition Program for Women Infants & Children (WIC)
- Medicaid: Medicaid is a good alternative for you if you are a low income individual for maternity insurance. If you are already enrolled into Medicaid then there is no need of filing a separate application for the new born. He or She is automatically eligible for Medicaid until the first birthday.
- Supplemental Nutrition Program for Women Infants & Children (WIC): WIC targets low income families who are need of prenatal and post natal care. Further information on WIC can be obtained
Maternity Insurance Coverage Options If You are Already Pregnant
All health insurance plans which offer maternity insurance have a waiting period ranging from 1 months up to 2 years. This is where “Maternity Cards” come into picture. Before we discuss this option, let me tell you that it is NOT a maternity insurance coverage but an alternative if you can’t find maternity coverage. It is a mean to reduce your cost of maternity treatment pre and post delivery. Also, if you already have Medicaid then you will not qualify for a maternity card.
Maternity Card Covers the Following:
It will provide cover for doctor visits.
Check Up For The New Born
Hospital Stay Expenses
Fertility and Sterilization Therapy etc.