Pregnancy insurance is one of the best ways to minimize the expenses that will come with your prenatal care and the hospital stay when you give birth. If you don’t have maternity insurance, you can anticipate spending around $10,000-$12,000. In 2011, the average cost of labor and vaginal delivery in a hospital was $10,657. This can increase by 50% or more if you have a scheduled or emergency C-section. The cost for either can increase dramatically if there are any complications.
How to Get Pregnancy Insurance
Under the Affordable Care Act, there have been many changes regarding health insurance, including pregnancy insurance. All qualified health plans (both within and outside of the Marketplace) are now required to provide maternity care and childbirth health benefits.
Prior to the Affordable Care Act, only a handful of insurance plans automatically provided maternity coverage. For some plans, such coverage had to be requested as an addition. Also, if a woman tried to apply for maternity coverage after she became pregnant, coverage was oftentimes either unavailable or more expensive.
Fortunately, now pregnancy coverage is much more accessible. If you do not have medical coverage through an employer, Medicaid, or CHIP (Children’s Health Insurance Program), you can find an insurance plan through the Marketplace. For more information on getting health coverage through the Marketplace, visit www.healthcare.gov.
If you already have health insurance, it is important to know if your plan is grandfathered or not. Grandfathered insurance plans are those that were in place on March 23, 2010, and have not been significantly altered to affect consumer benefits or the cost of insurance to consumers.
Individual grandfathered plans that you purchase yourself (not job-based grandfathered plans) are not obligated to provide maternity and childbirth benefits. If your plan is grandfathered, contact your insurance company to determine what coverage you have.
Medicaid Pregnancy Insurance for pregnant women
If you do not have coverage through the Marketplace or an employer, another option would be to apply for Medicaid and/or CHIP to cover maternity and childbirth health benefits. Eligibility is based on income requirements, which vary by state and are different for Medicaid and CHIP.
Also, several states have broadened their income requirements. As such, even if you did not qualify previously, you may now be eligible. You can also apply for these programs at any point during the year.
Health Care Discount Programs for Maternity Coverage
One discount service is AmeriPlan. This discount plan is currently available in every state except Alaska, Montana, North Dakota, South Dakota, Vermont, and Wyoming. AmeriPlan can reduce the cost of healthcare services by up to 50% or even more in some cases.
Benefits include physician, hospital, and ancillary services (i.e., lab work, tests, x-rays). Because AmeriPlan is not an insurance plan, all pre-existing conditions are covered (except orthodontic treatment in progress). There are no deductibles, no waiting periods, no claim forms, and no annual limits. For more information, you can go to AmeriPlanUSA or call them toll-free at (800) 647-8421.
Options for Managing costs with no maternity insurance
Some additional ways to help you manage costs related to prenatal care and labor include:
If you are delivering at a hospital, you can contact their accounting office to see if you can set up a payment plan or to find out if they offer a sliding scale. Though many hospitals offer these options, they are often overlooked by those who would benefit from knowing about them.
- If you do not have a high-risk pregnancy, consider giving birth at a birthing center. The estimated cost of delivery and prenatal care at a birthing center is about $3,000 – $4,000, which is half of what it would cost at a hospital. Many birthing centers also provide sliding scales, payment plans, and are willing to accept Medicaid.
Want to Know More?
Compiled using information from the following sources:
1. Childbirth Connection. (n.d.). Average U.S. facility charges for giving birth.
2. eHealthInsurance Services, Inc. (n.d). Maternity insurance coverage.
https://www.ehealthinsurance.com/maternity-insurance-coverage
3. U.S. Centers for Medicare & Medicaid Services. (n.d.). A one-page guide to the health insurance Marketplace.
https://www.healthcare.gov/quick-guide/
4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Grandfathered health insurance plans.
https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/
5. U.S. Centers for Medicare & Medicaid Services. (n.d.). Pregnant women.
https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant/
