Are you self employed and have Individual health insurance coverage?
Are you planning to start a family by getting pregnant and having baby?
If you answered yes to both of the above questions, you can almost forget about having a baby without losing all your savings. Yes, I say that with lots of frustration and sigh after going through the hassle ourselves during our pregnancy period this year for our second baby. It is hard to find a reasonable insurance coverage with maternity these days. You might be lucky to find some in certain states or cities but 75% of the time you will never see an insurance company covering maternity or pregnancy. That’s one of the biggest exclusion item.
I have spent number of hours googling and asking my friends and collegues around to finally got hold of one and only company which covered pregnancy in Texas(Assurant Health) with a reasonable deductible and major medical coverage for hefty price tag. But getting the insurance wasn’t hard part, getting them pay for the claims is the hardest of all. After you paid premiums every month for a year or so, you will shock to hear that they won’t cover certain claims.
Like any industry, there are lot of loop holes associated with the medical codes system where insurance companies easily find ways to get you pay as much as possible before they pay their share. I am just talking about for normal delivery and you can imagine how difficult and hard it would be for C section or delivery with complication. In this post and next posts, I plan to share the real experience of going through the hassle of finding a insurance carrier, how to get the coverage abiding with their restrictions and how it all turned out during the delivery time.
How much it cost?
First and foremost, lets share the maternity bill for my wife’s delivery which is normal delivery and no complications to get some perspective. These are aproximate figures closer to the billing charges. I got bills from almost 5-10 different providers. I thought I will only get bills from Hospital and Doctors but I was surprised by providers which are billed seperately and not included in the Hospital charges like pathologist, anesthesiologist , lab work, and so forth.
Hospital charges – $13500, $3000 (Baby)
Doctor’s Charges – $3500
Anesthesiologist – $$3800 (epideral medicine)
Pathologist – $200
Pediatrician – $1000
Total – $25000 (before insurance insurace discount)
With the insurance discount, it all came down to $15,000 or so. The charges are only for the delivery period. There are bills during the pregnancy period for lab work, scans and different pregnancy tests. Our mail box was always filled a bill or two every day.
According to the some reports, the pregnancy cost have gone so much and it ranges anywhere from $15000 – $25000 for normal delivery and cost more around $35000 or up for other types depending on the complications. That’s the main reason, I wanted to have maternity insurance. You should have one too. Baby delivery is so unpredictable and anything can happen for the mother and the baby and you better have coverage to cover otherwise don’t be shocked to see the Himalayan bill at a later point. To avoid heart attack and save your life savings, you should have a pregnancy/maternity insurance. I highly recommend it if you can find one in your state or city.
How to get Pregnancy/Maternity Coverage?
1. Easiest and cheapest solution, get a job in a company which offers group health insurance. I only paid $500 for my first kid when I was working for big company with good insurance 5 years ago, now I paid more than $5000. Even if your spouse can get a part time job in an organization and get health coverage, that would save your money if she/he doesn’t earn a lot. That would be best choice.
2. If self employed or own a company with employees, sponsor for group insuarnce for all and get maternity coverage. There are many insurance carriers like Aetna, BCBS, United Healthcare which offers good coverage for small business companies.
3. If you weren’t able to get any group coverage, then your last resort is to find a individual insurance with maternity coverage. You might be able to find coverage from companies like Cigna, Assurant Health(bought by Cigna now) and few others.
4. If you can’t get insurance coverage, atleast talk to your gynogolist and hospital where you planning to have a baby and workout a deal. Many providers/hospital are willing to work out a payment plan and give discounts which might work better. Because they are better off getting money from you than from insurance companies which only pays discounted/adjusted charges.
With the recent Health care Act changes gone effect on Sept 23, 2010, Kids can be covered under parents plan upto 26 years. If your parents have good health coverage and you are below that age range, you might have a chance to get covera but please check the insurance carrier.
In the next post, we will see some important things to consider while getting the Maternity/Pregnancy insurance coverage and after delivery.