health insurance coverage

19 October 2022 Category: Health Insurance

Planning for a Baby? Determine Whether Your Health Insurance Covers Your Unborn

If you are planning to have a baby, ensure to review your health insurance coverage and what it covers for your baby. If you fail to update your policy, you could end up paying more costs out of pocket, as pregnancy, delivery, and postnatal care come with a host of additional expenses. If you are wondering where to start, look at the following insights about health insurance and pregnancy coverage, and act accordingly.

Prenatal Care Coverage Has Made Compulsory by Law

Health insurance providers are legally required to cover at least some pregnancy costs, as the Affordable Care Act (ACA) has made it essential. As per ACA, an insurer must cover you if you want to sign up for coverage and change insurance policies during open enrollment or another eligible sign-up period.

However, if you have short-term insurance or a plan before ACA passed, your prenatal visits won’t be covered as these plans are not subject to compulsory maternity care coverage. You can change policies during open enrollment to extend your coverage.

Out-of-Network Care Is Costlier

Though your insurance covers maternity care, seeing providers inside the network will eliminate expensive out-of-pocket bills. If you see an out-of-network doctor, your insurer may not cover the bills (in some cases), you may have a higher deductible, or the provider may charge more than your insurer is willing to pay. This will make you liable for paying the difference or an entire bill out of pocket.

Infertility Treatment Has Limited Coverage

Many insurers provide limited or no coverage at all for infertility treatments. In such circumstances, you need to pay hundreds or thousands of dollars from your pocket. Ensure how much coverage your insurer can provide for fertility care and take measures to cover the differences, such as taking out a personal loan or working with a clinic that provides affordable financing options.

Your Newborn May Have a Separate Deductible

Babies are considered separate individuals, so insurers require you to pay their deductibles to begin their coverage. For example, if your baby needs medical care post-birth, you should pay the deductible before the coverage kicks in to cover the bills.

Childbirth Can Be Expensive

As childbirth-related costs are usually high, most insurance providers require coinsurance for hospital stays. Though delivery at the birth center or home with a midwife’s assistance can be cost-effective, such out-of-hospital deliveries won’t be covered by health insurance. It is good to review your policy to understand what it covers, and for what services you need to pay out of pocket so you can be prepared for your childbirth.

Now, you know how your health insurance pays for your pregnancy, so you can customize your policy accordingly, such as increasing the coverage limit or switching to comprehensive policies.

Get All-Inclusive Health Insurance from Massive Insurance

Are you looking for a comprehensive health insurance policy to cover your pregnancy costs? Contact our insurance agents today at Massive Insurance & Financial Services. We will offer personalized coverage tailored to your budget and unique health needs.