Nevertheless, if the situation deprives one of maternal insurance plan while self employed, local health department can help regarding the appropriate options on how to avail one. The cash pay basis can also be an option wherein  a couple can ask the hospital about the price for delivery and could negotiate the payments down to a package deal. Another option is to get a group health insurance. The small group can concise an employer and 2 employees, and from here you can search for maternity plans that you can hook with the group health insurance.

MSA (Medical Savings Account) is ideal for self-employed individuals wherein their tax-deferred deposits can be diverted to medical savings, and from there, it can be used to shop for the right insurance that can cover maternal expenses during conception. New York has an ultimately compromising offers regarding health insurances that can suffice various medical needs. From individual, group and down to a low income generating families can avail such assistance. Furthermore, the government is always ready to provide help in line with private sectors if the case is getting to be hopeless for a couple who is at the brink of facing financial risks in bridging to a solution for a pregnancy which is already at hand. Seek local government offices for sufficient information that can help you have the right option and the right choice.

Pregnant but without Health Insurance

Certain complications on health insurance options are caused by a woman’s pregnancy. Aside from the fact that pregnancy entails costly medical services (which often times affect the insurance provider’s claims exposure), there are federal laws that prohibit insurance providers from including pregnancy in the list of preexisting conditions. This means that insurance providers are to honor and respect the maternity benefits specified in the health insurance plan even if the pregnant woman changes health plans while pregnant. Insurers cannot deny the pregnancy claims specified in the health insurance plan.

So if one becomes pregnant at a time when no health insurance is availed yet, what options can the pregnant woman take?  Let’s look at the available options under the scenarios below :

• if the pregnant woman without any health insurance plan at the time of pregnancy,  happens to land a new job which provides for a health insurance, the new health insurance will not have to take effect and instead sit out a waiting period. In this case the pregnant woman has to shell out some money to pay for her pregnancy expenses.
• if the pregnant woman has a group health insurance plan at the time of pregnancy and change jobs with the new job giving a new group health insurance plan which has a one month eligibility period, the insurance provider is not compelled to cover the pregnancy until the plan is in full effect, meaning after the one month waiting period. Again in this case, the early stages of pregnancy will be paid from personal fund until after the waiting period is over. This is a protection provided for by HIPAA to employees switching jobs.

Chances are, the pregnant woman may not be able to comply with any of the above options for lack of financial preparedness. What happens to a low-income pregnant woman  who has not planned on getting pregnant but did, has no insurance and cannot afford to have one? Can the government offer some assistance to her in terms of medical benefits?

The answer is yes, fortunately. The government has allocated some funds for each state to make sure that uninsured pregnant women will be looked after in terms of their pregnancy and medical needs. About one third of the 13% uninsured pregnant women in the US are eligible for state-funded health insurance programs. We’ve heard about Medicaid which is available in all states. There’s also WIC (Women, Infant and Children). Medi-Cal is California-based government-funded insurance program for uninsured pregnant women.

Additionally, uninsured pregnant women may seek assistance from various organizations like American Pregnancy Association, Ameri-Plan, etc. These organizations are created with one common goal – and that is to offer healthcare coverage for uninsured pregnant women. Eligibility requirements and criteria will vary from one state or organization to another. But the important thing is, the stressed-out pregnant woman will no longer be that much worried about her condition and the expenses that go with it. The financial stress is somehow lifted and there will be time now to enjoy the pregnancy.

There are two things satisfied by a health insurance :  having access to medical care and making health care affordable. When faced with an illness, getting good quality medical care becomes overly difficult because of the spiralling costs of treatment, medical procedures, check-up, etc.. Without any health insurance plan, one will struggle with the financial impact of each and every medical service needed.

Individual and Group Health Insurance Plans

Individual Health Insurance Plans are offered for individuals who do not have employer-based health insurance.  This insurance will manage an individual’s health related needs from doctor’s visits to hospitalization to recovery. The health benefits or coverage will be largely dependent on an individual’s health or medical requirements. This normally costs more for the individual as the coverage may be customized to the needs of the insured.

Group Health Insurance Plans, on the other hand, are the medical care plans provided by employers to their employees as part of their work benefits and compensation package. Healthier employees mean healthier business for the employer. And since employers are mandated by law to provide health benefits through health insurance plans to all its employees, a good majority of Americans are covered through this type of insurance. And since the employers carry the bulk of payment, the coverage under this plans are somewhat restricted or limited.

Maternity Coverage

As mentioned earlier 13% of pregnant women in the US are not insured. This means they have no access to good quality health care and are oftentimes availing state-funded insurance programs to somehow help alleviate the costly pregnancy expenses, especially if their economic status render them incapable of shelling out money to pay for the insurance plans.

However, there are health insurance plans which do cover and include maternity benefits. Finding the insurance provider who offers this is a bit tricky as they have different conditions and parameters for this inclusion. Let’s summarize some of these conditions :

•  An existing individual health insurance may be attached with a maternity coverage rider. This is allowing additional coverage for maternity benefits at an extra cost
• An existing group health insurance plan may be requested for a maternity coverage supplement. The additional costs will be on the employee’s account
• Maternity coverage rider whether attached to an individual or group health insurance plan may require specific waiting period
• Insurance providers who offer maternity rider without waiting period may opt to increase additional insurance premiums for the desired additional coverage
• Maternity coverage rider also have conditions on not being pregnant at the time of getting the coverage. Otherwise, there would be considerable add-on to the premiums if already pregnant women are still accepted for coverage

It will take more than these limited information to be able to determine what available maternity coverage options offer the best deal. The best way would be to check every insurance plan, provider, state laws, etc., to make sure that the best and most affordable maternity coverage will be selected.

Alternatively, pregnant women may turn to the government for support. Government-funded insurance programs such as Medicaid, COBRA, WIC, American Pregnancy Organization and Ameriplan to name a few. All of them were created and are operating with one common objective, and that is, to provide assistance and support to pregnant women who, unfortunately do not have any health insurance plan.

While the country boasts of state-of-the-art medical facilities not matched anywhere in the world, the sad fact remains that not all Americans have access to these facilities which the government invested heavily. To address this problem, the US government has created state-funded or federal-sponsored health insurance programs which are made available to state residents provided they satisfy eligibility requirements and criteria.

Health Insurance in Texas

When a Texas resident finds out that she is expecting, there is a mixture of emotions that surface upon learning about the condition. A natural first reaction is that of excitement, anticipation and joy. The world is about to change and expectant mothers could never be happier.

But pregnancy is not all happiness. The exciting journey is interlaced with its own share of difficulties. The excitement is however, obscured by unnecessary worrying when there’s no insurance to cover for the medical expenses associated with the pregnancy.  And most of the time, pregnant women have to deal with this alongside the many emotional downs prompted by many different factors.

So how does a pregnant woman overcome this hurdle. Will there be any insurance provider in Texas who could help her manage the costly medical expenses through some sort of maternity coverage?

There are many health insurance plans available in Texas. However, there is no mandatory ordinance by the state for the inclusion of maternity benefits within an individual health insurance plan, Hence, most if not all insurance providers in Texas do not offer coverage for pregnant women.

What options are available? United Healthcare Texas, a local insurance provider offers a rather unique maternity coverage. Sometimes called ‘a defined amount benefit’, United Healthcare Texas provides two years of coverage for a fixed amount, increasing the fixed amount after maintaining the policy for at least 5 years.

Another insurance company, Assurant Health provides for a full coverage of a routine pregnancy after a $5 – $10,000 maternity deductible. This doesn’t look appealing at all!

Other  Options for Expectant Mothers 

Since Texas health insurance policies do not include maternity benefits, pregnant women are on the lookout for other alternative healthcare or medical care plans which could alleviate the financial burden of pregnancy. A possible alternative would be getting qualified and eligible to avail of Medicaid maternity benefits. Medicaid should eliminate the unnecessary worries of insurance premium payments as this plan is funded by the government.

Another option for pregnant woman who has no insurance at the time of pregnancy is to consider a job which offers good health insurance benefits. This is only possible if one is at the early stages of pregnancy because insurance providers would normally reject insurance coverage for already pregnant women.

Two other options to be checked are :

• If qualified and eligible to avail COBRA benefits (Consolidated Omnibus Budget Reconciliation Act)
• Get assistance from local Department of Health

With the increasing medical costs, the excitement that should go with the planning is masked by the worries brought about by the financial un-preparedness. Planning for pregnancy entails a lot of careful preparation, research and information gathering. These are important so that the couple will have a clear picture of what they are about to get into.

Pregnancy Preparation 

The emotional aspect will no longer be the focus here. What will be discussed and talked about are the preparations needed for the pregnancy to materialize and proceed without the hassles of worrying about finances.

Part of the early preparation for pregnancy involves a lot of decisions to make, but there are two which are most important and will impact the financial aspect of pregnancy. One is deciding on the healthcare provider (OB-GYN, midwife, or family practitioners). The other one is the decision on birthing location (hospital, birthing center or home)

Your decision on these two factors will have a big impact and implication in the overall cost of pregnancy or having a baby. It will also have an impact on the type of pregnancy insurance plan you need to avail such that coverage will include cost of health care provider  and cost of stay in either hospital or birthing center. Choosing to give birth at home would of course, pose the least expense.

Prenatal visits are important in making sure that the baby and the mother are both in good health and condition. This, too, should be included in the pregnancy insurance coverage.

Choosing the right pregnancy or maternity insurance plans (with all its intricacies) should factor in all parameters to ensure a healthy, safe and smooth pregnancy up to child birth. If  the pregnancy is high-risk, additional coverage or supplemental policy should be considered as well.

Since child birth would require caring for the newborn for a long time, prolonged or extended time off from work would have to be included in planning as you would need the means to support yourself and the baby. This is covered by supplemental maternity insurance plans, so it’s important that you avail of that, too.

Nutritional supplements, vitamins and minerals both for the baby and the mother could also chunk up the pregnancy budget.

If we stop here even if there are a lot more to consider, imagining the costs that go with each item will be stressful. How costly can getting pregnant be? But of course, if the pregnancy is planned way ahead, a substantial weight will be lifted once your health, maternity or pregnancy insurance, with all the supplemental benefits, are in place and ready to be utilized. Couples will be investing a great deal of money if insurance plans are availed individually and not provided by the employer.

Estimated Cost of Child Birth

The actual costs of having a baby will vary depending on the state of residency, insurance availed, etc. For the sake of information and giving couples who are planning to have a baby an idea of how much ‘investment’ they will be putting in, some estimated costs are listed below :

1. With Insurance coverage, normal child birth cost will range from as low as $500 to as high as $3000, depending on the insurance coverage availed
2. Without insurance coverage and without financial aid from government-funded insurance programs, normal vaginal child birth would cost around $8000 – $12000. Again the costs will vary depending on a lot of factors
3. Without insurance coverage, pregnancy complications like a c-section would cost around $13000 to as high as $20000
4. Without insurance coverage, premature child birth would cost an additional $10000 to as much as $30000 depending on how long the baby needs to stay at the neonatal IC unit of the hospital

These figures do not include other out-of-pocket expenses, copay, prenatal care and post neonatal care. These figures are just frightening! Can an average American couple afford having a baby?

Before frustration, stress and pressure set in, couples should know that there are available maternity / pregnancy assistance offered in so many different ways by government-funded organizations or state departments.

This statistic is highly contradicting the notion that the US Health Care System is the best in the world. This could only be true in terms of the highly-advanced medical technology and modern and up to date medical facilities available in most hospitals in the US. However, there is this problem of immense non-insurance among many Americans, which negates this notion. This has been the subject of never-ending debates among US policy makers. A lot of political debacle ensued following President Obama’s call for health reforms, which are supposed to improve the health benefits/coverage of the un-insured Americans. In 2009, it is said that about 13.5 million women of reproductive age have no insurance at all.  This goes without saying that about 13.5 million women have not received the required prenatal care and access to quality and complete care for pregnant women.

Insurance for Pregnant Women

As the costs of having a baby in the US can be extremely expensive, a pregnancy or maternity insurance is recommended as an important pre-pregnancy planning of a regular-income American couple. This  unfortunate financial burden quells a mother’s supposed happy and joy-filled anticipation on having a baby. Instead of worrying about how to care for the coming baby, the worrying is focused on how one can afford the costs of pregnancy and ultimately, the costs of delivering the baby.

While having maternity insurance will help dissuade this emotional stress, there are accompanying challenges faced by pregnant women in obtaining maternity or pregnancy insurance. First on the list is that some insurance providers consider ‘pregnancy’ as a pre-existing condition and, therefore, not included in the health insurance coverage. This challenge is actually countered by some government-funded healthcare programs like Medicaid, which is intended for low-income earners. This is a much-needed assistance from the government for low-income pregnant women since Medicaid will provide insurance coverage even if the insured is already pregnant contrary to the policy of some private insurance providers. However, the next challenge is qualifying for Medicaid insurance.  Details of Medicaid Eligibility will be found here.

There are employers, however, who include maternity insurance benefits to women employees as part of their health insurance although with some provisions on a waiting time before availment of said benefit. Other employers offer maternity insurance as an option for the women employees, outside of their health insurance coverage, requiring a certain amount to be shouldered by the employee. In any case, having maternity insurance, be it employer-sponsored or individually-availed, will give pregnant women the required prenatal care until delivery of the baby at a much lesser financial strain.

Average Cost of Delivery

Having a baby can really be financially draining, especially for those without maternity insurance. From pre-natal visits to food supplements to delivery, the accumulated costs can be staggering. The cost of delivery alone, sans the other procedures (if there are complications), will range from $6,000 – $8,000 for normal birth, without any complication and without insurance. This amount will undoubtedly shoot up to shocking figures if delivery is by cesarean section and for high-risk pregnancy.

Expect to shell out some $3,000 or less for the cost of delivery for those with insurance, excluding additional charges for the baby’s expenses.

So you see, the pregnancy or maternity insurance only helped but not totally eliminated all costs of having or delivering a baby. That’s why it is very important to find out the details of  coverage of the maternity or pregnancy insurance one is availing in order to be prepared if there are ‘exclusions’ or expenses not covered by the insurance and which need to be shouldered by the insured.

For stay-home mothers who are supported by a working spouse, this marks the beginning of a new milestone in her and her baby’s life. This is the start of a unique bonding between mother and child. After child birth, a mother would have to spend more time and attention to the newborn baby. Spending more time at home with the baby is not a problem with stay-home moms. There is no job or work to worry about. There’s only the baby to give full and undivided attention to.

On the other hand, working  mothers who have given birth to a child do not have the luxury of not worrying about staying home too long with the baby. Not because she did not want to. But mainly because there’s a job in the office waiting for your return, some weeks after child birth. As a working mom, your pressure is double – that of taking care of the newborn baby and that of keeping a job to support your baby. How does one deal with this?

Maternity Leave

Employers do have a responsibility to their workers (moms and dads) to provide them with the needed time off from work after a child is born in the family. This is commonly known to the workplace as maternity (for moms) or paternity(for dads) leave. Nowadays, this leave is referred to as parental or family leave. This paid time off from work is intended to allow parents to enjoy the coming of a new baby either by birth or by adoption.

In the United States, the Family and Medical Leave Act (FMLA) was passed in 1993. This act provided for workers to an entitlement of up to 12 weeks of paid leave. It is also known as job-protected medical leave  for birth or adoption, where parents are allowed to take leave from work for a maximum number of weeks. And the good part of this is, it’s paid. This is made possible by the provision of another type of insurance – Short term disability insurance. With some exceptions, most states allow women to avail this short-term disability leave to cover for child birth and post-partum recovery.

Short term Disability Maternity Insurance

Short term disability maternity insurance (STD) is designed to cover full or a portion of one’s salary during the job-protected leave taken. In most cases, employers and states do provide this benefit not as an option but as an automatic inclusion in the insurance package. A small amount out of one’s salary is taken out to pay for this insurance offered by the state or employer. Some employers even shoulder the full amount and the employee need not contribute to the premium amount.

If the state of residency does not provide for STD,  additional coverage may be purchased from private insurance providers, the premium of which shall be paid on a monthly basis. Benefits from STD may be coursed through the employer or through the insurance provider (if availed as an additional coverage to the existing employer-sponsored health insurance plan). The general term of this STD insurance is payment of the salary either 50% or 100% for a certain number of weeks. Standard for pregnancy is six weeks. For pregnancy with complications, the time frame covered is longer. These factors are dependent on one’s employment tenure with the company.

For STD insurance provided by the state, salary paid is usually half to two thirds and the period covered runs for four to six weeks and up to 12 weeks in some cases.

This short-term disability maternity insurance is one such insurance worth investing in, if it is not provided by the employer or the state. Whatever money you put into this plan will be utilized at a time when absence from work is required by child birth, adoption or recovery from pregnancy complications. This is something every pregnant woman should know about and plan for as this will take the financial worries off when one has to stay at home longer than necessary to care for the baby.

For Americans,  the medical care system is rather different and unique as compared to the health care system of other countries. While other countries have a national health insurance program for its citizens, the US have none. For a person to have insurance, one may avail either through employer or buying personally or through government-funded health care programs. Health insurance is a benefit accorded to employees by employers. Although smaller companies do without this benefit,  there are federal laws concerning the mandatory provision of health insurance  to employees of companies with more than 25 workers.

Health Insurance 

Employer-sponsored health insurance are given by companies as some sort of benefit to their employees. This is one way a person may have insurance coverage – through automatic enrollment in group health insurance by the company. But due to the high cost of insurance premiums, only big companies can be generous enough to provide comprehensive insurance coverage for its employees. Most of the employers, however, cannot afford full-coverage insurance and had to opt for health insurance with some limitations on the stipulated coverage. There are companies providing health insurance which does not include maternity coverage to married employees. There are also health insurance provided to employees which do not cover specific high-risk diseases. Some employers offer health insurance with options on wider coverage and inclusions for a certain amount to be shouldered by the employee.

Maternity Insurance

The most common insurance coverage which is very important to female employees, is that which covers maternity expenses. Usually, pregnancy or maternity insurance is packaged with other health insurance and not offered as a separate or stand-alone insurance. It should cover all medical costs related to pregnancy, from prenatal care to the delivery of the baby, and in some cases, up to postnatal care. It should include coverage for the medical requirements of both the mother and the baby.

Inclusions  

Some of the services one should look out for in a maternity insurance are :

• Prenatal visits and consultations with OB-GYN
• Postnatal visits
• Hospitalization (private room, medicines, other services / tests)
• Physician’s fees
• Routine procedures
• Preventive treatment (for high-risk pregnancy)

As a general rule, maternity insurance should be such that it will reduce your out-of-pocket pay-offs substantially so you can focus more on the exciting preparation for the coming of the baby and not the expenses that go with it.

Maternity Insurance for High-Risk Pregnancy

For pregnant women who are expected to give birth the natural or normal way, maternity insurance may just be a helpful means to ease up financial burden over a costly child birth. It’s being able to manage the expenses such that there will be minimal financial pressure.

On the other hand, women with high-risk pregnancy will find this insurance very important especially that which covers additional medical costs for pregnancies with complications. The costs for preventive care or treatment are sky-high, which without maternity insurance, will most likely get a family in deep medical debts. Maternity insurance which covers high-risk pregnancies will of course require additional copay which you will have to shell out from your own pocket. But in the long run, the benefits will outweigh the extra premium payments and help deliver a baby safely despite the complications.

Maternity Coverage

Maternity insurance is a health plan designed to cover medical costs that go along with pregnancy and child birth. It should cover the prenatal expenses, childbirth or delivery and postnatal care. The coverage should be for both mother and child.

Considering the high cost of medical care in the United States, it is no surprising that majority of insurance providers have taken out this coverage from their health insurance packages. Afraid of high exposure, insurance providers exclude pregnancy or maternity coverage although there are still some insurance providers who, under certain specific conditions and circumstances, include this extremely costly and complex health care plan for pregnant women.

Waiting Period

One such condition insurers give is a waiting period ranging from 3 months to one year or more before pregnancy could be allowed.  Pregnancy to some insurance providers is considered a preexisting condition, excluding it from the insurance coverage. In the case of an employee provided with a health insurance by the employer, an average waiting period of 3 months (from date of coverage) is given before the employee can get pregnant or before the insured can claim benefits. Other employers may have a different condition on the waiting period. Some employers consider maternity insurance as an optional coverage which the employee may avail on condition of additional payment to be shouldered by the employee.

Already pregnant women will find it hard to get covered. Their only option is to check out state- or federal-funded healthcare plans which could include coverage even if women are already expecting. But even this option presents some challenges such as eligibility and other state-specific requirements. The best way is to check out in advance all the requirements of the state for maternity coverage if you are planning to conceive a baby. This will at least give you an alternative just in case you are not able to get the maternity insurance in time for the child birth.

So, the question really is, “Is there maternity insurance with no waiting period?” Are there insurance providers who are sensitive enough to the needs of pregnant women?

The answer is yes. While most maternity insurance requires a waiting period before receiving maternity coverage or before the insured can get pregnant especially for employer-sponsored health insurance, there are other insurers who do not impose a waiting period. Maternity insurance with no waiting period is likely unable to provide hefty paybacks in the first year or two of coverage. This is despite the fact that you are to shell out (from your own pocket) additional money to pay for the coverage. The maternity insurance will cover an already pregnant woman, at an additional premium fee, but with less benefits until after the third or fourth year of coverage. And if this is the kind of maternity insurance you are likely to afford, long child birth planning is recommended.

For those who can afford the high cost of insurance premiums for maternity coverage with no waiting period, it’s all just a matter of choosing the insurance provider who can give the best payback in terms of benefits from prenatal, supplements, childbirth until postnatal or post baby and mother care.

Other Options

For pregnant women who are not covered by maternity insurance at all, there are other options to check, which will somehow help alleviate the burdening costs of childbirth.

Prenatal visits to the doctors alone are very expensive. It would take a lot of cash from your pocket and it will be for a number of times within the nine months of pregnancy. And this is just prenatal visits. Talk about other expenses like nutritional supplements for both the mother and the baby, laboratory work-ups, ultrasounds, sonograms, etc. The accumulated costs will be staggering and without any health insurance plan to take care of it, it’s just way too heavy to carry while pregnant. For this very reason, having a health plan or an insurance plan  covering your pregnancy and its expenses will be very helpful in making sure that the baby in your womb is well taken care of from the time of conception to  the time of child birth.

Maternity Insurance for Healthy Pregnancy 

There are many ways to keep a pregnancy healthy and good for both the mother and baby.   Pregnancy entails major lifestyle changes which are all geared towards achieving a positive effect on the expectant mother. It is believed that everything that happens to the mother has an effect on the child. Expectant mothers who has a positive outlook in life tend to pass it on to the baby in her womb. Hence, one should know that to have a healthy baby, the mother carrying the baby must be well and healthy, too.

This concern is addressed through a health insurance plan that covers pregnancy wellness from the very beginning until the end. Pregnancy wellness involves lifestyle changes (no smoking, alcoholic beverage, caffeine and prescription drugs), nutrition during pregnancy (essential nutrients and vitamins, nutritional supplements, folate/folic acid, etc.), complementary prenatal care (physical therapy, massage, chiropractic care), exercises and emotional changes (depression, mood swings, etc.).

It will be very ideal to get a health insurance that will provide for all of those pregnancy wellness requirements. However, in the event that the acquired health insurance cannot include all these, focus more on nutritional supplements and complementary prenatal care if possible.

Other Inclusions in the Maternity Insurance Plan

Aside from prenatal care, other benefits that should go with a maternity insurance plan are labor and delivery or child birth and neonatal care for the baby and postnatal care for the mother. Possibly with a reasonable increase in premium costs, the inclusion of pregnancy complications for pregnant women who cannot deliver normally should be thought of very carefully. Pregnancy with complications can be financially draining and if one can afford it, it would be the best available option to ensure the safety and health of the newborn baby.

Interestingly, there are a number of states that offer maternity insurance as a supplemental benefit. State-funded insurance plans may be combined with one’s existing health insurance with maternity coverage in order to maximize the benefits one can get from such insurance.

The key is having the time to ask around, choose from a number of referrals, inquire with one’s state’s options and take the best option  available and offered. All things considered,  pregnancy and child birth need not be that stressful anymore.