Maternity Health Insurance in Texas for your Pregnancy

Posted on March 27, 2012 by MaryAnderson

With the complex healthcare system in the United States, having a health insurance is as important as having a job. Without medical insurance coverage, an average American will not have access to good medical care if we are to base this on soaring medical costs and expenses.

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
At the end of the day, it is important that before getting pregnant, couples should prepare way ahead because the cost of prenatal, childbirth and postnatal procedures are no joke. Without any health insurance plan with maternity coverage, the pregnancy which ought to be a reason for joy and excitement will be a reason for unnecessary stress and worrying. Now who would want that? 
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The Cost of Having a Baby with and without Maternity Insurance

Posted on March 26, 2012 by MaryAnderson

When a couple plans on having a baby, the question that always surfaces is, “How much would it cost to have a baby?”

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.

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Average Cost of Pregnancy and Delivery With and Without Maternity Insurance

Posted on March 25, 2012 by MaryAnderson

Statistics show that there are about 50 million Americans who have no insurance – particularly, health insurance. For those who are lucky enough to have insurance, theirs is either under-insured or have very limited coverage. This is mainly due to the fact that most of the insurance availed by most Americans are employer-based insurance, which more often than not, gives a rather restricted insurance coverage to individuals as coverage is decided by the employers. About 60% of Americans are covered by employer-sponsored insurance.

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.

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