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Baby Insurance Plans Question & Answers

2014 January 1
by Sarah Fields

Ken asks…

No maternity care on individual insurance plans in TX?

I found out (2 months too late) that in TX there is no maternity care offered on individual insurance plans in TX. My husband and I both have steady, good jobs and therefore are not candidates for any government assistance programs. Aside from not going to the doctor as much as normal….Does anyone have any helpful ideas to defray costs?

Sarah Fields answers:

Midwives and birthing clinics cost a fraction of what obgyns do. If you have a low risk birth (>95% are low risk!) then you’re a perfect candidate. Nearly all of Europe has low risk babies birth with midwives and their infant and maternal mortality survival rates surpass ours.

Sandra asks…

After getting health insurance how long to wait before getting pregnant?

My husband and I have been married a little over a year now and we are trying to find a good health insurance plan for the two of us to be on. We would like to start a family as soon as we can, but I have been told not to tell insurance companies that because they will not cover us. I am wondering how long after we get insurance do we have to wait before we start trying to have a baby. I am also wondering if anyone knows of any good insurance companies for young couples looking to start a family. Thank you.

Sarah Fields answers:

As a direct result of “0bamacare” nearly all individual plans in most states have stopped offering maternity coverage on the policy. There are a few states that mandate maternity be offered so hopefully you live in one of those states.

The waiting period for policies that do offer maternity can vary by policy and by company and can be from 12 to 21 months. You’ll want to speak with a local agent that works with all of the major companies in your area. The agent can find you the best policy for your situation and budget. There is no charge to use an agent.

It doesn’t matter if you tell the agent you want to get pregnant because the insurance companies know that if you are going to spend the extra money to get the maternity coverage you are wanting to use the coverage.

Just for an example: in my state there is only one company that offers maternity to an individual, and they only have one policy available. The cost of this policy is $250 per month more than an exact like policy but without maternity. You also must have this policy for 21 months prior to delivery or your maternity costs will not be covered. That means you are spending an extra $5250 in premium over those 21 months. The policy has a $3500 deductible and then you are paying 30% of the delivery charge.

The global maternity rate in my state is at most $7500 (and in many hospitals it is less). This means you are paying the first $3500 plus 30% of the next $4000 (which is $1200) for a total of $4700 when you have a baby. When we add the $5250 that you’ve paid in extra premium to the $4700 you’ll pay for the delivery you are paying a total of $9950. This is $2450 more than you’d pay if you paid cash. This is why it doesn’t matter if the insurance company knows.

You still need insurance because even if you don’t have the maternity coverage complications of pregnancy, such as a C-section, will be covered.

I’m suggesting to my clients to get a hospital cash policy in addition to a regular traditional policy without maternity and to place any extra premium you would have spent for maternity coverage into a special savings account. The cash policy will pay you cash when you go into the hospital and is much more cost effective.

Susan asks…

Why do most Americans not have access to an affordable medical health-care Plan?

Unlike Canada or Mexico, the USA health care insurance plans are inefficient and unaffordable for the Lower and Middle class, but not for the upper class.
President Obama promised to reform the Health Care System, and make it affordable for all. We hope he does it. Si se puede!

Sarah Fields answers:

You are misrepresenting the situation. Although 47 million Americans do not have health insurance coverage (and that is a very inflated democrat number), they can get the care they need…. At the same time at least 85% of Ameircans do have good health insurance coverage. Do you really think 85% of Americans want to jeopardize their current health care for Obamacare?

Michael above — love that 10 month example…. Reserve your spot for delivery of your baby first, and then conceive it a month later….

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