If you are pregnant or thinking of having a child, you may be wondering what kind of insurance can help cover the costs. All ACA health insurance plans and Medicaid plans cover pregnancy. You can also get supplemental coverage to help with the costs or loss of income after giving birth.
There are several insurance plans that you can consider.
- All ACA health insurance plans and Medicaid plans cover pregnancy, but you may need supplemental coverage as well.
- There is no stand-alone maternity insurance policy; however, you can use add-ons or other insurance to bolster your coverage.
- If you plan on being pregnant, and if you buy independent insurance, look into various plans during the open enrollment period.
- If you wait until you are pregnant, you might not be able to enroll in some plans in time.
What Is Supplemental Maternity Leave Insurance?
Supplemental maternity leave insurance can provide extra coverage for costs associated with pregnancy and childbirth. It isn't a stand-alone insurance policy. Instead, it refers to add-ons or extra insurance options you can strategically use to supplement your maternity needs.
Two common types of insurance you can purchase to help with maternity leave and childbirth are:
- Short-term disability insurance: This helps replace income while you are not able to work due to medical reasons, including childbirth.
- Hospital indemnity insurance: This covers costs that come with admission to the hospital for labor and delivery; it also can help with any long hospital stays.
Along with buying extra insurance, you can review your current health plan to ensure that the policy you have provides what you need. Ask to see the Summary of Benefits and Coverage document for your health plan, and then compare it to those of other plans.
The Family and Medical Leave Act (FMLA) provides job security in certain cases for a brief leave when you are absent due to childbirth, but it does not guarantee income replacement. It covers up to 12 weeks of unpaid leave.
Compare Pregnancy Insurance Options Early
If you plan on being pregnant and buying insurance, look into the options available through various health insurance plans during the open enrollment period. Shopping ahead will always give you the greatest advantage. It will give you the time to compare the options for your pregnancy insurance coverage.
Your health insurance plan will help you cover the costs of care during your pregnancy and childbirth, but it won't make up for your lost income if you have to take unpaid leave. Look into disability and hospital indemnity insurance as soon as you can.
If you have employer-sponsored group benefits, you should find out what options you have when it comes to pregnancy coverage. You can ask to change your health plan, or you can add on coverage like a short-term disability plan. You may be able to get access to special programs.
Here are a few aspects of maternity insurance that you should compare:
- Compare the cost-sharing requirements. What is the deductible? What about co-pays?
- Compare in-network vs. out-of-Network costs. If you have an emergency, you may have no choice but to give birth out-of-network.
- Do you have a choice of doctor?
- Do you have a choice of hospital?
- Is there any coverage for specialists? These could include pediatricians, neonatologists, anesthesiologists, and others.
- Is there is a waiting period? How soon will your coverage begin?
- For short-term disability: Does the insurance include coverage for paid leave? Under what conditions?
Other Options for Maternity Insurance
Medicaid offers some options for maternity and childbirth. You can apply for Medicaid at any time, not just during open enrollment. If you do not qualify for Medicaid, you may still qualify for Pregnancy-Related Medicaid. Otherwise, you may:
- Coordinate benefits coverage. This is when you use your partner or spouse’s insurance to supplement you.
- Buy a maternity discount plan. This could save you a lot on your medical costs.
- Save money in an HSA or FSA. Then, use it for costs related to your pregnancy and childbirth.
- Buy short-term disability insurance to replace your income.
- Buy hospital indemnity insurance to cover extra bills.
- Take out a maternity leave loan.
Finding Maternity Benefits After You're Pregnant
If you wait until you are pregnant, you might not be able to enroll in time. Short-term disability, for instance, may have waiting periods.
The ACA covers pre-existing conditions like pregnancy. During open enrollment, be sure to enroll in a health plan that offers good benefits for pregnancy. Then, you will know you will benefit from coverage under that plan.
If you miss the open enrollment period, you might not be able to switch your policy when you find out that you are pregnant. Pregnancy is not a qualifying life event in most states, but there are some exceptions. For instance, New York lists pregnancy as a qualifying life event.
Being pregnant might not get you a special enrollment period, but having a baby will.
The Bottom Line
No maternity insurance policy can cover all your needs, but with a little research and planning, you could find the right combination of policies to provide you with additional income if you take time off of work. These health insurance moves can form part of a valuable strategy to help you see your family through the financial challenges of pregnancy, childbirth, and maternity leave.