Choose an Insurer That Covers Your Pregnancy and Postpartum Needs

Pregnancy is a time of joy and anticipation with significant financial considerations. You’ll need to buy maternity clothes, baby furniture, and a car seat to safely care for your newborn. You’re also responsible for those prenatal appointment co-pay and may take on some costs your baby’s birth. For the savvy mama, there are ways to borrow clothes and get discounts on nursery items and car seats, so you want quality healthcare that doesn’t cost a fortune, too, right?

Research your options and select the best insurance carrier that gives you financial security during your pregnancy and the first year after baby’s birth.

Know Your Needs

Start by thinking of the care you will need while pregnant. You’ll have monthly, bi-weekly, then weekly prenatal appointments. If you have any medical conditions that are being monitored while you’re pregnant there may be additional expenses like medication, tests, and even hospitalization. Make a list of the must-have insurance coverage that’s essential for you and your baby’s well-being.

Compare Insurance Providers

The Patient Protection and Affordable Care Act (ACA) became law in 2010. It makes affordable health insurance available to more people, expands the Medicaid program (state-dependent), and supports methods designed to lower health care costs. You can search the marketplace to compare insurance providers (even for Medicaid) if you don’t have private employer insurance.

Look for reputable companies with a strong track record in providing comprehensive pregnancy coverage. Ask questions about their policies, benefits, and claim settlement history. Read online resources, customer reviews, and ratings to gather as much information as possible.

Check In-Network Hospitals and Clinics

Select an insurance carrier with a large network of hospitals and clinics where you can make appointments and access services. One way to rank carriers is by how close they’re located to where you live so your visits are convenient.

Understand Waiting Periods

Most insurance policies have 30, 60, or 90-day waiting periods before you can receive maternity care benefits. Align your family planning timeline so that you’re not left waiting for your healthcare coverage to begin. If needed, stay on your old health insurance plan until your new one begins, enroll in a short-term insurance plan, or enroll in a standard plan with a qualifying life event (e.g., job loss, marriage).

Review Coverage Limits, Premiums, Deductibles

Coverage limits and deductibles associated with different insurance plans are hard to understand. High coverage limits will safeguard you from unexpected medical expenses, while low deductibles ensure your out-of-pocket costs are within your budget. Calculate these aspects to find the right balance. You may decide not to compromise on coverage just to have a lower premium. If you become overwhelmed by all the options reach out to an insurance expert who can offer insight.

Evaluate Maternity Packages

Some insurance carriers offer maternity packages designed for different stages of pregnancy. Study these packages across multiple providers to understand if they cover doula services, childbirth preparation classes (breastfeeding, sibling classes, pregnancy yoga), or any other classes during pregnancy. Due to the ACA, many insurers now offer free hospital-grade breast pumps. The companies may require you to send documents electronically to process your pump request. Submit your claim in time to receive your pump before giving birth.

Benefits and Riders

Your chosen insurance carrier may offer additional benefits or riders (for a fee) that could improve your pregnancy insurance plan. These benefits could include coverage for complications during childbirth, emergency medical expenses, or other birth options such as home or water birth. Keep your contact information up-to-date so you receive notices about special events happening in your area related to childbirth preparation (e.g., baby showers and free giveaways).

Considerations When Choosing a State Insurance Carrier

1. Coverage options and benefits: Review the specific coverage options provided for prenatal care, birth, and postpartum care.

2. Provider network: Ensure your preferred pregnancy care providers participate in the state insurance carrier’s network. If you’re receiving emergency Medicaid for your pregnancy, in most states you still need to select a carrier to tap into all the benefits.

3. Affordability: Study premium costs, co-pays, deductibles, and any available subsidies or discounted rates.

4. Support programs: Explore additional support programs offered, such as prenatal classes and breastfeeding support.

5. Customer satisfaction: Read consumer reviews and ratings to gain insights into the experiences of other expectant parents with the state insurance carrier.

Seek Professional Advice

Health insurance coverage with the right carrier can reduce some stress during pregnancy. Once you know your needs, research different providers, and consider factors such as waiting periods, coverage limits, premium affordability, deductibles, and added benefits, you’re ready to make an informed decision. Financial support during pregnancy and the first year after baby’s birth is essential so that you can focus on the occasion of welcoming your new baby into the world.

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AUTHOR

Shawana S. Moore, DNP, APRN, WHNP-BC, PNAP, FAAN