How Does Health Insurance Work When You’re Having a Baby?

Having a baby is never cheap. So if you are having a baby or planning to have one, you must also forecast the possible costs. That’s because the medical bills will come pouring in for the prenatal, monthly check-ups, labor, and delivery. And having health insurance can save you from massive expenses.

Here is how health insurance will work for you.

Maternity Coverage

Previously, maternity coverage does not give everyone a guaranteed benefit. Thanks to the Affordable Care Act in 2014, which qualified pregnancy as one of the ten essential health benefits. Meaning, from 2014 and onwards, all major health insurance plans will now include maternity coverage to give aid to all expectant mothers.

Health plans should cover maternity services such as doctor visits for prenatal and postnatal care, lab studies, medications, and all other outpatient services. Also, this may cover hospitalization during labor and delivery, as well as professional fees of attending physician, lactation counseling, and other newborn baby care advice from the healthcare experts.

However, it will vary from one health insurance provider to another. Better to check your insurance plan prints. Check on what it covers and what it does not. It will complement your maternity needs. If not, contact your provider and update your plan, provided that you get to update it during the scheduled enrollment period.

How to Get a Health Insurance Plan

The closest place to look is your employer. Check if your employer or your partner’s employer provides health insurance. Most of them do. It’s a good deal because it’s highly probable to get the most coverage at the best price. After all, they will be sharing the cost of premiums with you. Save a fortune for not paying insurance premiums at full price.

Next is to check in the health insurance marketplace. This may be a challenge for you because you have to identify which plans will give you the best benefits carefully. You will need to compare health insurance alongside your available budget if you are not well with this, better to ask experts for advice and to help you understand your insurance plan.

If you happen to choose a health plan, but your budget doesn’t seem to fit, you can apply for a government-run financial help to lower your out-of-pocket cost and premiums. But if you have a meager income and there are no other options that can make you purchase for a health plan in the insurance market, you can still sign up and be qualified under Medicaid or the Children’s Health Insurance Program (CHIP). It will vary depending on the state you are in, so make sure to check if your state has expanded its Medicaid coverage. And one good thing about this is you can apply anytime during the year. So you won’t need to wait for scheduled enrollment like in the marketplace.

Others You Might Need To Know

Health insurance might be a big help with your medical bills during pregnancy, but every rule has an exemption. One of these is if you are under a parent’s health insurance policy, which age is below twenty-six. Let’s say, for example, that you are pregnant at age twenty-four and under the maternity health plan of your mother. Yes, you will still be covered by the insurance of your mother as a dependent child, but not as to her grandchild. Meaning the law does not acknowledge extended maternity coverage.

Other options aside from Medicaid or CHIP? Shop for other available health plans such as the Consolidated Omnibus Reconciliation Act (COBRA). It is if you or your spouse lost a job, and you need to continue the employer-sponsored health insurance plan temporarily to support your maternity coverage.

Another is short-term health insurance. Though this may be a low premium plan, some of its plans offer limited protections. So be very careful to check fine prints if it covers maternity services. Moreover, if you miss to sign up for a health plan during the open enrollment, once you give birth to your child, you will get a ticket to a special enrollment period (SEP). The coverage will be effective upon the birth of the child, but the downside is, it does not cover maternity services.

Studies show that having a baby will cost you around $10,000. This is, however, for normal delivery without complication. This will increase if you factor in post-pregnancy care. So back up your pregnancy plans with health insurance and bring your baby with financial protection.