If you're expecting a baby, your life is about to change. And we're not just talking about the endless diapers and sleepless nights that are part of being a new parent. We're also talking about insurance.
Can you still get health insurance when you're pregnant? What kind of coverage should you look for? How does having a baby affect your existing policies? These are all important questions to ask yourself as soon as possible.
Don't worry - we've got you covered (pun intended). Here's everything you need to know about getting health insurance while pregnant.
The Basics of Pregnancy and Insurance
First things first: pregnancy is considered a pre-existing condition by almost all insurers in the United States. This means that if you don't have health insurance before becoming pregnant, it may be difficult or even impossible to find coverage once you conceive.
It's worth noting that some states have banned such discrimination against pre-existing conditions since it falls under an individual’s right for healthcare access under Title I of HIPAA regulations whereas other states might allow this practice with governmental plan limitations on certain factors such as age, waiting time period after diagnosis which could range anywhere between 6 months up until years depending on many interlinked aspects like the type of illness/condition one suffers from etc resulting in denial-of-service or higher premium rates compared to individuals without any prior medical record for cost-sharing purposes.
However, there's good news: if you have an existing policy that covers maternity care or general healthcare needs with prenatal benefits included, then congratulations! You’re already ahead of the game
Maternity Coverage
Maternity coverage refers specifically to helping cover costs related directly towards anticipating mothers during their entire journey including from conception leading up through birth itself starting usually at least in most cases during month four onwards namely ‘prenatal’ stage post diagnosis unlike abortion-related services or fertility treatments or complications from a miscarriage which would usually be subjected to different considerations.
Many employers provide health insurance benefits that include maternity coverage as part of their employee packages, however alternatives such as spouse's employer plan or
ACA Marketplace plans
With the Affordable Care Act requiring all insurers who offer individual policies to cover pregnancy and childbirth starting from 2014 when it is put into effect you should have a wide range of choices available. However, choosing one can be overwhelming since every policy may differ in its details like premiums hence you should allocate an ample amount of time comparing and contrasting ideal options with due consideration paid off towards important factors relevant to your personal circumstances including any deductible amounts thereof regardless whether they impose limitations in certain areas especially down payment upfronts for premium payments during initial stages though some might opt out due budgetary constraints limiting other healthcare expenses necessary etc.
You'll want to make sure that any plan you're considering covers both prenatal and post-birth care, as well as any necessary follow-up appointments after delivery. Pandemic-related matters could also come up so do your research on this front
And don't forget - if you're planning on growing your family even further in the future, make sure that whatever policy you pick covers those additional dependents too!
What About Medicaid?
Medicaid is a government-funded program which provides free or discounted health insurance coverage for low-income families who meet certain qualifications. Normally Maternity Coverage requires individuals fit within at least up-to-138% poverty line bracket range specific states but guidelines vary across borders dependent upon respective local economy combined amongst other determinants i.e single jurisdiction handling Federally Facilitated Exchanges (FFE) versus State-Based Marketplaces (SBMs).
If you qualify for Medicaid assistance there’s not much else required appointment-wise besides submitting requisite forms/signing upto whichever scheme/benefits are applicable also enrolling/regularly re-checking since conditions keep changing based on myriad external/emergency factors.
Make sure to check with your state’s Medicaid department to learn about their maternity coverage options and acquire relevant information about each policy that which best fits you under existing circumstances.
COBRA Eligibility
COBRA stands for Consolidated Omnibus Budget Reconciliation Act. Basically, it's a federal law that allows people who have lost their employer-sponsored health insurance the opportunity to continue being covered under those same policies by individually paying inflated premiums without original contribution from erstwhile employers or sponsors allowing for continuation of provisions in case an individual is not able secure alternative employment contracts generating equivalent healthcare benefits within a specific time frame typically 60 days (often limited up-to-18 months unless there has been talked about extension on this front pending legislative changes potentially affecting how many re-enrollments one can avail)
If you're currently enrolled in an employer-sponsored plan before pregnancy occurred and lose said job after diagnosis-completion stage looking towards policies covering related medical aspects ensure eligibility requirements are met since timing remains key factor. Some noteworthy pointers include:
• You must notify insurer of termination/loss within a set period usually between sixty days post completion/conception or sometimes earlier like couple weeks depending upon regulations concerning such documentation management.
• Premiums commonly need be taken care-of upfront. Check out whether eligible amongst other conditions prior acceptance thereof depends as well: example-- waiting periods while enrollment initiated/if certain previous illnesses previously untreated might affect agreement available etc could also influence policy choices/responding agencies make relative decisions once paper work submitted properly.
Of course, COBRA can be expensive - but it may still be cheaper than trying to find new coverage if you have trouble finding adequate coverage otherwise so weigh risks opportunity thoroughly via various sources before jumping into any decision
A Word About Deadlines
It may take some persistence but ultimately setting deadlines making all queries absolutely necessary through appropriate channels should help matters significantly since policies involving claims are complex in nature and require various sets of referrals within required parties especially if still unclear after reading company documents/manuals thoroughly.
It is recommended that you get started with the process as soon as possible, however. Keep in mind many policies may expire without notice, some employers no longer exist who would have been former sources coverage etc, thus creating an additional sense urgency for maximizing regenerative period during leave time taken by each parent according to relevant regulations
Conclusion
Remember: having a baby can be an exciting and daunting task at the same time.Healthcare shouldn’t have to be though, now with over a wide range or choices available designed specifically towards providing tailored assistance in unique cases like pregnancy occurring while already under employment which covers maternity care.
Do your due diligence when evaluating insurance options - it'll pay off (literally) in the long run!