Need Advice on Maternity Health Insurance Coverage

[DJAJ]

I was wondering if any of the health agents can assist me with which direction I should go. My wife is pregnant with what will be our 2nd baby. For our 1st we were on her companies insurance plan and the total out of pocket cost for us was $250. Well she was laid off since. I completely forgot to think about insurance for the second. It turns out our individual plan with BCBS covers maternity but after we meet a 5K deductible which resets on Jan 1. Our baby would cross the Jan 1 deadline. We haven't been to the doctor yet.

1. Is there any individual plans that cover maternity better then this?

or

2. I have a P&C business, i'm the only employee. Could I do a group plan through my business that would cover maternity?

Any advice would be helpful. Thanks!

 

[STIBROKER]

I was wondering if any of the health agents can assist me with which direction I should go. My wife is pregnant with what will be our 2nd baby. For our 1st we were on her companies insurance plan and the total out of pocket cost for us was $250. Well she was laid off since. I completely forgot to think about insurance for the second. It turns out our individual plan with BCBS covers maternity but after we meet a 5K deductible which resets on Jan 1. Our baby would cross the Jan 1 deadline. We haven't been to the doctor yet.

1. Is there any individual plans that cover maternity better then this?

or

2. I have a P&C business, i'm the only employee. Could I do a group plan through my business that would cover maternity?

Any advice would be helpful. Thanks!

WELL first off hard to believe that your indy bcbs covers maternity...second all exchange plans will cover maternity on jan 2014...but you have to look outside the box...... The insurance company's are not afraid of paying a claim for a normal delivery but rather that you have the right to add the child once they are born. In my case I wanted a little girl to go with my little boy and ended up with a set of boy/girl twins in neonatal for over $250,000. So when a individual plan has a maternity benefit they are at a higher risk of getting hit with a bill like this over a company that does not offer maternity.Plans that do not cover maternity still have to add a child once born.

 

[bluediamond]

BCBSFL had a maternity rider you could add to plans before July 1. Just purchase another plan between Oct 1 - Dec 15th to be effective Jan 1 and it will be covered.

 

[STIBROKER]

BCBSFL had a maternity rider you could add to plans before July 1. Just purchase another plan between Oct 1 - Dec 15th to be effective Jan 1 and it will be covered.

Even if they are currently pregnant.....

 

[ctg]

To answer your second question, a group plan most likely wouldn't be the answer. Right now, a group plan has to include everyone, regardless of any underwriting, so premiums are usually higher than going with individual plans. A group plan of 2 might be cost prohibitive. It may be a different story after 1/1/14.

Bluediamond is right, get a policy for a Jan 1 effective date if the due date is after the first of the year. If there are complications before then, most policies will cover that within the parameters of your policy.. Check if your policy says "Complications Only" for maternity.

But before you get a new plan, you'll have to get out a calculator once the new rates come in whatever state you're in if they haven't been released already. It may be cheaper to keep your plan and take the 5K deductible hit than go with a new plan.

 

[Yagents]

It depends........on your income for 2014, what state you live in, what you're paying now for premium, are you grandfathered, if you own an HSA plan, do you really have maternity for NON complications, or just for complications.

Talk to an agent in your state.

One thing I do know, you will be paying for that baby, Through deductible and premiums, either staying on your plan or through O'care.

 

[bluediamond]

Even if they are currently pregnant.....

No, they couldn't add the maternity being already pregnant. I thought he said he had the rider on there? Bill touched on something, if he is over 400% of poverty level and he is on a GF plan he would be better off staying on his $5000 deductible plan and biting the bullet.

 

[MyFIT]

Pay cash.. email me and ill show you where to get the pricing agrements depending on location.. my wife and I paid $5,500 cash. Its the cheapest way and most people over lokk it.. your plan will cover complications to pregnancy. (Examples -emergency c section.) Your obgyn will give u a payment plan..typically works like this... $1800 to dr.. covers all visits plus delivery. $800 anesthesiologist. $400 for 2-3 ultrasounds. (Some wome need rhogam shot $500 in addition) and 3, 000 for a 2 day stay for your wife.. theu take a 10-12 month paymeny plan at least.. stay away from florida hospitals.. stick to good ones...I personally have done this and do this for my cleants all the time.. lots of experience in negotiations. I even go to the extent of getting patients rx for free. There are so many things out there to be educated on.. could save lots of money... btw im in fl
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Wow just realized how many typos I have in that post from texting fast on phone please forgive that.. lol
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Also depending on state you are in.. in the month of august and month of august only you can do 1 man groups with bcbs hmo independent licensee carriers (like in my part of fl its florida health care plans). Or do a small group.. problem is they are pricey.. and plus deductible. . Plus coinsurance. . Etc.. I write with bcbs..but rarely.. I dont like them as a company and feel that a name doesnt qualify you as being the best. .. the will accept pre x preg on groups...

 

[DJAJ]

Thank you for the respones everyone. Here is some more info. We live in Maryland, we pay 535/ month in premiums. We just got off the phone with bcbs. It looks like our policy includes the maternity rider but the family deductible is 5k and the rider only covers room and board after 450 copay per day plus our deductible and complications after a 450 copay and the deductible. My wife is pretty much guaranteed for a c-section since thats how the first one went.

If any of you are licensed in Maryland and thinks they can help please pm. Thanks.