Question on Assurant's Maternity Coverage

[2112Greg]

OK, so assume a client takes it out. They get pregnant. It pays off.

Then what happens?

I assume the premium for the maternity portion goes away and so does the coverage.

What if they want to have another? Can they pick it back up again at some point?

Any experience with this? It's the first time I've had this question...

 

[Crabcake Johnny]

Coverage doesn't go away but deductibles reset Jan 1st so if she got pregant again next year she'd have to satisfy the deductible all over again.

And actually it's a double whammy if she got pregnant in the 4th quarter of the year since Assurant ditched their carry over deductible.

So let's say she chose a $5K maternity deductible and got pregnant in October - assume she incurs $2K worth of expenses through December with 3K left to go. Ooops, nope, resets Jan 1st and she still has 5K to go.

 

[somarco]

Some states, notably Georgia, require deductible carry over.

Their $5k maternity deductible is a good deal. The $10k is too for those looking to squeeze premiums and are capable of handling the full freight.

 

[2112Greg]

OK, thanks, guys!

I wonder if they still have the carryover deductible in Texas...

 

[somarco]

have the carryover deductible in Texas...

If it is a state mandate, and I don't believe it is, they do. Seems like I heard a while back that GA is the only state with a mandated deductible carry over. That is the reason why (so I am told) Time does not offer the higher deductible for pre-ex conditions.

 

[TXINSURANCE]

Their $5k maternity deductible is a good deal.

It's cheap (not their plans but the maternity option).

However I don't have a lot of 20 to 29 year olds saying "what a good deal" the maternity is after a separate $5000 maternity deductible. Instead what I hear is "this pays nothing!!!"

 

[dgoldenz]

Anthem has by far the best maternity coverage I've seen....$71/month flat rate no matter the plan, 6-month waiting period, subject to plan provisions. Co-pay plans get co-pay for office visits, HSA plans are just subject to the chosen deductible. Now if they just got rid of the $5k prescription limit....

 

[Crabcake Johnny]

Mandates mean nothing for association-based carriers. Be willing to bet Assurant doesn't honor the carry forward deductible provision in GA - just a guess.

 

[dgoldenz]

And speaking of Assurant, I was reading through a policy yesterday and there was no less than 50 exclusions spelled out over the course of 7 pages. That's a way to give your clients real confidence that they're buying a good policy....I understand the need for exclusions for certain things, but some of them were ridiculous. No coverage for kids wetting the bed? No coverage for acne/rosacea in adults over 30 years old? No coverage for manipulating cranial bone shapes, or something to that effect....where do they come up with this?

The policy was also over 100 pages in total and weighed about 76 pounds. Good thing they give the client 10 days to read and understand every single part of such policy.

 

[somarco]

I don't have a lot of 20 to 29 year olds saying "what a good deal" the maternity is after a separate $5000 maternity deductible. Instead what I hear is "this pays nothing!!!"

I hear the same thing, so I show them KP. They still have $3k OOP and pay more than they will for the Time plan.

Or I can show them BX which has a $3k hospital copay and everything else is run through the regular major med deductible leaving them OOP at least $5k and a 12 month wait before conception.

willing to bet Assurant doesn't honor the carry forward deductible provision in GA

You will lose that bet.

The policy was also over 100 pages in total and weighed about 76 pounds.

It was written by Senate Democrats.