Pregnancy and health insurance

Make sure that you know your health insurance situation well in advance of becoming pregnant, if possible, and have the coverage you need.

If you've been thinking about getting pregnant, you've probably encountered a vast amount of advice- on things to eat and not to eat, activities to do and not to do, even folk wisdom on how to conceive a baby of the desired sex.But as you worry about your folic acid intake and imagine going shopping for baby clothes, make sure that you take time to consider your health insurance situation, potentially a very significant factor in a healthy pregnancy.Before you get pregnant, assess your current health insurance situation and any possible changes to it, so that you can both ensure your pregnancy is covered, and have some idea what your out-of-pocket contribution will be.

Group Health Insurance

If you have health insurance through your employer or your partner's employer, make sure that you have maternity coverage (not all states mandate that employer health plans provide this coverage).Make sure, too, at this point that the plan will cover your newborn, and investigate what kind of co-pays you will incur during prenatal visits and childbirth.The simplest health insurance situation for pregnancy is that you already have group health coverage and there is no likelihood of your insurance changing.

Under federal law, pregnancy cannot be considered a pre-existing condition when you switch from one group health plan to another.For instance, if you plan on quitting your job sometime during your pregnancy, chances are good (but, of course, make sure in advance) that if you can obtain maternity coverage through your partner's employer, your pregnancy and childbirth will be covered.If, however, you have not had health insurance, or have had individual insurance, a waiting period (possibly longer than your forty-week pregnancy) may apply to pre-existing conditions, including pregnancy.



If you or your partner is considering leaving the job that provides your health insurance, make sure to consider the timing very carefully.At a new job, there may be a waiting period before the health plan takes effect.Lacking insurance coverage for, say, a month early in your pregnancy may not be a problem, perhaps just meaning that you have to pay for a couple of doctor visits out of pocket.As explained above, the new plan will be required to cover your pregnancy as long as you have previously had group coverage.But if there's a gap in your insurance late in your pregnancy, you could find yourself having to pay for your childbirth.

Individual Health Insurance

Individual health plans may not provide maternity coverage, or they may have an extra charge for a maternity rider and require that the rider be in place for a certain number of months before you become pregnant.If you have individual health insurance, look into having a maternity rider well in advance of becoming pregnant.Do not plan on switching from an individual plan to a group plan (for instance, if you are self-employed but have access to group coverage through your partner) after you become pregnant, as the new plan will likely not cover your pregnancy.

If you have temporary health insurance, make arrangements to switch to full individual or group coverage.Temporary health insurance generally does not provide maternity coverage, and if you become pregnant, many such plans will cancel your insurance altogether.

Your Rights in Childbirth

Federal and state laws make a number of provisions to help women make their childbirths less stressful.Most importantly, a federal law that applies to many plans (other plans may be covered by slightly different state regulations) requires that they cover a new mother's hospital stay for at least 48 hours following a vaginal delivery, or 96 hours following a caesarean delivery.You can find out from your insurance company what their policy is.

If you are interested in a non-traditional birth- a birth at home, at a birthing center, or even at a hospital with a certified nurse-midwife- be aware that insurance companies are not currently required to cover these births.Look into your options in advance.If you have a choice between two insurance plans (presumably, your own and your partner's), investigate the coverage each offers.If you find that your insurance company does not cover the kind of birth you would like to have, don't be afraid to argue for it.The website of the American College of Nurse-Midwives provides samples letters to send to your insurance company, not only asking for the coverage but also explaining why it is the best interest of your insurance company to provide it (for instance, a lower instance of caesarean section).

When Pregnancy is Unexpected

That pregnancy is not always planned months in advance is one reason why every woman of childbearing age should do her best to always have health insurance with maternity coverage.If you become pregnant unexpectedly and need to make life changes, remember that if you have already had group health insurance, you can switch to another group plan during your pregnancy.

The worst-case scenario is that you find yourself pregnant without health insurance or maternity coverage, or that your daughter becomes pregnant and your plan will not cover her pregnancy (not all states require that health plans provide maternity coverage for dependents).If this happens, do not try to save money by skimping on prenatal checkups; doing so will only increase the risk of (potentially expensive) complications later on.If your income is low, you may qualify for WIC and/or Medicaid to help with the pregnancy.Even if you are middle-income, your local health department may offer free or low-cost prenatal care.Another option to reduce costs is to join a health discount program, which does not provide insurance coverage but may help you save money on provider and hospital costs.

If you're willing to be more active in your birth, consider having your baby at home, if home birth is available in your area and if your health status makes you eligible for a home birth.Home births attended by licensed midwives have lower rates of caesarean delivery and other complications than hospital births, and you could save fifty to eighty percent.Many women have found the experience very rewarding emotionally, as well.

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