Baby health insurance: Coverage options for new parents
Jessica Stevenson
| 2 min read
Did you know delivering a baby without health insurance can cost upwards of 10,000? Starting a family can be nerve-racking. Add in the confusion of health insurance and you’re probably thinking growing your family will be difficult and expensive. If you’re planning for a new little bundle of joy, here is some helpful background to guide you during the decision process.
A Preferred Provider Organization plan (PPO) for individual health insurance gives you the chance to purchase a maternity rider to add onto your existing health plan. The maternity rider covers pre and postnatal exams, delivery and routine newborn care. With a PPO, your annual deductible may range from $1,500-$5,000 depending on if you have an individual or family plan. Once you reach your deductible amount, the coinsurance rate will kick in, allowing expecting parents to be covered until they reach the annual out-of-pocket maximum. Most annual out of pocket maximums may seem rather high, but the financial costs of delivering a baby are significantly more expensive than the out of pocket expense.
HMO plans (Health Maintenance Organization) also offer a maternity option, though it requires a review process, or medical underwriting. An HMO plan has a separate maternity deductible and copay for prenatal office visits. While the HMO plan is more comprehensive than the PPO plan, it is however, difficult to get covered due to the medical underwriting.
For Michigan residents currently pregnant, individual plans would consider the pregnancy a pre-existing condition, excluding you from coverage for the first 180 days of the plan. However, with the provisions to the Patient Protections and Affordable Care Act, you are covered 100 percent through individual health plans for preventive well-baby and well-child visits and select immunizations.
Most importantly – don’t forget a newborn dependent must be added onto the parents plan within the first 30 days after the date of birth in order for retroactive coverage. Make sure you get the new little one covered!
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