A benefit of the Affordable Care Act is that maternity coverage is required in all health insurance plans. This started in 2014 and has made having a baby easier than ever. Even though this coverage is one of the 10 required health benefits, you must still do some research to understand what your specific plan offers and what you will have to pay out of pocket.
Doctor or Midwife?
You will need to see a health care professional that is covered by your insurance program. Many obstetricians will be listed, as will some family doctors that offer maternity care for low-risk patients. It is possible to have a midwife for your doctor, but most insurance companies require that you use one that is working with an OB office. The midwife will report back to an OB who may step in if the pregnancy becomes high-risk or if there is a problem with labor and delivery.
If a midwife is working as part of an OB office, they will usually have physician's rights at the local hospital or birthing center. Make sure that this is accurate before you hire the midwife. Also, recognize that many insurance agencies will cover the costs at a hospital, but they will not cover costs at a birthing center.
Max Amount Per Person
If you have a high deductible insurance plan, you know that you will be paying for some of your care. You will have to reach your personal out of pocket maximum, or your plan's family out of pocket maximum yourself before the insurance pays for the rest.
You need to recognize that the hospital is going to bill you and your baby as two different people. That means that there will be physical costs, hospital stay bills, and medical bills for both mother and child.
Most likely, you will reach your family out of pocket maximum before both individual out of pocket maximums.
If You Don't Currently Have Insurance
Being pregnant is no longer considered a preexisting condition that allows an insurance company to turn you away. This gives women a lot more options. You may also qualify for Medicaid for yourself and your child.
Get the Tests You Need
The most important thing you can do when you are pregnant is to go see your doctor for your prenatal visits. Most insurance plans do not have any copays required at the time of the visits.
Your insurance company will cover the costs of the recommended prenatal tests such as: Rh compatibility screening, anemia screening, gestational diabetes screening, and screening for infections.
You have options with your health care. Do the research, ask the questions, and find out exactly what your plan is going to offer you. For more information, contact Meekins Insurance Services or a similar company.