What is Maternity Health Insurance: How it Works

Maternity is that period in a woman’s life when she becomes a mother. This process is quite complicated and the slightest can lead to the death of both mother and child. To repeat my words, health insurance can be complicated. The things you have to look for are what’s my deductible and what’s my copay? These questions are required when you are buying a new policy or going through your policy. Copay or copayment is a payment defined in the insurance policy and paid by the insured person each time a medical service is accessed.

What you need to keep in mind is the fact that most maternity related expenses are not related to the normal benefits of a health insurance policy. The expenses incurred in pre-natal care, delivery, and post-delivery care is not covered expenses under the normal health plan. The next thing you have to remember is that of you are already pregnant and you apply for a health insurance policy, then you won’t get maternity insurance as an additional cover. The only option is to try for state assistance.

There is one more thing one needs to keep in mind and that is that this kind of insurance does not come cheap. That’s the reason why as you grow older and if you have an incurable illness then you will be charged a higher premium on your insurance policy because the insurance company stands the risk of bankruptcy if they get 100 claims which are similar in nature.

One more thing to remember is that nobody goes for maternity insurance unless that person is planning to get pregnant in the future. That’s the second reason why maternity insurance is costly.

Maternity insurance covers the costs of pregnancy and delivery. There are two ways in which maternity insurance works. The first method which is adopted by most insurance companies is subjecting maternity benefits to a maternity deductible separate from the normal medical deductible. Besides that, maternity benefits are pretty normal. If you break your hand, then the claim will apply to your medical deductible. Though the cost of a routine pregnancy is $4000 to $6500, the maternity deductible runs to $10,000. There is a benefit behind having such a high maternity deductible.

In any case, covered expenses get negotiated rates, whereas non covered expenses get the full amount. For example, if you go to the emergency room and don’t have health insurance, you will have to pay the full $4000 whereas if you have health insurance, you will get the amount negotiated between the hospital and the insurance company, which could be anywhere between $2400 to $3200. The second way is that which has been used by United Health Care’s individual division, the Golden Rule. In this rule, you get first dollar benefits, meaning you don’t have to meet a deductible before your insurance starts paying benefits.


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