Babies on the Brain

Private pay insurance= no maternity coverage.....

My husband is considering starting his own business (and quitting his job, which provides our insurance).  He talked to the insurance rep. that his company goes through and she sent us comparables from different insurance companies for private pay insurance--- none of which covered maternity.  I've checked different websites, and that seems pretty standard for private pay insurance.  We have one beautiful little boy and definitely want more children-- and since we've already had one I have an idea of how much a normal pregnancy and delivery will cost  without insurance (thanks to the statements I received from the insurance company).  But what about a pregnancy with complications?  I guess what I'm asking is what do the insurance companies consider "maternity coverage"?  If I'm hospitalized during my pregnancy, is that covered?  And I know that with my husband's current insurance the baby is covered for 30 days and we have to add him on to the plan during that time, but what about with private pay insurance?  If my baby is born with something wrong, could they possibly deny him/her coverage, leaving us with no way to pay the medical costs to care for a sick child? 

 I have read that you can get a discount with hospitals (and possibly OBs) by paying before the baby is born, and we would definitely plan our next child so that we were able to do that, I'm just concerned about all of the "what if's" and how private pay insurance handles them.  Ofcourse I'll get all of the info I need from an expert, but as of now DH's insurance rep has not returned my email (from Thursday-- hoping she'll get back to me the beginning of this week), and we're really torn up about what to do-- Dh's current company has been struggling to find work for the crews (he's a land surveyor), and we're worried about him not having any PTO left and suddenly losing his paycheck.  He knows he could make money working for himself, but it's hard to even THINK about losing our insurance when BOTH of us know we want more children.  So any info you could give us from past experiences with this type of situation would really make the waiting easier! 



Re: Private pay insurance= no maternity coverage.....

  • Check this out:

    I plan on using CA's AIM program (Access for Infants and  Mother's) which is an insurance program for mid-income families.  Basically, I don't qualify for MediCare, but my private insurance does not cover maternity.  Luckily, most states have programs like these.  You just need to find the one in your state that will work best for you.

    Also consider less-expensive birth options like a birth center.  The midwife I was getting my Well woman care from only charges $4,000 for prenatal, labor and delivery, and postpartum care (for a home birth).  If you pay in full before you're full term she only charges $3,500. 

  • I've looked into private insurance here in NC, as I'm not exactly in love with my job that provides excellent insurance. ?Here, you can purchase a "maternity rider" for $200-$500 extra a month (ranging from coverage for real crazy emergencies only to approaching 'normal' maternity coverage). ?The rider must be in effect before you get pregnant, and many times there is a 6 month- 2 year waiting period. ?Again, this is just what I know about here in NC; I imagine this stuff varies greatly.

    If you are planning on getting pregnant again soon, you might consider getting pregnant, then your husband quitting, and getting COBRA or something? ?I don't know if this is feasible. ?Just an idea. ?It's expensive, but not as expensive as paying everything out of pocket. ?Good luck!?

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  • GBCKGBCK member

    self-employed insurance is...problematic to say the least.  (I speak from years of experience)

    while your DH is looking at these figures/costs/etc, I reccomend 2 things--1)check to see if local small-business groups offer insurance.   Sometimes small business assoc. [inc. roatry club and the like on occasion] will have a lot of small businesses 'pool' together to get group insurance.  It can be, sometimes, a helluva deal

    2) call your current ins co. and have them send you information on 'group conversion plans'.  That's when you convert from employer/group coverage to individual coverage.  No lapses, no pre-existing cond, and cheaper than what they offer to the general public.  Some of these had maternity coverage when we looked.  

  • I've never had trouble finding private insurance with maternity coverage.  Have you checked directly with large companies?  Like Blue Cross, Blue Sheild, Aetna.

    We currently have Kaiser, which has great coverage, but isn't available in all states.  But we used to have private insurance through Blue Cross.  Our deductible was really high, but we made sure it had maternity coverage before we decided.

    Perhaps the plans you are looking at don't offer it.  The more expensive options usually are the ones with the coverage.

  • Thanks to all who offered helpful information.  :-)  I actually have been looking at BCBS because that's who our current provider is.  I tried calling the customer service # I have on my card to see if they could compare my current plan with one they offer as private pay, but they told me to call someone else (gave me a # but I think it's just a regular agent-- the answering service didn't seem to know what I was talking about).  Also, all of the plans that I've looked at on the Aetna website said maternity wasn't covered.  And the list of comparables from the agent DH talked to went up into the pretty high premiums-- all said maternity was n/a or not covered.  But now that she knows we're specifically looking for that, maybe she'll have some more information for us.  I guess I'll just have to wait!  :-)  Thanks again to everyone who offered info.  Knowing people HAVE found private pay options with maternity coverage is reassuring. 
  • Good luck!  I DID find one company that would cover maternity care- for a whopping $350/month.  That's, oh, 1/4 of my income.  I don't feel you need to be rich in order to have a child and give them a good life and I think it's robbery that an insurance company can charge that much for just pregnancy coverage (with a $3,000 deductible, I may add).
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