What is maternity insurance
Thanks for visiting our maternity options FAQ section!
Read the sections below to best understand how we can help you.
Who is USAMaternity.com?
We are an informational service to inform you on the very best maternity benefits available to you in your area. We are not an insurance company, nor do we offer insurance ourselves. We simply get you in contact with the best agents in your area based on your needs.
Below is information we have gathered from the many agents we have worked with over the years. The following is for informational purposes only and is not an official offer for insurance.
There is no such thing as Maternity Insurance . So why are you here again? Don't panic. Supplemental Health Plans can cover many different types of medical hospital stays. Although they cover all kinds of hospitalizations, they just so happen to also cover maternity - but many plans have a 10 month waiting period meaning you must deliver sometime after being on the plan for 10 full months. The companies that offer supplemental plans change now and then. Some stop offering the plans to new clients after a certain date. The agents we work with offer the most current options available. See the insurance policy contract for limitations, exclusions and details.
What is "Supplemental Maternity" Insurance, anyway? This is not the real name for this insurance. There is no such thing as Maternity Insurance. It is a supplemental "hospital indemnity" insurance plan policy. Most individual major medical plans have no maternity, or only cover maternity after you pay the first $5,000 -$10,000. The plans then sometimes cover 100%. The supplemental plans are used to cover that maternity deductible. The money left over is yours to use as you see fit. The supplemental plans have to be in force for at least 10 months before you deliver, and you must be admitted into a hospital for at least 24 hours to get the benefit. Although they are often used for maternity, remember that it will cover other eligible hospitalizations after being in force for 30 days. For this reason many couples purchase the benefit for both spouses. This is especially attractive if the male is self employed and has no other disability or hospitalization benefits. Supplemental insurance pays you a flat amount for being admitted into hospital. Some also pay a flat daily amount for each day you are hospitalized. Regardless of the actual cost of your medical bills, supplemental plans only pay that flat amount (ie $2,000 for being admitted and $550/day). So your health plan might pay everything over $5,000 at 100%. The supplemental plans pay money directly to you. You can use that money to cover the $5,000 and yes, that means you can have 100% of your maternity covered or even more than 100%. Any money left over is yours to keep.
What are the medical Questions I need to answer to get these supplemental plans? You will get this information when the agent contacts you, but in general you need to answer the "dread disease" type questions: Aids, Heart problems, Cancer type questions. It is much easier to get a supplemental plan then to qualify for major medical health plans. The plans usually do not cover any pre-existing conditions.
What company in their right mind would take my $262/month and then pay me $6,300 after 10 months? No they aren't excited to lose money. In fact, many of the companies have stopped offering their plans in Utah. Go figure. And the premium you pay is not just for one company. But remember that there are thousands of people paying for hospital supplemental plans that will never use them for maternity. That is the same concept that applies here. They don't want to cover your maternity. They don't want to cover any hospital stay for any reason. But they cannot discriminate against you for using it for a maternity hospitalization. One main limitation is that they exclude maternity in the first 10 months of the policy. They then have to treat maternity as any other hospital stay. Remember, supplemental health policies should be purchased to be included into your LONG TERM insurance portfolio.
What if my employer has a great maternity coverage plan that covers most everything. Can I still take advantage of these plans? Yes. Many people have virtually complete coverage through their employer's health insurance plan and still take advantage of supplemental plans. They often purchase the maximum benefit possible and pocket the difference. They use the money for various things. Some use the money to take longer maternity leaves from work. Others save it for future expenses. Even others have used it to got to Maui, etc. Really, it is your choice. No questions asked.
Why can't I just purchase the supplemental plan and drop my major medical insurance? Major medical insurance will cover medical expenses after a deductible is paid and a co-insurance is shared (ie the 80/20 split with the insurance company.) After meeting the deductible and co-insurance, an out of pocket maximum is met (usually $2,000 - $3,000 maximum). Some health insurance plans have a $5,000 maternity deductible but then cover 100% after that deductible is met. Many do not cover maternity at all. In any case, after the out-of-pocket maximum is reached, the insurance company might cover 100% of the cost up to a maximum benefit (usually $1Million, etc). If you had a $500,000 hospital bill, Major medical would cover you very well. If you only had supplemental insurance you would be left paying about 98% of the bill all by yourself! Supplemental insurance should only be used when you have a major medical plan in force. Supplemental plans are used to pay for your deductibles and Co-Insurance that your major medical plans do not cover. Unlike Major medical plans, money you receive from supplemental plan can be used for any expenses you choose (like rent, mortgage, car payments, diapers, Maui. whatever!)
Aren't there any health plans that include maternity? Yes, there are a few. By the way, we can refer you to the very best health insurance agents that know the health plans with the best maternity options in your area. Some companies offer a separate maternity rider. It allows you to pay a separate $500 deductible and then cover 100% up to a cap of $2,500, $5,000 or even $10,000! The Problem? They can be a little "pricey" and
most people find a better option through our supplemental plans. Although it sounds like a good option, there may be other options using different health plans. Let us refer you to an agent in your area that specializes in Health Insurance with Great Maternity options.
What if I have no health insurance, or a plan that excludes maternity. Can I still get these plans? There are a few things to consider. For example the new Health Savings Account Plans (HSA) are becoming very popular. However most individual/family plans do not cover maternity. This means you have to pay for all maternity expenses yourself and pay for them out of your HSA account. But this causes some problems when it comes to In-Network discounting. When you go to a hospital with a health insurance plan you get "in network" discounts. When you go for a non-covered event (such as maternity), or you have no insurance and are paying with cash you don't get the discount. This can be a very big deal. For example, a typical hospital bill for a two day maternity stay is apx $8,000 - 11,000 plus. Because most people have insurance the hospitals agree to apply the in network discount. This drops the bill to around $5,000 to $6,000 or less. You could owe a whole lot if you have a plan that doesn't cover maternity or if you are paying cash and don't get the in network discount. Some have successfully negotiated a "cash discount" with some providers. This is supposed to be illegal for the medical profession to charge you one price if you have insurance and another price if you are paying cash (ie should be $11,000 either way before the in network discount). Just know these facts before you try to pay for a delivery yourself or pick a health insurance plan that doesn't cover maternity. That is why we recommend Health Plans. they have a $5,000 maternity deductible and then cover 100% of the balance. Some have a $7,500 Maternity deductible or higher. If you need a better health insurance plan? We can help. Let us have an agent contact you that knows the maternity issues inside and out. Click Here or call (801) 999-8504.
Who is eligible for supplemental insurance? Most plans allow anyone to purchase them regardless of employment situation. (Example is a "stay at home mom" can pay $262/month and would get $6,300 for a two day stay in the hospital). You can get some plans through your employment. We can get you with a representative that knows how to find the very best options available without the "fluff."
Why do some of the plans require me to cover dependents also? The companies have set up guidelines for their products in each state. In Utah they have established this requirement in order for you to apply for the plans. The good news is that family members also get a benefit if they happen to be hospitalized. The 10 month waiting period is only for maternity. Any other qualified hospital stay would entitle you to receive the benefit after being on the plan for 30 days. OK, there must be a catch to the supplemental plans. How could I mess up? You caught us. There are ways to mess up. Many people have told us about the following are 6 things you could do to NOT get the benefit even though you pay each month: 1) Deliver anytime during the first 10 months of the plan. You deliver early, you don't get a penny. 2) Deliver outside of a Hospital. If you deliver at a birthing center or at home no benefit is paid. 3) Deliver at a hospital, but check yourself out before 24 hours. 24 hours to trigger the benefit. 4) Stop paying your premium before your hospitalization. Policy must be in force when you deliver.
5) Deliver outside the United States. You must deliver in the US to get the benefits. 6 ) Enroll in a Government welfare program like Medicaid. All benefits are then paid to Medicaid, not you. These are all ways to not get paid when you have a baby. Make sure you don't fall in these traps and you will receive a benefit. Do I have to use certain doctors or hospitals? No. You can go to any doctor any hospital. Just use the facilities that your health insurance plan uses (must be in the USA). How do I get my money from the plans? There are two ways.
1) Give all of your supplemental insurance plan details to the hospital when you deliver and sign the papers for them to claim on your behalf and let them send you any left over money (do you see any problem with that? I do!). Of course, we don't recommend this first option. The next option is better:
2) Only give the hospital your medical health insurance information when admitted. Then use the supplemental plan claim form and a copy of the hospital bills and send them into the companies yourself (or you can fax them). That way you get the money paid in a check mad out to YOU. Doesn't that make a little more sense? It is a little more hassle, but it ends up with you holding the money. People tell us they get paid 7-10 business days after submitting a claim. The check arrives in the mail. How cool is that! What if my hospital bill is less than the supplemental benefit? This is a trick question. The supplemental plans don't care if you have insurance or not. They don't care if you go to the most expensive hospital or not (as long as it is in the USA!). It doesn't matter how much the hospital bill is, the supplemental plan pays you a flat amount for being hospitalized for at least 24 hours, and for each day after that. If you had a $30,000 bill, you don't get more money from the supplemental plans. If your bill is less than your supplemental benefit you keep what is left over.
I am pregnant already. What are my options? Although options are somewhat limited if you are already pregnant, there are some state plans in your area that may be of assistance. However, none of the supplemental plans we know of will help you if you are already pregnant as they have a 10 month waiting period before you deliver.Source: usamaternity.com