Everyone needs insurance to cover one thing or the other. If you are pregnant, then you probably need insurance too that will cover your doctor’s visits, prenatal visits, hospital stays for your delivery, and any other potential complications.
With the best insurance options for pregnancy, maternity care, and newborn care would be provided for you and your family.
In this article, you will learn about the 15 best insurance options for pregnancy, why you need the best insurance options for pregnancy, and who needs the best insurance for pregnancy.
Table of contents
- Why Do You Need the Best Pregnancy Insurance?
- Who Needs Best Insurance for Pregnancy?
- How Do You Know Which Insurance is the Best for Pregnancy?
- How Can I Get the Best Insurance Option for Pregnancy? Step by Step Guide
- 15 Best Insurance Options for Pregnancy
- #1. Marketplace insurance
- #2. Employer-sponsored health insurance
- #3. Medicaid or CHIP
- #4. Medicare
- #5. Short-term disability insurance
- #6. Hospital Indemnity
- #7. Centene (Ambetter)
- #8. ManipalCigna Pro-health Insurance
- #9. Aditya Birla Activ Health Enhanced Health Insurance
- #10. Bajaj Allianz Health Guard Family Floater Health Insurance
- #11. UnitedHealthcare
- #12. Anthem
- #13. Aetna
- #14. Cigna
- #15. Humana
- Frequently Asked Questions
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Why Do You Need the Best Pregnancy Insurance?
There are several reasons why you need the best pregnancy insurance. Some of the reasons are-
- Health coverage makes it easier to get the medical check-ups and screening tests to help keep both you and your baby healthy during pregnancy.
- You have the freedom of electing which plan you want to use. Each plan costs a different amount of money and covers different services for you and members of your family.
- You can find plan summaries and get information about health plans for you and your children in your state’s Health Insurance Marketplace. This is an online resource set up by the Affordable Care Act that helps you find and compare health plans in your state. This makes the whole process easy for you
- The insurance option for pregnancy would act as a back-up plan, keeping you afloat in case of any complications.
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Who Needs Best Insurance for Pregnancy?
You would need the best insurance for pregnancy if you;
- do not have health coverage
- currently have marketplace coverage
- have Medicaid or CHIP
- are pregnant or planning to get pregnant
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How Do You Know Which Insurance is the Best for Pregnancy?
There are quite a lot of insurance options for pregnancy. At a point, you might get confused as to which one is the best pregnancy insurance.
When comparing insurance options for pregnancy, look at the costs to help you decide if the plan is right for you. In considering this, you should check out-
- Premium. This is the amount of money you pay each month for insurance.
- Deductible. This is the amount of money you have to spend before the plan starts paying for your health care. For example, if you have a $500 deductible, you have to spend $500 on health care before your plan will pay. Your deductible does not include your premium.
- Co-payment (also called co-pay). This is the amount of money you pay for each health care service, like a visit to a health care provider.
- Maximum out-of-pocket cost or expense. This is the highest amount of money you would have to pay each year for health care services. You don’t have to pay more than this amount, even if the services you need cost more.
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How Can I Get the Best Insurance Option for Pregnancy? Step by Step Guide
The process of getting any of the best insurance options for pregnancy is quite an easy one. These steps to be taken are-
Start by creating an account to apply for Marketplace coverage through the Open Enrollment Period or a Special Enrollment Period.
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If you select the option to get help paying for coverage on your application, you will be asked if you are pregnant.
Reporting your pregnancy may help you and your family members get the most affordable coverage.
If you do not qualify for a special enrollment period right now, you will be eligible to apply within 60 days of your child’s birth.
You can also enroll in 2021 coverage during the next Open Enrollment Period this fall.
If eligible for Medicaid or CHIP, your coverage can begin at any time.
If you currently have Marketplace coverage or if you already have Marketplace coverage when your baby is born, you can keep your current plan and add your baby to your coverage, or create a separate enrollment group for your baby and enroll him or her in any plan for the remainder of the year.
No matter when your child is born, you should report their birth to the Marketplace by updating your application as soon as possible.
Your coverage options and potential savings may change as a result. You may qualify for more savings than you’re getting now, which could lower what you pay in monthly premiums.
To update the application, log into your account to “report a life change”. When you update your application, you will be told if you or your baby may be eligible for Medicaid or CHIP.
If found eligible during your pregnancy, you would be covered for 60 days after giving birth. After 60 days, you may no longer qualify.
Your state Medicaid or CHIP agency will notify you if your coverage is ending. You can enroll in a Marketplace plan during this time to avoid a break in coverage.
If you have Medicaid at the time of delivery, your newborn will be automatically registered in the program and will be eligible for at least a year.
15 Best Insurance Options for Pregnancy
#1. Marketplace insurance
This is one of the best insurance options for pregnancy out there. If you do not yet have insurance and are looking for an individual marketplace plan, Marketplace insurance might just solve your problems.
You would however need to wait until an open enrollment which usually begins on the 15th of each year.
While marketplace plans typically provide robust and comprehensive health coverage, these plans are typically more expensive than federal programs or employer-sponsored insurance. Marketplace plans cover all essential health benefits, including maternity services.
#2. Employer-sponsored health insurance
Employer-sponsored health insurance can provide coverage through either the pregnant mother or through a spouse from a group insurance plan.
These plans are beneficial if the employer pays for a portion of your health insurance premiums to help reduce your payments.
Adult children classified as dependents under an employer health care plan are not eligible to receive coverage for pregnancies of their children.
In this case, the best health insurance option would be to look into Medicaid or marketplace health insurance.
#3. Medicaid or CHIP
A pregnant woman can enroll in Medicaid and CHIP’s federal programs that provide free or low-cost health coverage to millions of Americans.
Specifically, these programs assist low-income families and children and pregnant women and newborns in affording healthcare.
Eligibility for these programs depends on household size, income, citizenship, or immigration status. The states both administer Medicaid and CHIP, so specific rules and benefits may vary, depending on your location.
While Medicare is typically associated with coverage for individuals over 65, you may be eligible for Medicare due to disability.
For pregnancy or childbirth, you would be covered for hospital services under Medicare Part A. Medicare Part B would protect the doctor services and outpatient procedures, including lab tests and blood work. After the birth of your child, Medicare would not cover services for your baby at all.
#5. Short-term disability insurance
Disability insurance may replace the mother’s income during maternity leave or be directed by her doctor to be on bed rest.
Each employer has its own family leave policy, and not every employer pays your full salary while on leave upon extension of your leave.
The Federal Family Leave Act (FMLA) only guarantees 12 weeks of unpaid leave under specific doctor directs her eligibility criteria.
#6. Hospital Indemnity
Hospital indemnity insurance is helpful for labor and delivery, but prenatal services are limited. These types of plans cover all of your expenses for hospital admission and delivery of your child.
If your child is born prematurely or needs to be admitted to the neonatal intensive care unit (NICU) or ICU, they design these plans to help cover more extended hospital stays.
If you expect a high-risk pregnancy or delivery, these low-cost supplemental plans could be something to consider.
#7. Centene (Ambetter)
Centene is a publicly-traded insurer. It expanded its participation in the Obamacare healthcare exchange in 2018.
Ambetter is Centene’s health insurance marketplace (HIM) product and operates in these states: Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Michigan, Mississippi, Missouri, New Hampshire, New Mexico, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Washington.
It offers one of the most attractive insurance options for pregnancy.
#8. ManipalCigna Pro-health Insurance
Prohealth policy offered by ManipalCigna Health Insurance is a comprehensive health insurance solution for your illness as it is loaded with basic covers, value-added covers, and optional covers.
The minimum entry age for this policy is 91 days for children and 18 years for adults, and the good news is that there is no limit on the maximum entry age for this policy.
You can purchase the policy on an individual or family floater basis for a term of 1 year, 2 years, or 3 years as per your requirement and budget.
#9. Aditya Birla Activ Health Enhanced Health Insurance
Activ Health Enhanced plan is a premium variant of Activ Health Plan by Aditya Birla Health Insurance Co. Ltd.
The plan protects health while offering rewards at the same time. Designed to provide support in the journey towards well-being, Activ Health Enhanced Plan offers coverage and good insurance options.
#10. Bajaj Allianz Health Guard Family Floater Health Insurance
Health-Guard Family Floater Policy offered by Bajaj Allianz General Insurance is an indemnity based health insurance policy that offers comprehensive coverage for various health care expenses.
The three variants are Silver, Gold, and Platinum, which differ from each other in terms of coverage benefits and sum insured options.
You can buy this policy for 1 year, 2 years, or 3 years but it is recommended to buy it for the long term so that you do not have to renew it from time to time. Some coverage benefits that you can avail of under this policy include in-patient hospitalization expenses, pre-hospitalization and post-hospitalization expenses, domiciliary hospitalization expenses.
UnitedHealthcare, part of UnitedHealth Group, is the largest health insurance company by total members.
Basically, UnitedHealthcare offers a variety of products from individual health insurance to full employer benefit plans for some of the biggest corporations.
Along with having the most members, UnitedHealthcare also has a network of over 1.3 million physicians and health care professionals, with more than 6,500 hospitals. This means that if you have UnitedHealthcare, you will have many options to choose from to receive care.
Anthem is the second-largest medical insurance provider by total members, with more than 45 million members.
The company’s Commercial and Business health care segment offers network-based care to large and small businesses, individuals and Medicaid and Medicare markets.
Anthem is part of the Blue Cross Blue Shield Association. This means that when searching for Anthem policies on your state marketplace exchange, you may find products with the BCBS name, but you will be buying from Anthem. It is one of the best insurance options for pregnancy.
Aetna was acquired by CVS Health Corp. in 2018. CVS Health now operates the company and has been able to seamlessly integrate its provider networks with Aetna’s membership base.
Founded in 1853, Aetna is the third-largest provider of health insurance and services, by the membership.
However, much of its membership comes from providing health insurance to employers and their employees in the private market. Aetna returned to a limited number of ACA marketplaces for the 2023 plan year. It is one of the best insurance options for pregnancy.
Cigna is the fourth-largest major medical insurance company in the United States.
Basically, Cigna offers health insurance and health services to companies throughout the world.
In addition to corporate health insurance policies and management of those plans, Cigna also offers dental, behavioral health, vision, supplemental health and Medicare/Medicaid benefits.
Humana comes in as the fifth-largest health insurance company by the membership. The provider was founded in 1961 and originally sold long-term care insurance before expanding into selling health insurance policies.
Humana has not offered new individual ACA health insurance since January 2018 but will continue to honor its existing ACA policies.
Humana is now focused on serving the Medicare market, with either a Medicare Advantage or a supplemental plan (or both) available in every state. It is one of the best insurance options for pregnancy.
Frequently Asked Questions
C-sections cost nearly $10,000 more than a natural vaginal delivery if the mother is uninsured. With insurance, C-sections cost a little over $4,000 more than standard delivery.
All plans have to cover prescriptions, but each plan covers them differently. A prescription is an order for medicine given by a health care provider. If you use prescription medicine, you can find out what prescriptions are covered by each health plan in the online Marketplace.
When planning to acquire insurance during pregnancy, the rates will depend on your age and current condition. If you are at risk of some severe pregnancy conditions, it is most likely that your premiums will be higher. These things will affect the cost of your insurance premiums which makes you pay higher amounts, but an insurance company is not allowed, by law, to raise insurance premiums based on pregnancy.
The range differs for each family depending on household income. Still, generally, a mother should parcel out at least $12,500 for the year for all the necessities along with health insurance.
If you currently are using a surrogate for pregnancy, then there are health insurance implications that you should be aware of. Intended parents are always required to provide health insurance for a surrogate. You would need to use your health insurance to cover the maternity and newborn expenses during the pregnancy of the surrogate.
Whether you are planning children into your future, amid a pregnancy, or have just given birth, having the best insurance options for pregnancy is essential for managing the planned and unplanned healthcare costs for you and your baby.
Maternity and infant care can be expensive, but health coverage enables you to engage in prenatal and postnatal care, minimizing the mother, your chances of complications during pregnancy.
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