Sunday, August 29, 2010

Maternity Insurance Plans in Texas

If you already own a Health Insurance (Major Medical Insurance) Plan that covers Maternity Benefits, you can keep it (in most cases). 

New Major Medical PPO Insurance Plans (on the private market in Texas) are not offering maternity benefits any longer. 
They do cover:
- Complications of Pregnancy 
....Illness or injuries related to a pregnancy 
- Complications of Delivery 
....This could be worth millions-of-dollars to you!
....So don't be without a Comprehensive Major Medical Health Plan!!!
- Emergency C-section Deliveries 

.....if they are TRUE Comprehensive Major Medical Plans 
.........that have been approved by the Tx Dept of Insurance. 

If you already own a Comprehensive Major Medical Health Plan, you can keep it! 
It probably offers millions-in-coverage for the unexpected things that might happen. 

That's the true purpose for insurance... cover those unexpected events that might happen
......that could wipe-us-out (cost us tens-of-thousands or millions). 

If you are not sure what you own, we can help you figure that out. 
You can always buy a new policy (if needed)... 
...that will give you the millions-in-coverage that you need
We have many excellent policies available. 

Instant Online Quotes: 

Best Health Insurance Rates in Texas


If you need a new policy with routine maternity (pregnancy & delivery) coverage, you'll want to ask about GROUP Health Insurance: 
- At work 
- From your Trade Association 
- From your University 
- From your Local Hospital System  (in some areas)

COBRA (extension-of-GROUP-benefits) IS usually available... 
... if you recently lost Group Health Insurance at work. 
Just call the 800 number on your Group Health ID card for COBRA info. 


If Group Health Insurance is not an option for you, there are other solutions: 

1 - Limited Benefit Health Insurance Policies (Most popular) 

These policies are not maternity plans!
But, most of them cover maternity claims as-ANY-other-condition. 

They can supplement a Comprehensive Major Med (Health Insurance) policy. 

They have a 12-month waiting period before covering pre-existing conditions
ie:  If you're pregnant, that's a pre-existing medical condition. 

Some of them will give you pre-x credit (if you have current coverage). 
Requires submission of a Certificate of Creditable Coverage. 
If you submit this COCC, pre-existing medical conditions are covered. 

These are not Comprehensive Major Medical Health Plans!!!!!!! 
They are LIMITED Benefit Health Plans. 
They'll pay-out LIMITED benefits.... OR direct-to-the-provider (Dr, Hospital, Lab) 

They will negotiate medical prices for you! 
...for all covered medical treatment. 
This alone could save you $10,000 (to have a baby). 
So....they are worth considering! 
I've seen $20,000 maternity/delivery claims re-priced down to $10,000. 

2 - Set up an HSA to pay for maternity expenses with tax-FREE dollars 

For more info about HSA Health Plans, please visit our HSA Blog:   

3 - Negotiate your own cash discounts. 

If you're willing to pre-pay (in advance), Doctors & Hospitals are willing to give you substantial discounts (just like they give the insurance companies). 

They know that they'll get their money from an insurance
If they know (up front) that you will pay them quickly, they are much more willing to discount their prices for you. 

This works very well with an HSA Health Plan (#2 above).  

4 - Govt assistance:

5 - HMO's - Like Scott & White in the Waco, Killeen, Temple, Round Rock or Gatesville areas  -  

6 - Medical costs are cheap in many other countries.  If you have relatives in another country, ask about the options that are available there.

7 - ObamaCare (with maternity benefits) will be available by 2014.
We still can't read (understand) most of this massive new HealthCare Law. 
It was very poorly written! 


Info about the LIMITED-Benefit Health Insurance Plans: 

Many of them will cover maternity benefits as-ANY-other-condition! 

But (with most of them), you can't be pregnant (when you buy coverage) unless you have prior "creditable" Health Insurance coverage.....(continuous coverage for the past 12 months). 
You can have a break-in-coverage not-to-exceed 63 days. 

We do not anticipate having Limited Benefit Plans that will cover an existing pregnancy if you have NO prior coverage! a Health Insurance Plan!

You can buy millions-in-coverage for less-than $100/month....
...a Comprehensive Major Medical Policy
...that will cover complications-of-pregnancy, complications-of-delivery & more!
We'll help you find the right price (for you)! 

The LIMITED-Benefit Health Plans pay-out limited benefits!!!
  ....NOT necessarily payment-in-full! 

The insurance companies pay the LIMITED benefits:
- Direct to you
- Direct to your Dr......(if Dr agrees to direct payments)
- Direct to your hospital (if hospital accepts direct pmts)
- Direct to your lab........(if they accept direct payments)

Remember that this is not always payment-in-full for the services rendered! 
Sometimes it's more than the Dr charges you! 
Sometimes it's less
It's a fixed amount.....for each visit/treatment. 
See examples below. 


PPO Network Discounts: 
This can save you hundreds......even thousands! 

I've seen $20,000 maternity claims re-priced down to $10,000 (and less). 

The LIMITED-Benefit Health Plans do give you access to PPO networks. 
The doctors & hospitals & labs that are IN the PPO networks will give you discounted medical prices. 

You don't get guaranteed percentages (discounts). 
These discounts are negotiated for you... 
...for all covered benefits. 

We often see 50% off.......but (in your case) it could be 40% off.....or 60% off. 

Just remember to use the Doctors, Hospitals & Labs that are in your PPO network. 
This will get you the lowest medical prices. 

There will be links at the Limited-Benefit Health Plans to: 
- Find a Doctor          (in the PPO network)
- Find a Hospital       (in the PPO network)
- Find a Provider       (in the PPO network)
- Etc 


Examples of LIMITED-Benefits:   

$  100 - Each Dr Visit................with a limit of 5 per calendar year/per person 
$  100 - Wellness Check-ups 
$  200 - Diagnostic/Xrays/Labs.........3 per calendar year/per person 
$  500 - Emergency Room Benefit
$1000 - Hospital Admission..............2 per calendar year/per person 
$1000 - Surgery Benefit
$1000 - Daily Hospital Benefit..........up to 30 days per confinement 
$1000 - Anesthesia Benefit 
$2000 - Accident Benefit 

Using the above example, let's look at a common Routine Pregnancy & Delivery...  

$500 - Mom's Dr visits.........2010 
$500 - Mom's Dr visits.........2011 
$300 - Baby.....3 visits..........2011 
$600 - Mom.....3 sonograms/labs.......2010 
$600 - Mom.....3 sonograms/labs.......2011  
$200 - Baby.....1 lab...........................2011 
1000 - Mom...........Hospital Admission in 2011 
1000 - Baby...........Hospital Admission in 2011 
2000 - Mom...........Daily Hospital Benefit........2 days in the hospital 
2000 - Baby...........Daily Hospital Benefit........2 days in the hospital 
1000 - Mom...........Surgery Benefit ......for stitches or other "repairs" 
1000 - Mom...........Anesthesia Benefit

$10,700 - Total Benefits pd by the insurance company (to you or your providers) 

If your PPO discounts get your bills re-priced down to $10,000........'ve made $700. 

If your PPO discounts get your bills re-priced down to $12,000.........'ll owe the medical providers a balance of $1300. 


We cannot predict your final price! 
Medical costs could skyrocket over the next year. 
They could remain stable. 
They probably won't drop. 
Major metropolitan areas have higher medical prices than rural areas. 
There are many variables involved. 


Look for additional Blog Posts as we find the BEST Limited-Benefit Policies... 
...that will cover maternity benefits as-ANY-other-condition. 

Ruth ...
Best Health Insurance Rates in Texas 

Texas Health Insurance License # 1012551 

Instant Online Quotes for Health Insurance Plans: 
- Instant Online Quotes 


We are here to HELP you....when you need us! 
We are HAPPY to be of assistance! 
But, we do not
- Call you (without a specific invitation to call) 
- Send out constant emails   (fill up your inbox with JUNK) 

We don't like "sales" calls! 
So, we won't do that to YOU. 

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So, we won't do that to YOU. 

We'll keep this Maternity Insurance Blog updated. might want to "Follow the Blog" (however that's done)....on the right side of this screen. 


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