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...
...to 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:
http://www.instexas.com/
That's: InsTexas.com
Best Health Insurance Rates in Texas
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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.
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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....
....direct-to-you 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:
http://hsaplans.blogspot.com/
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 company....
fast!
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:
http://www.hhsc.state.tx.us/Help/HealthCare/Women/index.html
http://www.pcip.gov/
5 - HMO's - Like Scott & White in the Waco, Killeen, Temple, Round Rock or Gatesville areas - SWHP.org
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!
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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!
So..........buy 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 one.....at 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.
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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
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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...
...pay-out:
$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........
......you've made $700.
If your PPO discounts get your bills re-priced down to $12,000.........
.....you'll
owe the medical providers a balance of $1300.
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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.
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Look for additional Blog Posts as we find the BEST Limited-Benefit Policies...
...that
will cover maternity benefits as-ANY-other-condition.
Thanks!
Ruth ... InsTexas.com
Best Health Insurance Rates in Texas
Texas Health Insurance License # 1012551
Instant Online Quotes for Health Insurance Plans:
-
http://www.instexas.com/
- Instant Online Quotes
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We are HAPPY to be of assistance!
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- Call you (without a specific invitation to call)
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We'll keep this Maternity Insurance Blog updated.
So......you might want to "Follow the Blog" (however that's done)....on the right side of this screen.
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