Individual Health Insurance Maternity
Coverage

From LoveToKnow Pregnancy

Individual health insurance maternity coverage is sometimes offered as extra coverage known as an optional rider.

Individual Health Insurance Maternity Coverage can help with prenatal care

Individual Health Insurance

Many people receive their health insurance coverage through their employers. However, 5 percent of Americans buy health insurance on an individual basis, including:

  • Self-employed people
  • Early retirees
  • Students
  • Workers without health benefits

Regulations governing how private health coverage is sold vary from state to state.

If you are in the market for individual health insurance coverage, look for an independent licensed insurance agent who specializes in health insurance. Independent agents sell plans from several insurance companies. Because they work with more than one company, they can help find coverage that meets your specific needs. In today's technological society, insurance agents and brokers can be contacted via the Internet if you prefer. Listed below are a few options to help you get started in your search for individual health insurance with maternity coverage:

Individual Health Insurance Maternity Coverage

When insurance is provided by your employer, you are part of a group health plan and coverage is determined based on which plan your employer chooses. For individual health insurance, some benefits covered under a group policy like maternity coverage are not considered standard. As you shop for your individual health insurance, talk to your agent if maternity is something you want covered. Some individual health insurance companies offer an option to add services like maternity coverage for an extra fee. This additional coverage is known as an optional rider.

Maternity Coverage Rider

If you plan to start a family, purchasing individual health insurance maternity coverage is worth the extra cost because coverage will pay for expenses related to routine childbirth. Maternity coverage is not always available, and some riders provide more coverage than others. Talk over the details with your insurance agent. Ask questions like:

  • Will it cover pregnancy like any other medical event?
  • Can the maternity benefit be purchased after you are pregnant?
  • Do the maternity benefits have a different deductible?
  • What percent of expenses are paid once the deductible is met?

Pregnant without Coverage

For individuals who learn they are already pregnant before they purchase maternity coverage, the overwhelming financial burden of prenatal care can be frightening and stressful. If you find yourself in this predicament, there are a few avenues such as Medicaid that may be of financial assistance.

As a federal benefits program, Medicaid is available to help specific low-income individuals and families. If you qualify, Medicaid pays your healthcare providers directly for services you receive. Medicaid is governed state by state and is a form of medical insurance available to people who meet specific requirements. Women experiencing financial challenges who are pregnant qualify, but income level is one of the determining factors.

Cost of Individual Health Insurance

When you have to pay for your own health insurance, cost is a big factor. It is also the reason policies are usually simpler but also why deductibles and co-pays tend to run higher. The reason deductibles and co-pays are lower with a group insurance is because they are able to spread the risk among the high volume of customers covered. As an individually insured customer, your insurance agent uses your medical history to determine the insurance risk you pose. Predetermined risk factors influence the rates paid for coverage. Based on your health, the insurance company groups you with other individuals who have similar health histories. The premium you are charged for coverage is the same rate all the people within this group are charged. When it comes time to renew your policy, your rate won't be adjusted based on your individual claims, but on the claims submitted by the entire group to which you have been assigned..

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Comments

Sherpa, unfortunately, it will be difficult for you to get coverage for her at this point without paying high premiums. Your best bet may to be to check with your local human services office to see if she qualifies for any assistance through the government or WIC.

-- Contributed by: HollySwanson

Hello guys, Greetings, We just found out that my wife is pregnant. Currently we dont have health insurance, Does any one know which insurance company would provide health insurance for my wife. She is already pregnant and we need to start going to check up with doctors. Any insurance company out there for us?? your response is greatly appreciated. thank you.

-- Contributed by: Sherpa

Holly, unless your health insurance has different coverage for labor and delivery, you will likely need to pay the $5000 deductible for the C-section. Your husband's human resource department or insurance carrier should be able to provide you with more information.

-- Contributed by: HollySwanson
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