pregnancy coverage

How to Ensure You Are Properly Covered For Your First Child

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Are you expecting your first child? Then you’ve likely started preparing for your baby’s arrival. One thing to consider alongside diaper bags, onesies, and breastfeeding is your and your baby’s health insurance. The right policy can help cover costs of prenatal and maternity care for you, along with immunizations and pediatric visits for your child. Consider the following information to get ready for the birth of your first child.

What Do You Need to Know About Coverage During Your First Pregnancy?

There’s a huge range in how much a pregnancy can cost you. In medical bills, it can run you anywhere from $3,296 to $37,227 for an uncomplicated pregnancy. This all depends on the hospital you visit and the care you’re provided with. Whichever end of the scale you fall on, you’ll want health insurance to help cover these costs.

If you work for an employer with 15 or more employees, federal law mandates that they provide pregnancy-related medical coverage, so chances are you may already be covered for this type of care. However, your current policy may only cover your hospital care, so be sure you’re familiar with your policy and that you add your child to your insurance within a few days of delivery. If you have an individual health care policy, you’re probably not covered for maternity care, so check over your policy carefully.

Also be aware that coverage varies drastically, with some policies covering as low as 25 percent of costs after deductible and others covering as much as 90 percent of the costs.

What Questions Should You Ask Your Insurance Carrier?

Coverage for yourself and your child during and after pregnancy will vary greatly depending on your insurance provider and your policy. That’s why it’s crucial you understand your coverage before the baby is born. Start with these questions to better understand your health insurance policy:

  • Does my plan cover prenatal and maternity care? What types of prenatal tests are covered?
  • Will I need preauthorization for any care I receive while pregnant?
  • Will I need a referral from my primary care doctor to see a specialist in the event of complications?
  • What types of fees are associated with my plan?
  • Do I have to notify the company when I go into labor?
  • What are your rules in regards to in-network and out-of-network health care providers and hospitals? Can I have a list of in-network services in my area?
  • How long can I stay at the hospital after delivery?
  • Does my plan cover home births if I choose to go that route?

How Do You Add the Baby to Your Insurance?

With most insurance providers, you have 30 days from your child’s birth to add him or her to your insurance. This is not something that will be done automatically for you. If you enroll during this period, you can avoid additional premiums, and any medical expenses accrued from your child’s birth will usually be covered.

To add your baby to your insurance, simply get in touch with your provider, and have your child’s full name, social security number—which you’ll know before leaving the hospital—and birth date on hand.

What Are Gaps in Coverage to Be Aware Of?

The biggest gap in coverage you’ll need to be aware of is when your individual policy doesn’t provide maternity or childbirth coverage. Only 12 percent of individual plans offer this coverage.

As Childbirth Connection points out, other gaps in coverage may include, “counseling and behavioral services, preconception and interconception care, postpartum care that includes mental health and family support services, and care that is tailored to meet the needs of women and families related to such factors as language, access, and socioeconomic status.”

To better prepare your coverage for your first child, get in contact with your insurance provider to understand your unique policy.

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