What Maternal Health Benefits Are Included In My Coverage?
January 23 is Maternal Health Awareness Day, so The Insurance People are sharing what expecting and new mothers need to know about their health insurance plans and how to best utilize their maternal health benefits. Since the Affordable Care Act (ACA) covers maternal health as one of their 10 essential health benefits, these are unlimited benefits, meaning pre-existing conditions have no influence on access to coverage. Learn more about the maternal healthcare covered by your plan:
-Prenatal care and birth is covered by all plans. When people plan to have a baby, cost has a real and important bearing on the consideration. Whether you have an HMO or PPO, it’s critical to understand your plan’s components so you can prepare for the cost of birth. Because of the frequent visits to providers for prenatal care, which is included in the ACA’s benefits, elect a plan that relies on heavier use for that time. If you already have a doctor or hospital group in mind for your prenatal care and birth, make sure the doctor and group is in network so the experience will be more cost-effective.
-Mothers have 30 days to add their baby to their health insurance plan. For the first 30 days of life, babies are covered under their mother’s health insurance plan. For clients of The Insurance People, all you need to do is tell us the name and date of birth of your child, and we’ll get your new bundle of joy added to your family’s plan! You don’t actually have to wait for their social security number to arrive, either—just as long as it occurs in the first 30 days of their life. In the past, people have attempted to update their application on the Marketplace website, but have ended up making unnecessary changes by accident. But if you notify us, we’ll contact your employer, your plan, all the key players to get your newborn’s coverage added to your plan in time.
-Postpartum care is essential to your wellbeing. Whether you struggle with mental health, need pelvic floor therapy, or have an additional therapeutic need in your postpartum period, all of these fall under the umbrella of maternal health and are covered in your network. Plus, the cost of giving birth often meets a person’s out-of-pocket maximum with a PPO for the year, so after birth is a good time to utilize your benefits. Note: HMO plans often have copays for birth, so it is less likely you’ll meet your maximum after birth. But HMOs offer low copays, so it depends on the insured’s preferences.
-Don’t be afraid to take disability. Many of our clients have access to short-term disability insurance, and this is an extremely helpful benefit after having a baby. Vaginal births are typically covered up to five weeks, and c-sections are covered up to 12 weeks. Depending on your policy, up to 60% of your salary can be paid with a varying cap, which is policy dependent. Also, while it isn’t always talked about, postpartum depression is common. Combined with therapy, disability can also be taken for mental health leave. We’re happy to talk more with clients about how this works—we’re here to help you through this time.
At The Insurance People, we frequently help clients obtain maternal healthcare and newborn healthcare. Contact us today to learn more about plan elections that work for you and your family.