There is no such thing as Maternity
Insurance. So why are you here again? Don't panic.
The Supplemental Health Plans described on this website cover
many different types of medical hospital stays. Although they
cover all kinds of hospitalizations, they just so happen to also
cover maternity - but only after a 10 month waiting period. The
companies that offer supplemental plans change now and then.
Some stop offering the plans to new clients after a certain
date. These are the most current options available. See the
insurance policy contract for limitations, exclusions and
details.
What is
"Supplemental Maternity" Insurance, anyway?
This is not the real name for this insurance.
There is no such thing as Maternity
Insurance. It is a
supplemental "hospital indemnity" insurance plan policy.
Most individual major medical plans either don't cover maternity
at all, or only cover maternity after you pay a large deductible
like $5,000 or more before covering 100%. The supplemental
plans are used to cover that maternity deductible. The
money left over is yours to keep. The supplemental plans
have to be in force for at least 10 months before you deliver,
and you must be admitted into a hospital for at least 24 hours
to get the benefit. Although they are often used for maternity,
remember that it will cover other eligible hospitalizations
after being in force for 30 days. For this reason many
couples purchase the benefit for both spouses. This is
especially attractive if the male is self employed and has no
other disability or hospitalization benefits.
Supplemental insurance
pays you a flat amount for being admitted into hospital. Some
also pay a flat daily amount for each day you are hospitalized.
Regardless of the actual cost of your medical bills,
supplemental plans only pay that flat amount (ie $2,500 for
being admitted and $400/day). SO, your health plan might
pay everything over $5,000 at 100%. The supplemental plans pay
money directly to you. You can use that money to cover the
$5,000. YES, that means you can have 100% of your
maternity covered or even more than 100%. Any money left
over is yours to keep.
What are the medical Questions I need to answer to get
these supplemental plans? You need to answer the
"dread disease" type questions: Aids, Heart problems,
Cancer type questions. It is much easier to get a supplemental
plan then to qualify for major medical health plans.
What
company in their right mind would take apx. $400/month from me
and then pay me $8,450+ when I deliver?
No they aren't excited to lose money. In fact,
many of the companies have stopped offering their plans in the
state. Go figure. And the premium you pay is not just for
one company. For example this premium is a combination two
different companies. But remember that there are thousands of
people paying for hospital supplemental plans that will never
use them for maternity. That is the same concept
that applies here. They don't want to cover your
maternity. They don't want to cover any hospital stay for
any reason. But they cannot discriminate against you for using
it for a maternity hospitalization. As long as you are not
pregnant on your effective date, they then have to treat
maternity as any other hospital stay. Remember,
supplemental health policies should be purchased to be included
into your LONG TERM insurance portfolio.
What if my employer has a great maternity coverage plan
that covers most everything. Can I still take advantage of these
plans? Yes. Some of our best clients have
virtually complete coverage through their employer's health
insurance plan. They purchase the maximum benefit possible and
pocket the difference. They use the money for various
things. Some use the money to take longer maternity leaves from
work. Others save it for future expenses. Even others have
used it to got to Maui, etc. Really, it is your choice.
No questions asked.
Why can't I
just purchase the supplemental plan and drop my major medical
insurance?
Major medical insurance will cover medical expenses after a
deductible is paid and a co-insurance is shared (ie the 80/20
split with the insurance company.) After meeting the
deductible and co-insurance, an out of pocket maximum is met
(usually $2,000 - $3,000 maximum). Some health insurance
plans have a $5,000 maternity deductible but then cover 100%
after that deductible is met. Many do not cover maternity at
all. In any case, after the out-of-pocket maximum is
reached, the insurance company might cover 100% of the cost up
to a maximum benefit (usually $1Million, etc). If you had a
$500,000 hospital bill, Major medical would cover you very well.
If you only had supplemental insurance you would be left paying
about 98% of the bill all by yourself! Supplemental
insurance should only be used when you have a major medical plan
in force. Supplemental plans are used to pay for your
deductibles and Co-Insurance that your major medical plans do
not cover. Unlike Major medical plans, money you receive from
supplemental plan can be used for any expenses you choose (like
rent, mortgage, car payments, diapers, Maui... whatever!)
Aren't there
any health plans that include maternity?
Yes, there are a few. By the way, we would LOVE to help you
with your
health insurance needs and to
be your agent and help you apply for
Assurant Health Plans (or
Humana, but they exclude maternity) Assurant even has as
low as a $2,500 maternity deductile with 100% coverage after
that is met by the client. I recommend one of these two plans
and add a
supplemental health plan.
What if I
have no health insurance, or a plan that excludes maternity. Can
I still get these plans?
Most
Supplemental plans are NOT compatible with HSA eligible High
Deductible Plans. Specifically, if you have a daily benefit on
the supplemental plan you choose, then you CANNOT have an HSA
account (NOTE: you CAN have an HSA Eligible Health Plan, but the
deductibility of the separate HSA Account is in question if you
have certain supplemental plans . Having said this, there are a
few things to consider. For example the new Health Savings
Account Plans (HSA) are becoming very popular. You have to
pay for all maternity expenses yourself or out of your HSA
account. This presents a problem with discounting. When you go
to a hospital with a health insurance plan you get "in network"
discounts. When you go for a non-covered event, or you have no
insurance and are paying with cash you don't get the discount.
This can be a very big deal. For example, a typical
hospital bill for a two day maternity stay is apx $11,000 plus.
Because most people have insurance the hospitals agree to apply
the in network discount. This drops the bill to around $6,000 or
less. You could owe a whole lot if you have a plan that
doesn't cover maternity or if you are paying cash and don't get
the in network discount. Some have successfully negotiated a
"cash discount" with some providers. This is supposed to be
illegal for the medical profession to charge you one price if
you have insurance and another price if you are paying cash (ie
should be $11,000 either way before the in network discount).
I just want you to know these facts before you try to pay for a
delivery yourself or pick a health insurance plan that doesn't
cover maternity. That is why we recommend
Assurant Health Plans. they
have as low as a $2,500 maternity deductible and then cover 100%
of the balance. Let us help you decide help.
Click Here.
Who is
eligible for supplemental insurance?
These plans allow anyone to purchase them regardless of
employment situation. (Example is a "stay at home mom" can pay
apx $400/month and would get $8,450 for a two day stay in the
hospital). See agent for details and eligibility.
OK, there
must be a catch to the supplemental plans. How could I mess up?
You
caught me. There are ways to mess up. The following are 6
things to remember:
1)
You can't be pregnant on your effective date.
2)
Don't Deliver outside of a Hospital. If you deliver
at a birthing center or at home no benefit is paid.
3)
Stay in the hospital at least 24 hours. If you are
not there 24 hours, you have not been "admitted."
4)
Don't Stop paying your premium before your hospitalization.
Policy must be in force on delivery.
5)
You Must Deliver in the
United States.
6)
Don't enroll in a Government welfare program like Medicaid.
This can compromise your benefit.
Make sure you follow all of the above in order to receive a
benefit.
Do I have to
use certain doctors or hospitals?
No. You can go to any doctor any hospital. Just use the
facilities that your health insurance plan uses (must be in the
USA).
How do I get
my money from the plans?
There are two ways.
1) Give all of your supplemental insurance plan details to the
hospital when you deliver and sign the papers for them to claim
on your behalf and let them send you any left over money (do you
see any problem with that? I do!). Of course, we
don't recommend this first option. The next option is better:
2) Only give the hospital your medical health insurance
information when admitted. Then use the claim forms and a copy
of the hospital bills and send them into the companies yourself
(or you can fax them). That way you get the money paid in
a check mad out to YOU. Doesn't that make a little more
sense? It is a little more hassle, but it ends up with you
holding the money.
What if my
hospital bill is less than the supplemental benefit?
This is a trick question. The supplemental plan doesn't
care if you have insurance or not. It doesn't care if you
go to the most expensive hospital or not (as long as it is in
the USA!). It doesn't matter how much the hospital bill
is, the supplemental plan pays you a flat amount for being
hospitalized for at least 24 hours, and for each day after that.
If you had a $30,000 bill, you don't get more money from the
supplemental plans. If your bill is less than your
supplemental benefit you keep what is left over.
I am pregnant already. What are my options?
We currently do not have a plan for you if you are already
pregnant. Consider calling your local hospital and asking them
if they have any "pre-paid" delivery plans. Also the State
Government may have some options for you?
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What
if I move out of the state? Can I still use the plans?
Yes. However, be VERY careful when you leave the state and
make sure that you don't let the bank accounts lapse your
policies by you closing the bank accounts and forgetting to
transfer the payments to your new bank. (that was a mouthful!).
Also you need to plan ahead with your health insurance. Many
plans will drop you if you leave the state. The stat you move to
may not cover you if you are already pregnant when you apply for
coverage. They look at it as a pre-existing condition.
Some plans are portable from state to state. However most of
them don't cover maternity which result in you not getting the
in network discount. Call (801) 999-8504 so we can make
sure your health insurance plan fits your needs if moving out of
the state is a possibility while pregnant.
Further Questions? Call (801) 999-8504 or
Contact Agent by Email
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