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Maternity Health Insurance for the Pregnant: Is It Possible?

2011 May 25
by Tim Thompson

An update to this post is now available, with more details and an additional option on the California Maternity Health Insurance page of the website.

The short answer is probably not unless you qualify for one of two exceptions. These exceptions are, join a group health insurance plan at your work or your spouse’s company, or if you have a non-maternity plan check to see if your insurance company will allow you to transfer to a plan that covers maternity care (Blue Shield of CA will allow a transfer to a maternity plan).

If the above options don’t help you, do you have other choices? Depending upon what state you live in, there are government programs to provide care for pregnant mothers to be, so check with your State Department of Insurance to determine what your local options are. In California, there is the state Medi-cal program (Medi-cal is the California version of Medicaid), and the Access for Infants and Mothers (AIM) program.

If you are pregnant and don’t have health insurance, then you should start with Medi-cal first to see if you qualify for coverage through their program. Medi-cal provides a zero-cost health plan for pregnant women that meet specific income limits. Medi-cal is intended to cover families and women that are below the federal poverty level. If you don’t qualify for Medi-cal then apply to the AIM program.

The AIM Program is low-cost health care coverage for pregnant women, and is provided for middle-income families who don’t have health insurance and whose income is too high for no-cost Medi-cal. AIM is also available to women who have private health insurance plans with a maternity-only deductible or co-payment greater than $500. To be eligible for AIM a single mother’s monthly household income must be between $2,453 to $3,679 (there is a table with income ranges for families with other children at http://www.aim.ca.gov/Costs/Income_Guidelines.aspx). The AIM program is funded by the State of California, and although funding is usually available, if the program is filled up, then no additional mothers will be enrolled.

Although health insurance is not usually available after you become pregnant, there are other options that can help. The Medi-cal and AIM programs are designed to provide maternity care to the uninsured mother, so there should be a solution for all mothers to be.

For additional information about AIM and Medi-cal see the following websites:

http://www.aim.ca.gov/AIM_Program/ Information about the AIM program

http://www.dhcs.ca.gov/services/medi-cal/Pages/MCIndividual.aspx Information about Medi-cal

http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/PE_Info_women.aspx Information about the Presumptive Eligibility program to gain access to Medi-cal.

 An update to this post is now available, with more details and an additional option on the California Maternity Health Insurance page of the website.

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