California Maternity Insurance After Obamacare

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Every plan in California now provides maternity coverage. But some plans are better at reducing your costs. We’ll show you which ones. Picking the right plan is now very important.

Although health care reform (Obamacare) is supposed to reduce costs, most thought they would see the reduction in lower monthly premiums. Best Health Insurance In California For MaternityThe new Obamcare maternity insurance plans do reduce the total cost to have a baby by making the prenatal care free. You’ll see this result in the analysis shown below.

We’ll briefly cover the key benefits you’ll want in good maternity insurance, then we’ll show you the Best California Maternity Insurance Plans, and we’ll review how Obamacare has effected maternity care options in California. Finally, we’ll give you a simple step by step process to find the right health coverage for your pregnancy and delivery, and show you a simple trick to reduce the overall cost of your baby by timing when you give birth.


See the Top Pregnancy Health Plans in San Diego







All Obamacare health insurance provides maternity coverage, but that doesn’t make ANY plan a good option. We analyzed all the California health insurance options and show you which are the Best California Maternity Insurance plans. The best pregnancy coverage for you is the one that reduces your total out of pocket costs, including the monthly premiums and any costs associated with the prenatal care and delivery. To get the top maternity insurance, California mothers need to talk to the experts. At SPF Insurance we are your maternity insurance experts. Because of the regional differences in which plans are available in California, the best plans in San Diego might not be the best plans in Fresno or San Francisco. Ask us and we’ll do the analysis for your region and show you which plans are your best options.


Best Maternity Insurance In California Post Obamacare

The best insurance for pregnancy is a Co-Payment Platinum HMO plan. We’ve analyzed the health insurance plans in each region of California and determined what the top plans are for you. The top plans are different in each region. This happens because many of the smaller insurance companies only operate in a few of the 19 regions. Plus some of the major companies are not available in every region.

Select the tab with the name of your county/region to see the best maternity choices for you.

Top Maternity Plans In San Diego County

2016

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $4,508

  3. Health Net Gold 80 (HMO)
  4. TOOPC = $4,824

  5. Sharp Health Plan Platinum 90 (HMO)
  6. TOOPC = $4,905

  7. Kaiser Permanente Platinum 90 (HMO)
  8. TOOPC = $5,024

  9. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  10. TOOPC = $5,116

  11. Sharp Health Plan Gold 80 (HMO)
  12. TOOPC = $5,232

  13. Kaiser Permanente Gold 80 (HMO)
  14. TOOPC = $5,376

  15. Molina Healthcare gold 80 (HMO) CoveredCA Only
  16. TOOPC = $5,420

  17. Anthem Blue Cross Platinum 90 (Tiered PPO)
  18. TOOPC = $6,176

  19. Anthem Blue Cross Gold 80 (HMO)
  20. TOOPC = $6,440

  21. Anthem Blue Cross Platinum 90 (HMO)
  22. TOOPC = $6,584

  23. Blue Shield Platinum 90 (PPO)
  24. TOOPC = $6,880

Total Out Of Pocket Cost in San Diego California
is based upon a 30 year old woman living in Encinitas, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The Health Net CommunityCare network is only available in some southern California areas, and is a small network of community clinics and lower cost providers. The Sharp Health Plan options are only available in San Diego county, and include all the Sharp providers and hospitals.

The most notable differences between 2015 and 2016 maternity plans is that premiums mostly went up in 2016, so the cost to have a baby increased by up to $748 (Kaiser reduced their rates on Platinum 90, so it moved up in the rankings). On average the increase in cost was about $110. Molina Healthcare is a new entrant this year.

HMO plans still dominate in 2016.

The Health Net CommunityCare Platinum 90 HMO plan provides the lowest TOOPC of all the 2016 maternity health plans. The top 5 2013 California maternity insurance plans had TOOPCs less than $5,000 where only three of the 2016 plans are below that level.

To see the detailed breakdown of the Total Out Of Pocket Costs for the San Diego California maternity insurance options, click here.

Top Maternity Plans In Contra Costa County

2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. TOOPC = $5,636

  3. Kaiser Permanente Gold 80 (HMO)
  4. TOOPC = $5,940

  5. Blue Shield Gold 80 (PPO)
  6. TOOPC = $6,860

  7. Blue Shield Platinum 90 (PPO)
  8. TOOPC = $7,204

  9. Health Net Platinum 90 (EPO)
  10. TOOPC = $7,216

  11. Sutter Health Plan 90 (PPO)
  12. TOOPC = $7,504

  13. Anthem Blue Cross Platinum 90 (PPO)
  14. TOOPC = $7,612

Total Out Of Pocket Cost in Concord California
is based upon a 30 year old woman living in Walnut Creek, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and the 2016 best California maternity insurance plans is that rates are about $132 to $612 higher than in 2015. Cigna dropped their maternity plans and no longer offers a good maternity option in California. Kaiser Permanente maintains the lead as the lowest cost provider for maternity coverage.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Contra Costa California maternity insurance options, click here.

Top Maternity Plans In Orange County

2016

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $4,472

  3. Health Net Gold 80 (HMO)
  4. $4,800

  5. Oscar Health Insurance Platinum 90 (EPO)
  6. $4,964

  7. Kaiser Permanente Platinum 90 (HMO)
  8. $5,168

  9. Kaiser Permanente Gold 80 (HMO)
  10. $5,520

  11. Anthem Blue Cross Platinum 90 (HMO)
  12. $5,552

  13. Anthem Blue Cross Platinum 90 (tiered PPO)
  14. $5,692

  15. Blue Shield Platinum 90 (PPO)
  16. $6,244

Total Out Of Pocket Cost in Orange California
is based upon a 30 year old woman living in Irvine, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable change from 2015 is that the premium costs went up. This makes having a baby in Orange County about $120 to $750 more expensive than last year. Also, Cigna is no longer a player in the California market as their plan pricing is un-competitive. Lastly, HMO plans dominate the top 5 spots.

In 2016 the lowest is an HMO plan with a TOOPC of $4,472. This is an increase of $240 from last year. The top PPO plan has a TOOPC of $6,244. This is almost 40% higher than the best plan.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Orange County California maternity insurance options, click here.

Top Maternity Insurance Plans in Fresno, Kings, and Madera Counties

2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $4,880

  3. Kaiser Permanente Gold 80 (HMO)
  4. $5,244

  5. Blue Shield Gold 80 (PPO)
  6. $5,756

  7. Blue Shield Platinum 90 (PPO)
  8. $5,788

  9. Kaiser Permanente Gold 80 (HMO) Co-Insurance
  10. $5,864

  11. Valley Health Gold 80 (PPO)CoveredCA Only
  12. $5,936

  13. Valley Health Platinum 90 (PPO)CoveredCA Only
  14. $5,980

  15. Anthem Blue Cross Platinum 90 (PPO)
  16. $6,088

  17. Health Net Platinum 90 (HSP)
  18. $6,712

Total Maternity Insurance Cost in Fresno California
is based upon a 30 year old woman living in Fresno, CA, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and the 2016 Obamacare maternity plans is that the price to have a baby has gone up $167 to $691 in this region.

The 2 HMO offerings from Kaiser Permanente are the lowest cost in this region. However there are plenty of PPO option to choose from as well. This is very different from many other regions.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Fresno, Kings, and Madera California maternity insurance options, click here.

Top Maternity Plans In Los Angeles California South

2016

The South Los Angeles region (Region 16) includes the following range of ZIP codes:
90001 – 90510
91301 – 91499
91601 – 91618

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $3,956

  3. Molina Healthcare Gold 80 (HMO) CoveredCA Only
  4. $4,020

  5. Health Net Gold 80 (HMO)
  6. $4,340

  7. La Care Platinum 90 (HMO) CoveredCA Only
  8. $4,353

  9. Oscar Health Insurance Platinum 90 (EPO)
  10. $4,384

  11. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  12. $4,396

  13. LA Care Gold 80 (HMO) CoveredCA Only
  14. $4,524

  15. Kaiser Permanente Platinum 90 (HMO)
  16. $4,784

  17. Anthem Blue Cross Platinum 90 (HMO)
  18. $4,856

  19. Kaiser Permanente Gold 80 (HMO)
  20. $5,160

  21. Blue Shield Platinum 90 PPO (PPO)
  22. $6,460

Total Out Of Pocket Cost in Long Beach California
is based upon a 30 year old woman, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable changes between 2015 and 2016 are that premiums went up so the cost to have a baby in South Los Angeles increased by $70 to $1,000. Oscar Health Insurance entered the California marketplace in 2015 so there is a new EPO plan in the top 5. The only other PPO choice is Blue Shield, and they raised their annual premium cost by about $1,000.

Obamacare pregnancy plans require you to make a choice between staying with your Obstetrician and paying a higher price for PPO coverage, or opting to pay less by selecting a physician from a smaller, lower cost HMO network.

To see the detailed breakdown of the Total Out Of Pocket Costs for the South Los Angeles maternity insurance options, click here.

Top Maternity Insurance Los Angeles North

2016

The North Los Angeles region (Region 15) includes the following range of ZIP codes:
90601 – 91226
91501 – 91526
91702 – 93599

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $3,788

  3. LA Care Health Plan Platinum 90 (HMO) CoveredCA Only
  4. $4,172

  5. Health Net Gold 80 (HMO)
  6. $4,176

  7. LA Care Health Plan Gold 80 (HMO) CoveredCA Only
  8. $4,380

  9. Kaiser Permanente Platinum 90 (HMO)
  10. $4,592

  11. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  12. $4,648

  13. Anthem Blue Cross Platinum 90 (HMO)
  14. $4,772

  15. Anthem Blue Cross Gold 80 (HMO)
  16. $4,884

  17. Kaiser Permanente Gold 80 (HMO)
  18. $4,980

  19. Molina Healthcare Gold 80 (HMO) CoveredCA Only
  20. $5,024

  21. Blue Shield Platinum 90 (PPO)
  22. $5,200

  23. Anthem Blue Cross Platinum 90 (Tiered PPO)
  24. $5,392

Total Out Of Pocket Cost in Los Angeles California
Is based upon a 30 year old woman living in Glendale, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and 2016 is that prices went up. Therefore the cost to deliver a baby increased by $29 to $530 (depending upon your health plan). LA Care had the smallest increase, while Molina Healthcare had the largest increase.

HMO policies still dominate the top of the list. The best PPO plan is from Blue Shield, but they are number 11 in the rankings.

Obamacare requires you to now make a choice between staying with your Obstetrician and paying the higher price for PPO coverage, or opting to pay less by selecting a physician from a smaller, lower cost HMO network.

To see the detailed breakdown of the Total Out Of Pocket Costs for the North Los Angeles maternity insurance California options, click here.

Top Maternity Insurance In Alameda County

2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $5,768

  3. Kaiser Permanente Gold 80 (HMO)
  4. $6,072

  5. Blue Shield Gold 80 (PPO)
  6. $6,680

  7. Blue Shield Platinum 90 (PPO)
  8. $6,976

  9. Sutter Health Plus Platinum MI01 (HMO)
  10. $7,504

  11. Anthem Blue Cross Platinum 90 (PPO)
  12. $7,588

Total Out Of Pocket Cost in Oakland California
Based upon a 30 year old woman living in Berkeley, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The main difference between 2015 and the 2o16 Obamacare maternity options is that the price to have a baby went up by $230 to $928. This is large increase. The Kaiser increases are the lowest, and Anthem Blue Cross has the largest premium increases.

In Alameda county you are forced to decide between using Kaiser Permanente or using your own OB/Gyn at the hospital of your choice for a much higher price. The difference between Kaiser and the next lowest option from Blue Shield is $912. Oelecting a physician from a smaller, lower cost HMO network.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Oakland maternity insurance California options, click here.

Top Maternity Insurance In Santa Clara County

2016

  1. Valley Health Plan Platinum 90 (HMO) CoveredCA Only
  2. Total Out Of Pocket Costs (TOOPC) = $5,588

  3. Valley Health Plan Gold 80 (HMO) CoveredCA Only
  4. $5,724

  5. Kaiser Permanente Platinum 90 (HMO)
  6. $5,768

  7. Kaiser Permanente Gold 80 (HMO)
  8. $6,072

  9. Anthem Blue Cross Platinum 90 (PPO)
  10. $6,808

  11. Anthem Blue Cross Gold 80 (HMO)
  12. $6,828

  13. Anthem Blue Cross Platinum 90 (HMO)
  14. $7,028

  15. Health Net Platinum 90 (EPO)
  16. $7,174

  17. Sutter Health Plus Platinum Individual 90 (HMO)
  18. $7,252

  19. Blue Shield Gold 80 (PPO)
  20. $7,712

Total Out Of Pocket Cost in San Jose California
Based upon a 30 year old woman living in Santa Clara county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and the 2016 Affordable Care Act maternity plans is that there are new plans on the list, and the total out of pocket cost is higher in 2016. The price changes range from a $32 reduction to a $374 increase.

The priced difference between the top HMO plans and the first PPO plan is over $700. The flexibility of a PPO network is costly for maternity purposes.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Clara maternity insurance California options, click here.

Top Maternity Insurance In San Mateo County

2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $6,176

  3. Chinese Community Health Plan Platinum 90 (HMO)
  4. $6,368

  5. Kaiser Permanente Gold 80 (HMO)
  6. $6,444

  7. Chinese Community Health Plan Gold 80 (HMO)
  8. $6,516

  9. Anthem Blue Cross Platinum 90 (PPO)
  10. $7,588

  11. Anthem Blue Cross Gold 80 (PPO)
  12. $7,628

  13. Sutter Health Plus Platinum Individual (HMO)
  14. $8,032

  15. Blue Shield Gold 80 (PPO)
  16. $8,240

  17. Health Net Gold 80 (EPO)
  18. $8,312

Total Out Of Pocket Cost in Daly City California
Based upon a 30 year old woman living in Daly City, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and 2016 in this region is the dramatic swings in pricing that occurred. The range of price changes from 2015 to 2016 was -$156 o $1,932. A few plans had price reductions while most saw increases with large increases in some of the PPO & EPO plans.

HMO plans still dominate in San Mateo county. The best of the PPO plans requires that you pay $1,072 more than the next closest HMO plan. That is a lot of money for the flexibility of having a PPO plan.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Clara maternity insurance California options, click here.

    Top Maternity Insurance In San Jaoquin, Stanislaus, Mercend, Mariposa, or Tulare County

    2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $5,096

  3. Kaiser Permanente Gold 80 (HMO)
  4. $5,448

  5. Anthem Blue Cross Platinum 90 (PPO)
  6. $6,040

  7. Anthem Blue Cross Gold 80 (PPO)
  8. $6,308

  9. Sutter Health Plus Platinum Individual (HMO)
  10. $6,472

  11. Sutter Health Plus Gold Individual (HMO)
  12. $6,752

  13. Blue Shield Gold 80 (PPO)
  14. $7,136

  15. Health Net Platinum 90 (EPO)
  16. $7,324

Total Out Of Pocket Cost in Merced California
Based upon a 30 year old woman living in Stockton, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and 2016 is how much the rates went up in this San Joaquin Valley region. The rate increases ranged from $120 to $1,584. The HMO plans tended to have lower price increases compared to the PPO plans.

In this region, Kaiser Permanente is easily the best option if you want to deliver a baby for the smallest cost. Obamacare requires you to now make a choice between staying with your Obstetrician and paying a higher price for PPO coverage, or opting to pay less by selecting a physician from a smaller, lower cost HMO network.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Merced maternity insurance California options, click here.

Top Maternity Insurance In San Francisco County

2016

  1. Chinese Community Health Plan Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $5,936

  3. Chinese Community Health Plan Gold 80 (HMO)
  4. $6,120

  5. Kaiser Permanente Platinum 90 (HMO)
  6. $6,176

  7. Kaiser Permanente Gold 80 (HMO)
  8. $6,444

  9. Blue Shield Gold 80 (PPO)
  10. $7,232

  11. Blue Shield Platinum 90 (PPO)
  12. $7,660

  13. Health Net Gold 80 (EPO)
  14. $7,868

  15. Health Net Platinum 90 (EPO)
  16. $7,888

  17. Sutter Health Plus Platinum Individual MI01 (HMO)
  18. $8,032

  19. Anthem Blue Cross Platinum 90 (Tiered PPO)
  20. $8,152

Total Out Of Pocket Cost in San Francisco California
Based upon a 30 year old woman living in San Francisco, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and 2016 is that the lowest cost to have a baby remained the same, $5,936, but is now provided by Chinese Community Health instead of Kaiser Permanente. Kaiser increased the rates of it’s Gold and Platinum plans by $240 – $256, while Chinese Community Health reduced their rates by $108 – $144.

In 2013 some of the top plans had total costs of less than $5,000, and four were PPO plans. In 2016, only 1 is below $6,000 and the lowest PPO plan will cost you almost 45% more than $5,000. Obamacare requires you to now make a choice between staying with your Obstetrician and paying a higher price for PPO coverage, or opting to pay less by selecting a physician from a smaller HMO network.

To see the detailed breakdown of the Total Out Of Pocket Costs for the San Francisco maternity insurance California options, click here.

Top Maternity Insurance In Monterey, San Benito, Santa Cruz County

2016

  1. UnitedHealthCare Gold 80 (PPO) CoveredCA Only
  2. Total Out Of Pocket Costs (TOOPC) = $7,424

  3. Health Net Platinum 90 (EPO)
  4. $7,468

  5. Health Net Gold 80 (EPO)
  6. $7,508

  7. Anthem Blue Cross Platinum 90 (PPO)
  8. $7,612

  9. Anthem Blue Cross Gold 80 (PPO)
  10. $7,652

  11. Blue Shield Gold 80 (PPO)
  12. $7,808

  13. UnitedHealthCare Platinum 90 (PPO) CoveredCA Only
  14. $7,864

Total Out Of Pocket Cost in Santa Cruz California
Based upon a 30 year old woman living in Monterey county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and the 2016 Obamacare maternity plans is that Assurant health plans are gone, but UnitedHealthCare is now available on Covered California in this area. The cost to have a baby in this region is $496 higher in 2016.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Monterey maternity insurance California options, click here.

Top Maternity Insurance Plans In Riverside & San Bernadino Counties

2016

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $4,004

  3. Health Net Gold 80 (HMO)
  4. $4,320

  5. Anthem Blue Cross Platinum 90 (HMO)
  6. $4,904

  7. Anthem Blue Cross Gold 80 (HMO)
  8. $5,016

  9. Blue Shield Platinum 90 (PPO)
  10. $5,0068

Total Out Of Pocket Cost in Palm Springs California
Based upon a 30 year old woman living in Riverside county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable differences between 2015 and the 2016 Obamacare maternity plans is that the best options have HMO networks in the southern Region 17, and Assurant health plans are gone. Because of this, finding a PPO plan that your doctor accepts will be challenging.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Riverside maternity insurance California options, click here.

Top Maternity Insurance Plans In Sacramento, Yolo, Placer & El Dorado Counties

2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs = $5,636

  3. Kaiser Permanente Gold 80 (HMO)
  4. $5,940

  5. Western Health Advantage Platinum 90 (HMO)
  6. $5,948

  7. Western Health Advantage Gold 80 (HMO)
  8. $6,168

  9. Anthem Blue Cross Platinum 90 (PPO)
  10. $7,072

  11. Anthem Blue Cross Gold 80 (PPO)
  12. $7,184

  13. Sutter Health Plus Platinum Individual MI01 (HMO)
  14. $7,208

  15. Blue Shield Gold 80 (PPO)
  16. $7,232

  17. Health Net Platinum 90 (HSP)
  18. $7,408

  19. Health Net Gold 80 (HSP)
  20. $7,460

Total Out Of Pocket Cost in Sacramento California
Based upon a 30 year old woman living in Sacramento county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable difference between 2015 and 2016 Obamacare maternity plans in this region is that the PPO plans had substantial cost increases while the HMO plans had small increases or decreases. For example, the largest increase was the Blue Shield Platinum 90 PPO plan at $1,608. While the biggest decrease happened on the Sutter Health Plus Platinum Individual plan at -1,068.

In region 3 the cost difference between the best HMO and PPO pregnancy plans is now $1,435. This is a heavy price to pay for the flexibility of being able to pick your own doctor using a PPO plan.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Placer maternity insurance California options, click here.

Top Maternity Insurance Plans In Napa, Sonoma, Marin, & Solano Counties

2016

  1. Western Health Advantage Platinum 90 (HMO)
  2. Total Out Of Pocket Costs = $5,612

  3. Kaiser Permanente Platinum 90 (HMO)
  4. $5,900

  5. Western Health Advantage Gold 80 (HMO)
  6. $5,916

  7. Kaiser Permanente Gold 80 (HMO)
  8. $6,192

  9. Blue Shield Gold 80 (EPO)
  10. $7,352

  11. Anthem Blue Cross Platinum 90 (PPO)
  12. $7,360

  13. Health Net Platinum 90 (EPO)
  14. $7,384

    1. (tie) Anthem Blue Cross Gold 80 (PPO)
    2. $7,184

    3. (tie)Health Net Gold 80 (EPO)
    4. $7,184

Total Out Of Pocket Cost in Santa Rosa California
Based upon a 30 year old woman living in Sonoma county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable difference between 2015 and 2016 Obamacare maternity plans in this region is that the PPO plans had substantial cost changes while the HMO plans had small changes. For example, the largest increase was the Blue Shield Platinum 90 EPO plan at $1,680, and the Health Net Platinum 90 EPO plan had the largest cost decrease of $1,176. The HMO plans in this region had much lower cost increases, ranging from $156 to $288.

In region 2 the cost difference between the best HMO and PPO pregnancy plans is now $1,740. This is a heavy price to pay for the flexibility of being able to pick your own doctor using a PPO plan.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Napa maternity insurance California options, click here.

Top Maternity Insurance Plans In Kern County

2016

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs = $4,472

  3. Health Net Gold 80 (HMO)
  4. $4,800

  5. Kaiser Permanente Platinum 90 (HMO)
  6. $4,976

  7. Kaiser Permanente Gold 80 (HMO)
  8. $5,328

  9. Blue Shield Gold 80 (PPO)
  10. $5,864

  11. Blue Shield Platinum 90 (PPO)
  12. $5,932

  13. Anthem Blue Cross Platinum 90 (PPO)
  14. $5,980

  15. Anthem Blue Cross Gold 80 (PPO)
  16. $6,248

Total Out Of Pocket Cost in Bakersfield California
Based upon a 30 year old woman living in Kern county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable difference between 2015 and 2016 Obamacare maternity plans in this region is that the PPO plans had larger cost changes while the HMO plans had small changes. For example, the largest increase was the Blue Shield Platinum 90 PPO plan at $732, and the Health Net Platinum 90 HMO plan had the largest cost decrease of $1,020. The HMO plans in this region had much lower cost increases, ranging from $156 to $288.

In region 14 (Kern County) the cost difference between the best HMO and PPO pregnancy plans is now $1,392. This is a heavy price to pay for the flexibility of being able to pick your own doctor using a PPO plan. However, the total out of pocket cost for the best PPO plan ($5,328) is still significantly lower than in northern regions of California.

To see the detailed breakdown of the Total Out Of Pocket Costs for the Napa maternity insurance California options, click here.

…..

The overall effect of Obamacare on maternity health insurance in California has mostly been neutral. The new health care reform offerings with the lowest total out of pocket costs are all lower priced than in 2013.

However, there are fewer PPO options, and many Ob/GYNs are in only one or two PPO networks (or none of the HMO networks), so the selection of a good plan is more important than ever.


Golden Gate Bridge in California


How To Select The Best California Maternity Insurance

The new Obamacare maternity options are not as good as they were in 2013, and the overall effect is to make the process of selecting good pregnancy coverage more difficult.

We’ll give you a simple step by step approach to make it a little bit easier.

  1. Determine if you can qualify for a subsidy
  2. Run a California maternity insurance quote to see which insurance companies offer plans in your area
  3. Search for your doctor in the provider directory search tools, (or call your doctor) to determine which individual networks are accepted
  4. Use the lists above as your starting point
  5. Select the plan that both your doctor accepts and will reduce your total costs
  6. Call or email us if you qualify for a subsidy, or use the “Apply Now” link in your quote if you do not qualify for a subsidy

If you need help determining which Obamacare plans are the best in your region of California, call us and we’ll help you pick the right plan. If you have any questions contact us.


Planning Tips For Pregnancy Health Insurance

If you are planning to have a baby and can “time” when you have the baby, there are some ways you can reduce your overall costs for health insurance with maternity coverage in California. We do this by considering the full pregnancy as being composed of two time frames.

  1. The Prenatal Period
  2. Delivery Time

During the Prenatal Period, you will primarily have multiple office visits. Each doctor visit will require some lab tests to check on the health of you and the baby. In Bronze, Silver, Gold, and Platinum coverage, these prenatal visits and the labs are covered as preventive care. Therefore it does not make a difference which plan you choose if you have a normal prenatal period.

If there are any complications or abnormal health issues that arise during the prenatal period, the extra tests and medical services will be covered based on the standard benefits of your health coverage.

Therefore, Silver is the ideal coverage for the prenatal period.

At Delivery Time we know there will be a large cost associated with delivery in a hospital. Ideally you want a plan with NO deductible, and a fixed co-payment for the hospital costs. Therefore, Gold and Platinum HMO maternity plans are best. Usually Platinum plans will have a better “benefit versus cost ratio” than the Gold plans.

Therefore, Platinum plans are the best maternity health insurance California plans for delivery.

From a timing standpoint, if you know that you can wait until at least April or May to get pregnant, then you can select a Silver plan at the beginning of the year. During the next year’s open enrollment period in the fall, you can then move into a Platinum plan for delivery the next year.

Timeline to get maternity health insurance California
Pick The Best California Insurance For Maternity Based On When You Expect To Deliver The Baby

Once the baby is born, that creates a Special Enrollment Period. During the 60 days after the baby is born you can switch from the higher cost Platinum delivery plan to a lower cost Silver or Bronze plan (depending upon your needs).

This way you can take advantage of the full benefits of the Affordable Care Act rules.

In Summary: You get to use Platinum benefits for the delivery, and then immediately move back into a lower cost plan.


Need Maternity Insurance? Already Pregnant California Woman Are Saved By Obamacare

In the last 12 years, we have received thousands of calls from women who were pregnant and looking for health insurance. Until Obamacare we’ve had limited ability to help them get coverage. Obamacare changed that.

The Affordable Care Act removed the “pre-existing condition” exclusion so that pregnant women can get California health insurance with maternity coverage. During the yearly open enrollment periods you can select any policy you want. Even if you are pregnant at that time.

You must make sure to sign up for a plan during the open enrollment periods. Outside of open enrollment, getting pregnant is not a “qualifying event” that would allow you to apply for coverage. If you become pregnant without insurance, you will either have to qualify for Medi-Cal or Access For Infants & Mothers (AIM), or pay for your care until the beginning of the next year when you can enroll for pregnancy insurance.


Maternity Insurance Plans Need These Key Benefits

A standard pregnancy has 14 prenatal office visits, various lab tests performed during each office visit, amniocentesis, and 1 or 2 ultra-sound. In California, these prenatal services are now considered “preventive.”

After the prenatal period the next big cost is the actual delivery. A typical delivery is a 2 day hospital stay that can cost between $8,000 to $12,000, and a C-section requires 3 days. With these standard services in mind, the key benefits that a good maternity plan will provide, are the following:

  1. Unlimited Doctor Office Visits for a Copay
  2. You’ll have a $0 copay for these visits in Bronze, Silver, Gold, and Platinum policies.

  3. Low Deductible or No Deductible
  4. At some point, your baby will be born, and when that time comes, you have to reach the deductible before your insurance company begins paying for any part of the delivery costs if you have a PPO plan. HMO plans do not have a deductible.

  5. Small Out Of Pocket Maximum
  6. Once you meet the deductible, you begin sharing costs (co-insurance) with the insurance company until you reach your out-of-pocket maximum. All the Bronze, Silver, and Gold policies have a $6,350 out-of-pocket maximum. Only the Platinum plan has a lower limit at $4,000.

  7. Fixed Copay for Hospital Stays
  8. Some plans, HMOs, require a co-payment for inpatient care at a hospital while others, PPOs, require the co-insurance mentioned above. The HMO co-payment is usually on a per-day basis. An HMO maternity plan with a lower per-day co-pay will minimize your costs more than a PPO policy.

  9. Fixed Copay for Lab Tests and Imaging
  10. During each prenatal office visit your doctor will order lab tests to check on your health and the health of your baby. As long as your pregnancy is normal, then the lab tests will be considered preventive and no additional cost regardless of your plan.

    If there are potential issues, then diagnostic tests will need to be covered. Bronze plans make the diagnostic lab tests part of your deductible, while Silver, Gold, and Platinum plans offer co-pays for lab tests.

  11. Affordable Monthly Premium
  12. The monthly premium is a big part of the total out of pocket cost to have a baby. Having a lower premium can help, but only if you are comparing similar plans. All Platinum Co-payment plans have the same benefits, so the lowest cost Platinum Co-payment plan that your doctor accepts could be the best plan for you.

These benefits are all important, but the largest reduction in overall costs can typically be obtained by picking a plan that reduces the delivery costs to a co-pay. This makes HMO plans the best option in most areas.

If having the flexibility of a PPO plan is important, then you must pick a plan with the lowest out-of-pocket maximum, co-insurance percentage, and deductible. PPO plans are typically used when a specific doctor is wanted, and that physician is not part of a major medical group.

Depending upon what time of the year you plan to begin trying to get pregnant, there are some strategies that can help lessen the insurance costs. See the section titled Planning Tips For Pregnancy Health Insurance Plans below.

Finally, the maternity insurance plans and prices are different in most regions of California, so analysis of the specific maternity plans in your area is important.






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2 Comments

  1. This good and thanks for care of mothers.
    I am visitor and I am pregnant can I use the Obamascare or maternity insurance.

    1. Author

      Rangina,
      Health insurance plans in California can be used by any resident of the state.
      Your definition of “visitor” will determine if it is possible to get health insurance. The assumption from the insurance companies is that you are a person that is and will be living in California and establish a residence in the state while you are here. This means being able to show a lease/rental/purchase agreement for a living space, and/or utility bills for your address. Plus the ability to show you have a visa that allows you to be in California for a longer period of time.
      Someone that is just using a visitor’s visa (less than 6 months) will not be able to get health insurance.
      As long as you sign up for maternity insurance during this open enrollment period, you will be accepted. The open enrollment period will end on 1/31/16.

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