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. California Maternity Insurance plans ObamacareThe 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 typically a Co-Payment Platinum 90 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

2017

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $5,072

  3. Health Net Gold 80 (HMO)
  4. TOOPC = $5,316

  5. Kaiser Permanente Platinum 90 (HMO)
  6. TOOPC = $5,324

  7. Sharp Health Plan Platinum 90 (HMO)
  8. TOOPC = $5,492

  9. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  10. TOOPC = $5,526

  11. Kaiser Permanente Gold 80 (HMO)
  12. TOOPC = $5,568

  13. Sharp Health Plan Gold 80 (HMO)
  14. TOOPC = $5,664

  15. Molina Healthcare Gold 80 (HMO) CoveredCA Only
  16. TOOPC = $6,408

  17. Anthem Blue Cross Gold 80 (HMO)
  18. TOOPC = $6,996

  19. Blue Shield Platinum 90 (HMO)
  20. TOOPC = $7,424

  21. Anthem Blue Cross Platinum 90 (HMO)
  22. TOOPC = $7,472

  23. Blue Shield Gold 80 (PPO)
  24. TOOPC = $8,244

  25. Blue Shield Platinum 90 (PPO)
  26. TOOPC = $8,310

  27. Anthem Blue Cross Platinum 90 (EPO)
  28. TOOPC = $8,898

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.

The average vaginal childbirth in San Diego county costs $14,341. The average cesarean childbirth costs $20,817.

The Health Net CommunityCare network is only available in some southern California areas, and is a network of community clinics, lower cost providers, and the Scripps Healthcare system (doctors and hospitals). Sharp Health Plan options are only available in San Diego county, and include all Sharp providers and hospitals.

The most notable difference between 2017 and 2016 maternity plans is that the transition to using more accurate delivery costs showed that all PPO/EPO plans are more expensive.

HMO plans will dominate from this time forward.

The Health Net CommunityCare Platinum 90 HMO plan continues to provide the lowest total cost of all 2017 maternity health plans.

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

2017

  1. Kaiser Permanente Platinum 90 (HMO)
  2. TOOPC = $5,972

  3. Kaiser Permanente Gold 80 (HMO)
  4. TOOPC = $6,156

  5. Blue Shield Gold 80 (HMO)
  6. TOOPC = $7,968

  7. Blue Shield Platinum 90 (HMO)
  8. TOOPC = $8,864

  9. Sutter Health Plus Platinum Individual MI01 (HMO)
  10. TOOPC = $8,971

  11. Blue Shield Platinum 90 (PPO)
  12. TOOPC = $9,763

  13. Health Net Platinum 90 (EPO)
  14. TOOPC = $9,823

  15. Blue Shield Gold 80 (PPO)
  16. TOOPC = $10,250

  17. Anthem Blue Cross Platinum 90 (PPO)
  18. TOOPC = $10,591

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 average vaginal childbirth in the Bay Area costs $21,432. The average cesarean childbirth costs $28,335.

The most notable differences between 2016 and the 2017 best California maternity insurance plans is that the difference in cost between the best pregnancy plans and the rest grew significantly. This is primarily due to our change to a more accurate cost estimate for the hospital delivery costs.

Blue Shield has introduced HMO plans in this area. Outside of Kaiser’s plans, the Blue Shield options are the next best choice for HMO and PPO networks.

In general, the total cost to have a baby with health insurance has increased between $210 to $3,0446. 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

2017

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $4,952

  3. Oscar Health Insurance Platinum 90 (EPO)
  4. $5,120

  5. Health Net Gold 80 (HMO)
  6. $5,240

  7. Oscar Health Insurance Gold 80 (EPO)
  8. $5,268

  9. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  10. $5,442

  11. Kaiser Permanente Platinum 90 (HMO)
  12. $5,480

  13. Anthem Blue Cross Gold 80 (HMO)
  14. $5,700

  15. Kaiser Permanente Gold 80 (HMO)
  16. $5,712

  17. Anthem Blue Cross Platinum 90 (HMO)
  18. $5,924

  19. Molina Healthcare Gold 90 (HMO) CoveredCA Only
  20. $6,325

  21. Blue Shield Platinum 90 (PPO)
  22. $6,918

  23. Anthem Blue Cross Platinum 90 (EPO)
  24. $7,398

Total Out Of Pocket Cost in Orange County 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 average vaginal childbirth in the Los Angeles Area costs $14,228. The average cesarean childbirth costs $20,235.

The most notable change from 2016 is that the PPO plans now look less attractive cost-wise in 2017. Having a baby in Orange County is now $192 to $706 more expensive than last year.

Health Net again has the top maternity health insurance plans with their CommunityCare HMO offerings. While Oscar Health continues to edge closer to the top of this list with it’s EPO plans.

In 2017 the lowest is the Health Net Platinum 90 HMO plan with a total cost of $4,952. The highest cost plan on the list, Anthem Blue Cross Platinum 90 EPO has a total cost of $7,398. This is almost 50% 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.

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

2017

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $5,168

  3. Kaiser Permanente Gold 80 (HMO)
  4. $5,424

  5. Anthem Blue Cross Gold 80 (HMO)
  6. $6,564

  7. Anthem Blue Cross Platinum 90 (HMO)
  8. $6,968

  9. Blue Shield Platinum 90 (PPO)
  10. $7,105

  11. Anthem Blue Cross Platinum 90 (PPO)
  12. $7,321

  13. Blue Shield Gold 80 (PPO)
  14. $7,756

  15. Health Net Platinum 90 (HSP)
  16. $8,617

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 average vaginal childbirth in California costs $16,092. The average cesarean childbirth costs $21,759.

The biggest difference between 2017 and the 2016 Obamacare maternity plans is the price to have a baby has gone up at least $288 in this region. The other change is that United Healthcare is no longer offering covering in California.

The 2 HMO offerings from Kaiser Permanente are the lowest cost in this region. If you choose to have your baby outside the Kaiser system you will pay at least $1,140 more to use any other insurance company.

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

Best Maternity Plans In Los Angeles California South

2017

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

  1. LA Care Platinum 90 (HMO) CoveredCA Only
  2. Total Out Of Pocket Costs = $4,448

  3. LA Care Gold 80 (HMO) CoveredCA Only
  4. $4,596

  5. Health Net Platinum 90 (HMO)
  6. $4,808

  7. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  8. $4,962

  9. Kaiser Permanente Platinum 90 (HMO)
  10. $5,072

  11. Health Net Gold 80 (HMO)
  12. $5,088

  13. Anthem Blue Cross Gold 80 (HMO)
  14. $5,136

  15. Oscar Health Insurance Platinum 90 (EPO)
  16. $5,168

  17. Anthem Blue Cross Platinum 90 (HMO)
  18. $5,240

  19. Oscar Health Insurance Gold 80 (EPO)
  20. $5,304

  21. Kaiser Permanente Gold 80 (HMO)
  22. $5,340

  23. Blue Shield GOLD 80 (HMO)
  24. $5,832

  25. Molina Healthcare Gold 80 (HMO) CoveredCA Only
  26. $5,905

  27. Blue Shield Platinum 90 (PPO)
  28. $7,878

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 average vaginal childbirth in Los Angeles costs $14,228, and the average cesarean childbirth costs $20,235.

The cost to have a baby in South Los Angeles increased by $72 to $1,148. LA Care takes over the top spot in 2017’s list. Their offerings had the smallest increase of $72, while the former top Health Net Platinum HMO raised it’s cost by $852.

The PPO plans have almost fallen completely out of the top list, but we’ve keep Blue Shield in the list for you. Oscar offers an EPO plan which functions like a PPO, and it is priced very attractively in Los Angeles. If you need a PPO/EPO I suggest you use Oscar.

The domination of the list by HMO plans is going to continue for the foreseeable future.

To get 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

2017

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

  1. LA Care Health Plan Platinum 90 (HMO) CoveredCA Only
  2. Total Out Of Pocket Costs = $4,268

  3. LA Care Health Plan Gold 80 (HMO) CoveredCA Only
  4. $4,440

  5. Health Net Platinum 90 (HMO)
  6. $4,508

  7. Health Net Gold 80 (HMO)
  8. $4,812

  9. Kaiser Permanente Platinum 90 (HMO)
  10. $4,868

  11. Blue Shield Gold 80 (HMO)
  12. $4,872

  13. Molina Healthcare Platinum 90 (HMO) CoveredCA Only
  14. $4,878

  15. Anthem Blue Cross Gold 80 (HMO)
  16. $4,932

  17. Anthem Blue Cross Platinum 90 (HMO)
  18. $5,000

  19. Blue Shield Platinum 90 (HMO)
  20. $5,036

  21. Kaiser Permanente Gold 80 (HMO)
  22. $5,160

  23. Molina Healthcare Gold 80 (HMO) CoveredCA Only
  24. $5,845

  25. Blue Shield Platinum 90 (PPO)
  26. $6,450

  27. Anthem Blue Cross Platinum 90 (EPO)
  28. $7,230

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).

in Los Angeles California the average vaginal childbirth costs $14,228, and the average cesarean childbirth costs $20,235.

In 2017 the Los Angeles market pregnancy insurance price increases range from $60 to $1,838. The largest increases came in the PPO plans. This is similar to what is happening to all PPO plans in California.

HMO policies still dominate the top of the list. The best PPO plan is from Blue Shield, but they dropped from 11 to number 13 in the rankings for 2017.

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

The Top Maternity Insurance In Alameda County

2017

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $6,116

  3. Kaiser Permanente Gold 80 (HMO)
  4. $6,288

  5. Sutter Health Plus Platinum MI01 (HMO)
  6. $9,031

  7. Blue Shield Platinum 90 (PPO)
  8. $9,163

  9. Blue Shield Gold 80 (PPO)
  10. $9,770

  11. Anthem Blue Cross Platinum 90 (EPO)
  12. $10,615

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 average vaginal childbirth in the Bay Area costs $21,432. The average cesarean childbirth costs $28,335.

The biggest change between 2018 and the 2017 Obamacare maternity options is that the price to have a baby went up between $216 to $2197. This is a large increase. The Kaiser increases are the lowest, and Blue Shield has the largest premium increase.

In Alameda county you are forced to decide between Kaiser Permanente or using your OB/GYN at the hospital of your choice for a much higher price. The difference between Kaiser and the lowest PPO option from Blue Shield is $3047.

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

2017

  1. Valley Health Plan Platinum 90 (HMO) CoveredCA Only
  2. Total Out Of Pocket Costs (TOOPC) = $5,624

  3. Valley Health Plan Gold 80 (HMO) CoveredCA Only
  4. $5,760

  5. Kaiser Permanente Platinum 90 (HMO)
  6. $6,116

  7. Kaiser Permanente Gold 80 (HMO)
  8. $6,288

  9. Blue Shield Gold 80 (HMO)
  10. $6,996

  11. Anthem Blue Cross Gold 80 (HMO)
  12. $7,032

  13. Anthem Blue Cross Platinum 90 (HMO)
  14. $7,520

  15. Anthem Blue Cross Platinum 90 (PPO)
  16. $8,324

  17. Sutter Health Plus Platinum Individual 90 (HMO)
  18. $8,600

  19. Health Net Platinum 90 (EPO)
  20. $9,356

  21. Blue Shield Gold 80 (PPO)
  22. $10,409

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).

A vaginal childbirth in Santa Clara costs $17,607 on average. A cesarean childbirth costs $25,422.

The price increase between 2016 and the 2017 Affordable Care Act maternity plans is from $36 to $2,697.

The price difference between the top HMO plans and the lowest cost PPO plan is $2700. That makes the flexibility of a PPO network costly for maternity purposes. Determining which networks your OB/GYN accepts is critical in Santa Clara county.

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 Plan In San Francisco County

2017

  1. Chinese Community Health Plan Plat 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $6,392

  3. Chinese Community Health Plan Gold 80 (HMO)
  4. $6,540

  5. Kaiser Permanente Plat 90 (HMO)
  6. $6,548

  7. Kaiser Permanente Gold 80 (HMO)
  8. $6,684

  9. Oscar Health Gold 80 (EPO)
  10. $7,184

  11. Blue Shield Gold 80 (HMO)
  12. $7,620

  13. Oscar Health Plat 90 (EPO)
  14. $7,980

  15. Sutter Health Plus Plat Individual MI01 (HMO)
  16. $9,511

  17. Blue Shield Plat 90 (PPO)
  18. $10,339

  19. Health Net Plat 90 (EPO)
  20. $10,663

  21. Blue Shield Gold 80 (PPO)
  22. $10,682

  23. Anthem Blue Cross Plat 90 (EPO)
  24. $10,843

  25. Health Net Gold 80 (EPO)
  26. $11,498

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).

A vaginal childbirth in San Mateo costs $21,432 on average. A cesarean childbirth costs $28,335.

In 2017 San Francisco county gets a new insurance company, Oscar Health Insurance, providing pregnancy insurance. The rates for all other carriers were increased which raised the cost to have baby by $240 to $3,630. Chinese Community Health and Kaiser Permanente still hold the top spots.

Oscar Health offers the lowest cost EPO plan in this area. Their Gold EPO plan will only cost $792 more than the lowest cost HMO plan.

Blue Shield of California also introduced an HMO option in San Francisco county. These HMO plans from Blue Shield are lower cost than Blue Shield’s PPO plans, but the network is also smaller. You will need to check to see if your OB/GYN is in the Blue Shield HMO network.

Obamacare requires you make a choice between staying with your Obstetrician and paying a higher price for PPO/EPO 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.

Best Maternity Insurance Plan In San Mateo County

2017

  1. Kaiser Permanente Plat 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $6,548

  3. Chinese Community Health Plan Plat 90 (HMO)
  4. $6,956

  5. Kaiser Permanente Gold 80 (HMO)
  6. $6,684

  7. Chinese Community Health Plan Gold 80 (HMO)
  8. $7,056

  9. Blue Shield Gold 80 (HMO)
  10. $8,496

  11. Sutter Health Plus Plat Individual (HMO)
  12. $9,511

  13. Anthem Blue Cross Plat 90 (EPO)
  14. $10,375

  15. Anthem Blue Cross Gold 80 (EPO)
  16. $11,210

  17. Blue Shield Plat 90 (PPO)
  18. $11,347

  19. Blue Shield Gold 80 (PPO)
  20. $11,486

  21. Health Net Gold 80 (EPO)
  22. $12,054

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).

A vaginal childbirth in San Mateo costs $21,432 on average. A cesarean childbirth costs $28,335.

The most notable differences between 2016 and 2017 in this region is the dramatic swings in pricing that occurred. The range of price increases for 2017 was $240 to $3,742. The EPO/PPO rate increases were towards the high end, primarily due to the change we made in the childbirth cost estimates.

Other changes are that Blue Shield introduced an HMO network in San Mateo. The rates in this HMO network are right behind those from Kaiser and Chinese Community. Anthem Blue Cross changed their PPO network to an EPO network. Effectively eliminating any out-of-network benefits you would get.

HMO plans still dominate in San Mateo county. The best of the PPO plans requires that you pay $3,827 more than the lowest cost HMO plan. That is a lot of money for the flexibility of having a PPO network.

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 Mariposa, Merced, San Jaoquin, Stanislaus, and Tulare County

    2017

  1. Kaiser Permanente Plat 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $5,396

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

  5. Anthem Blue Cross Plat 90 (PPO)
  6. $7,225

  7. Blue Shield Gold 80 (HMO)
  8. $7,260

  9. Sutter Health Plus Plat Individual (HMO)
  10. $7,345

  11. Anthem Blue Cross Gold 80 (PPO)
  12. $7,934

  13. Blue Shield Platinum 90 (HMO)
  14. $7,988

  15. Sutter Health Plus Gold Individual (HMO)
  16. $8,150

  17. Blue Shield Gold 80 (PPO)
  18. $9,206

  19. Health Net Plat 90 (EPO)
  20. $9,433

  21. Health Net Gold 80 (EPO)
  22. $9,842

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).

A vaginal childbirth in San Joaquin county costs $16,092 on average. A cesarean childbirth costs $21,759.{California averages}

The big change between 2016 and 2017 is how much the rates went up in this San Joaquin Valley region. The rate increases ranged from $192 to $2,109. 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.

Blue Shield of California introduced a set of HMO plans that can be a good option if your doctor is in that network. Anthem Blue Cross again has the best PPO option in this region with their Platinum 90 PPO.

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 Monterey, San Benito, Santa Cruz County

2016

  1. Kaiser Permanente Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $6,116

  3. Kaiser Permanente Gold 80 (HMO)
  4. $6,288

  5. Blue Shield Gold 80 (HMO)
  6. $6,600

  7. Blue Shield Plat 90 (HMO)
  8. $7,172

  9. Health Net Plat 90 (EPO)
  10. $9,764

  11. Health Net Gold 80 (EPO)
  12. $10,289

  13. Blue Shield Gold 80 (PPO)
  14. $10,637

  15. Anthem Blue Cross Plat 90 (PPO)
  16. $10,784

  17. Anthem Blue Cross Gold 80 (PPO)
  18. $11,117

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).

A vaginal childbirth in California costs $16,092 on average. A cesarean childbirth costs $21,759.{California averages}

The most notable change in 2017 is that United Healthcare is gone, and Blue Shield of California and Kaiser Permanente are now offering HMO maternity insurance plans in this region.

The cost to have a baby in this region is between $300 to 3,465 higher in 2017.

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

Best Maternity Insurance Plans In Riverside & San Bernadino Counties

2017

  1. Health Net Platinum 90 (HMO)
  2. Total Out Of Pocket Costs (TOOPC) = $4,484

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

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

  7. Anthem Blue Cross Gold 80 (HMO)
  8. $5,400

  9. Blue Shield Platinum 90 (PPO)
  10. $6,782

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).

A vaginal childbirth in Riverside county costs $12,623 on average, and a cesarean childbirth costs $14,106.

In 2017 the best maternity plans have HMO networks in Region 17. Because of this, finding a good pregnancy PPO plan that your doctor accepts might be challenging.

The best PPO options are from Blue Shield of California. The Anthem Blue Cross and Health Net PPO networks are more than $1,000 more than the Blue Shield’s PPO.

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.

…..

We’ve switched from using a generic $10,000 delivery cost estimate to more detailed Childbirth estimates provided by Guroo.com. Using this tool we can get average costs in various regions of California, and use those costs in the total cost estimates shown in the tables above.

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 cost are typically HMOs. This makes searching to see if your doctor is in an HMO network very important.

There are few low-cost 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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6 Comments

  1. Thank you for the information, I live in California, right now I have a bronze plan in covered CA, but I’m planning to get pregnant at the end of the year, if I get the same bronze plan, can I have access to the government programs for pregnant women? or should I chose an “upgraded” plan for next year?

    1. Author

      Ivonne,

      Your ability to qualify for the Medi-Cal Access Program or the Pregnancy Related Medi-Cal is completely dependent on your household Adjusted Gross Income (AGI). If you can qualify for either program, then those programs will be a better “financial” decision in terms of reducing your out-of-pocket cost for the pre-natal and delivery costs.

      Check our subsidy table for 2017 to determine if you can qualify for the Medi-Cal programs based on what you expect to earn in 2017, and what your current income is (last 3 months).

      If you can qualify, then I would recommend staying in the Bronze plans. Once you become pregnant we can report your new status to Covered CA and that will start the process of evaluating your Medi-Cal eligibility, and then transitioning to Medi-Cal.

      If you do not qualify, then I would recommend selecting a delivery plan for 2017. We will be updating the above maternity plans in the next couple weeks, once the new plans and pricing are available.

  2. Thank you for writing this article! Has definitely been helpful for me! My husband and I are looking to get pregnant next year so are wanting to change our health plan to make the cost as minimum as possible. & I’m originally from Canada so all of this health care stuff is very confusing to me!!

    1. Author

      I’m glad this was helpful for you. We update the tables every year when the new rates and plans become available.
      We will begin updating with 2017 data during the first couple weeks of November.
      Once the updated tables are ready, would you do us a favor and use the “apply now” links inside the quotes to enroll in your new coverage? The rate you will pay is exactly the same as if you went straight to the insurance company or Covered CA. Using our links enables the insurance companies to pay SPF Insurance for helping you enroll in a health plan. That way we can keep providing this type of information to everyone that visits our website.
      Let us know if you have any questions.

  3. 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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