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Health Insurance For Pregnant Women


Lowest California Health Insurance Prices Anywhere

The California Department of Insurance regulates California health insurance premiums. It doesn’t matter if you go directly to the carrier or apply with SPF, you will get the same price wherever you go. Working with SPF you don’t have to visit multiple health insurance for pregnant women websites, we have all the information you need right here, and can help you simplify the process to make it fast and easy.


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Health Insurance for Pregnant Women: Will I Be Able To Get It?

The short answer is perhaps, because there are three insurance options you might qualify for, and two state assistance programs. It’s hard to get maternity health insurance when you are already pregnant because insurance companies view being pregnant as a “Pre-existing Condition,” and the costs for a normal prenatal and delivery are much greater than the total monthly premiums you would pay for a maternity health insurance plan. Additionally, if there are complications then the costs climb at an exponential rate (premature babies can use over $30,000 – $85,000 in medical costs in the first weeks of life, and more than 1 in 10 California babies are premature or underweight). Because of these costs and risks, Health insurance companies will decline applications from women that are pregnant when they apply, so other strategies will have to be explored by the mother to be, in order to get maternity coverage.

Join a Group Health Insurance Plan to get Insurance For Pregnant Women

Insurance option number one is to join your company’s health insurance plan, Pregnant without Insuranceor the group health insurance plan at your spouse’s company. Most group health plans offer maternity coverage, and are guaranteed issue – meaning that you can’t be declined when you apply to join the group plan, even if you are already pregnant. The difficulty with this option is that company plans have open enrollment windows during which you can add the plan. If your pregnancy is outside the window, you may have to wait for the next annual window before you can join the plan. Ask your company if a special enrollment period can be set up. If not, and the normal open enrollment happens within 6 months of the time you become pregnant, this option can work.

Transferring to a Maternity Plan to Get Health Insurance For Pregnant Women

Health Insurance option number two applies to women that have their own medical insurance plan, but without maternity care. In this case, you should ask the health insurance company if you can transfer to a plan that offers maternity care. Blue Shield of California will allow this kind of transition, but other health insurance companies in California will not.

Get Health Insurance For Pregnant Women By Signing Up For PCIP California

Insurance option number three is to apply for the Pre-Existing Condition Insurance Plan California (PCIP California) that was created by the Affordable Care Act. This plan became available in 2010, and requires that you have been uninsured for a least 6 months, and been declined by a medical insurance company. The plan provides rich PPO benefits that will cover prenatal care and delivery services, and will keep your out of pocket costs to less than you would pay with most of the regular maternity insurance plans. This plan is one of the top 5 maternity insurance plans, in terms of minimizing your overall out of pocket expenses throughout the pregnancy.

If these options don’t solve the problem, then look to see if there are programs offered by your State’s Department of Insurance. Every state offers a version of the Medicaid program and many states offer other programs for women that do not qualify for Medicaid. The state of California offers the Medi-cal program (California’s version of Medicaid), and the Access for Infants and Mothers (AIM) program.

Medicaid Provides Insurance For Pregnant Women

Your state Medicaid program, or Medi-cal in California, should be your starting point. If you meet the income limits for Medi-cal you can apply for this no-cost health plan that provides benefits for pregnant women. Medi-cal is intended to provide coverage for low income families and women that are below the federal poverty level. If your income is above the Medi-cal qualification levels, then you should apply for the AIM program.

AIM Provides Health Insurance For Pregnant Women

The AIM program is provided for middle-income families that don’t have maternity health insurance, or have a health plan with a deductible or co-payment greater than $500. AIM is a low-cost program that you may qualify for if your income is too high to meet the Medi-cal limits. For example, a single mother’s monthly household income can be between $2,453 to $3,679 and qualify for AIM (there is a table with income ranges for families of difference sizes at http://www.aim.ca.gov/Costs/Income_Guidelines.aspx). One caveat for the AIM program is that it’s funding is provided by the State of California, and although money is usually available, if the program fully utilizes its available funds, then no additional mothers will be enrolled.

Individual health insurance with maternity coverage is not usually available after a woman becomes pregnant, but not having maternity coverage can be a financial disaster due to the cost of maternity care and baby delivery. The five options outlined here, joining a company health insurance plan at your workplace or your spouse’s, transferring to plan with maternity coverage, applying for the PCIP plan, or applying for State programs such as Medi-cal or AIM, will usually provide a solution for all mothers to be. With these solutions, having a baby can be a time of joy and new beginnings.

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/default.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 quickly


Health Insurance For Pregnant Women – Here Are Your Solutions

Health Insurance For Pregnant WomenThe most recent March of Dines PeriStats data shows that 22.3% of women between the ages of 18-45 are uninsured, and that number increased over 12% from 2007 to 2009. Therefore, being pregnant without health insurance is not a rare situation, and has in fact become more commonplace. If you are a woman who is pregnant, no insurance coverage means that the full cost of the prenatal care and delivery costs will be billed to you, and those costs are $12,000 to $20,000, based on what part of the country you live in and the type of delivery you have. To prevent having to pay these costs, finding health insurance for pregnant women is important.

Fortunately there are options to get insurance for pregnant women no matter how much or how little your income is. The 2 options you should explore are your state Medicaid department, and then the Pre-Existing Condition Insurance Plan (PCIP).

The federal PCIP program provides affordable health insurance to people that have not been able to get health insurance, and is offered in all 50 states. This makes the PCIP a great solution for women that are pregnant without insurance.

The PCIP California offers a robust set of benefits at attractive prices. The pre-existing condition insurance plan California offers $25 office visit copays, a $1500 deductible, a $2500 maximum out of pocket limit, and provides both generic and brand name prescription benefits. To be eligible for the California PCIP you must have been uninsured for at least 6 months, and had an application for health insurance declined by an insurance company. So if you are pregnant with no insurance in California, visit the PCIP California page to find out how much it will cost, get the simple 4 page application, and enroll in this program to protect yourself and your baby.

When compared against other maternity Health insurance plans, the PCIP is the third best California maternity insurance plan. The best plan for pregnancy health insurance is the Kaiser Permanente 0/1500 HSA plan with a total out of pocket (TOOP) cost of $4854, the second best plan, with a TOOP of $5064 is the Kaiser $50 Copay, barely ahead of the PCIP plan with a TOOP of $5068. From the other 3 companies offering maternity insurance plans in California, the best plan is the Anthem Blue Cross Select HMO plan and a TOOP of $7570.

Click here to learn more about the “California Maternity Health Insurance Plans Analyzed” article mentioned above.

If you are pregnant without insurance you don’t have to worry about how to get maternity health insurance for you and your baby. Between Medicaid and the PCIP, there is a solution that will provide health insurance for pregnant women in California. So go ahead and take the first step to determine which plan is right for you. Call your state Medicaid office today, then call an insurance broker to get information about your state pre-existing condition insurance plan California.


Frequently Asked Questions about Health Insurance For Pregnant Women

1. How do I know if I can qualify for Medicaid?

The easiest way to determine that is to call your local Medicaid office. The rules regarding what counts towards your total income and what is excluded are too numerous to cover here. The local people in the Medicaid offices can assist you in determining what your Medicaid income is.
Click here To find the nearest county Medi-cal office to you.

2. Are Discount Maternity Plans Worthwhile?

There is only 1 discount plan left for pregnant women (AmeriPlan). The other discount plan, Maternity Card, offered by Affordable HealthCare Options, (AHCO), has gone out of business after losing a court case in Texas for not providing any benefit to the subscribers.

The discount card companies say they can save 50% off the retail cost of medical services. That would be great since the regular cost of having a baby can be over $20,000.

AmeriPlan has a network of Doctors that will accept their discount plan, so you should check with your physician to make sure they are part of the network before you sign up. AmeriPlan uses a network of physicians from “BeechStreet”, and their own contracted physicians. I found only 6 Ob/Gyn’s in San Diego county that would accept the AmeriPlan card.

Last I heard this AmeriPlan cost $39.95/mo, so is it worth it? I can’t really say since there is no proof of actual savings….yet.

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