- Overview of Maternity Insurance In California
- Obamacare’s Best Maternity Insurance Plans California
- 6 Steps To Get California Health Insurance Plans With Maternity Coverage
- Planning Tips: Timing Is Everything With California Maternity Health Insurance
- Already Pregnant? You Can Still Get Maternity Insurance Coverage In California
- California Health Insurance Plans With Maternity Coverage Need These Benefits
Although health care reform (Obamacare) is supposed to reduce costs, most thought they would see a reduction in lower monthly premiums. 
The new Obamacare maternity insurance plans 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 affected 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, but not always, 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 the birth of your baby.
We’ve started working on updates for 2023. If you see “2023” above the list of plans in your region, that means it’s updated to 2023 plans/rates.
Best Maternity Plans In San Diego County
2023
- Molina Healthcare Gold 80 (HMO) CoveredCA Only
- Blue Shield Gold 80 (Trio HMO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Health Net Gold 80 (Ambetter HMO)
- Anthem Blue Cross Gold 80 (HMO)
- Blue Shield Platinum 90 (Trio HMO)
- Sharp Health Plan Gold 80 (Premier HMO)
- Kaiser Permanente Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Sharp Health Plan Platinum 90 (Premier HMO)
- Health Net Platinum 90 (Ambetter HMO)
- Health Net Platinum 90 (Ambetter PPO)
- Health Net Gold 80 (Ambetter PPO)
TOOPC = $11,916 - Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $5,074
TOOPC = $5,285
TOOPC = $5,403
TOOPC = $5,716
TOOPC = $5,767
TOOPC = $5,837
TOOPC = $5,942
TOOPC = $6,216
TOOPC = $6,473
TOOPC = $6,488
TOOPC = $6,516
TOOPC = $10,686
TOOPC = $12,397
TOOPC = $12,826
The average 2020 vaginal childbirth in San Diego County increased less than 1% to $16,030. The average cesarean childbirth costs $20,709.
There are two reasons for the significant reshuffling of the top childbirth plans in San Diego County in 2023. First, both Molina Healthcare and Blue Shield have been aggressively reducing the cost of their Gold and Platinum health plans. Secondly, the hospital copay for the Gold plans was reduced from $600 per day to $350 per day. This typically made Gold plans a better option for maternity purposes.
Molina captured the 1st and 3rd spots, and Blue Shield grabbed the 2nd spot. The Sharp Health Plan Platinum 90 Premier HMO plan, which previously was the top plan, fell to 10th place
HMO plans continue to dominate the top of the lists. Using a PPO plan will cost you at least $5,600 more than an HMO plan.
If you have to have a PPO plan, then the best options are from Health Net.
To see the detailed breakdown of the Total Out Of Pocket Costs for San Diego, California maternity insurance options, click here.
Top Maternity Plans In Contra Costa County
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Sutter Health Plus Platinum MI01 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Gold MI01 (HMO)
- Blue Shield Platinum 90 (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
- Health Net Platinum 90 (EPO)
TOOPC = $6,165
TOOPC = $6,362
TOOPC = $8,569
TOOPC = $8,984
TOOPC = $9,693
TOOPC = $10,974
TOOPC = $10,797
TOOPC = $11,333
TOOPC = $13,317
The average vaginal childbirth in the Bay Area costs $18,550. The average cesarean childbirth costs $25,881.
There were significant price increases for maternity plans in Contra Costa County in 2018 and this resulted in significant cost increases to have a baby. Kaiser Permanente plans experienced the smallest changes, with increases of only $200, while Blue Shield and Health Net had cost increases of $1,016 to $3,494.
Sutter Health Plus is making a big move in this region to gain market share. The Sutter Health Plus Platinum plan is now the 3rd best option and the Gold plan is number five. Blue Shield and Health Net both fell back in the standings due to their cost increases. Contra Costa County is definitely Kaiser country and Sutter Health is trying to keep Kaiser from running away with everything.
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
2019
- Health Net Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Oscar Health Insurance Gold 80 (EPO)
- Health Net Platinum 90 (HMO)
- Blue Shield Gold 80 (HMO Trio)
- Kaiser Permanente Gold 80 (HMO)
- Oscar Health Insurance Platinum 90 (EPO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Molina Healthcare Gold 90 (HMO) CoveredCA Only
- Blue Shield Platinum 90 (HMO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,046
$6,404
$6,432
$6,507
$6,579
$6,617
$7,069
$7,309
$7,989
$8,455
$9,094
The average vaginal childbirth in Orange County costs $15,712 in 2017, down 0.01% from 2017, and the average cesarean childbirth costs $19,704, down slightly from 2017.
The most notable change from 2018 is that many plans experienced significant rate increases. Having a baby in Orange County is now $280 to $848 more expensive than last year.
Health Net kept the top maternity health insurance spot with their CommunityCare Gold HMO plan. Most of the top plans in Orange County changed, and Gold plans now tend to be better than the Platinum plans.
Blue Shield’s Gold HMO plan had the smallest rate increase and climbed up to the 5th spot in the list.
If you will only be in the delivery plan for a small number of months, remember to check the price difference between Gold and Platinum to see if a Platinum plan would be lower cost for you.
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
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $5,331
$5,601
$7,105
$8,029
The average vaginal childbirth in California costs $17,028, up ~1% from 2017. The average cesarean childbirth costs $21,396, a 1.7% decrease from 2017.
A difference between 2018 and the 2017 Obamacare maternity plans is the price to have a baby has gone up on average $409 in this region. The biggest change is that Anthem Blue Cross and Health Net are no longer offering coverage in this region of California.
The 2 HMO offerings from Kaiser Permanente are the lowest cost in this region. If you choose to have your baby using Blue Shield you will pay at least $2,554 more.
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 West
2023
The West Los Angeles region (Region 16) includes all zip codes not in Los Angeles East
- LA Care Gold 80 (HMO) CoveredCA Only
- LA Care Platinum 90 (HMO) CoveredCA Only
- Blue Shield Gold 80 (Trio HMO)
- Molina Healthcare Gold 80 (HMO) CoveredCA Only
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Health Net Gold 80 (Ambetter HMO)
- Anthem Blue Cross Gold 80 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Oscar Health Insurance Gold 80 (EPO)
- Health Net Platinum 90 (Ambetter HMO)
- Health Net Gold 80 (EC PPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs = $4,538
$4,864
$5,840
$5,118
$5,452
$5,642
$5,680
$5,714
$5,930
$6,077
$6,427
$9,320
$9,625
The average vaginal childbirth in Los Angeles costs $15,712 in 2018, down 0.01% from 2017, and the average cesarean childbirth costs $19,706, down slightly from 2017.[/jbox]
The cost to have a baby in South Los Angeles is increasing $181 to $1,223 in 2019. LA Care maintains the top spot in the 2019 list. The LA Care Platinum 90 had an increase of $181, while Health Net Platinum 90 HMO had the largest price increase ($1,223) in the region.
PPO plans have almost fallen completely out of the list, but we’ve kept Blue Shield on the list, along with the new Enhanced Care PPO network plan from Health Net. Oscar offers an EPO plan which functions like a PPO, and it is priced much lower than the other PPO options in Los Angeles. If you need a PPO/EPO I suggest you check out 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 East
2019
The East Los Angeles region (Region 15) includes the ZIP codes starting with 906 to 912, 915, 917, 918, and 935
- LA Care Health Plan Platinum 90 (HMO) CoveredCA Only
- LA Care Health Plan Gold 80 (HMO) CoveredCA Only
- Health Net Gold 80 (HMO)
- Health Net Platinum 90 (HMO)
- Blue Shield Gold 80 (Trio HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Oscar Health Insurance Gold 80 (EPO)
- Blue Shield Platinum 90 (Trio HMO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Oscar Health Insurance Platinum 90 (EPO)
- Molina Healthcare Gold 80 (HMO) CoveredCA Only
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs = $4,764
$4,954
$5,218
$5,480
$5,524
$5,672
$5,945
$6,374
$6,402
$6,891
$6,996
$7,637
$8,309
$8,477
in Los Angeles California the average vaginal childbirth costs $15,712, and the average cesarean childbirth costs $19,706.[/jbox]
In 2019 the Los Angeles market pregnancy insurance price increases range from $406 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 Oscar Health in the 8th spot, although Oscar uses an EPO network which excludes out of network providers.
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
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Platinum MI01 (HMO)
- Blue Shield Platinum 90 (HMO)
- Sutter Health Plus Gold MI02 (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,315
$6,498
$7,560
$8,944
$9,058
$10,396
$10,995
$11,042
The average vaginal childbirth in the Bay Area costs $21,871 up 2% from 2016. The average cesarean childbirth costs $29,384 up 3.7% from 2016.[/jbox] Blue Shield is introducing a new HMO network option in Alameda County, and these plans will offer a lower cost option to women who don’t want to use Kaiser for their childbirth.
The biggest change between 2017 and the 2018 Obamacare maternity options is that the cost to have a baby went changed by $-87 to $1879. This is a large increase. Sutter actually reduced the price of their Platinum plan, 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 alternative (Blue Shield Gold HMO Trio) is $1,062.
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
2018
- Valley Health Plan Gold 80 (HMO) CoveredCA Only
- Valley Health Plan Platinum 90 (HMO) CoveredCA Only
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Platinum Individual MI01 (HMO)
- Blue Shield Platinum 90 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Anthem Blue Cross Gold 80 (EPO)
- Anthem Blue Cross Platinum 90 (EPO)
- Health Net Platinum 90 (EPO)
- Health Net Gold 80 (EPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,107
$6,124
$6,315
$6,498
$7,728
$8,710
$9,284
$9,641
$10,263
$10,346
$10,376
$10,742
$11,355
A vaginal childbirth in Santa Clara costs $16,948 on average, a reduction of almost 4% from 2017. The average cesarean childbirth costs $26,2224, which is an increase of 3.2% from 2017. [/jbox]
The biggest change between 2017 and 2018 is that the Anthem Blue Cross HMO plans are no longer available. The price increase between 2017 and the 2018 Affordable Care Act maternity plans is between $108 to $1,768.
The price gap between the top HMO plans and the lowest cost PPO plan is now $4,156. This gap has been widening for the last several years. Therefore the flexibility of a PPO network is 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
2018
- Kaiser Permanente Plat 90 (HMO)
- Chinese Community Health Plan Plat 90 (HMO)
- Chinese Community Health Plan Gold 80 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Oscar Health Gold 80 (EPO)
- Blue Shield Gold 80 (HMO)
- Oscar Health Plat 90 (EPO)
- Sutter Health Plus Plat Individual MI01 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Blue Shield Gold 80 (PPO)
- Health Net Plat 90 (EPO)
- Blue Shield Plat 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,762
$6,771
$6,884
$6,910
$8,320
$8,480
$8,896
$9,661
$11,034
$11,750
$11,931
$12,051
A vaginal childbirth in San Francisco costs $21,871 on average. A cesarean childbirth costs $29,384.[/jbox]
In 2018, Chinese Community Health and Kaiser Permanente still hold the top spots in San Francisco County.
Oscar Health offers the lowest cost EPO plan in this area. Their Gold EPO plan will cost $1,558 more than the lowest cost HMO plan. The trend of PPO/EPO rate increases being greater than HMO increases is continuing. The smallest EPO/PPO cost increase was $916 and the largest was $1,864. Meanwhile, the HMO cost increases ranged from $150 to $413.
Blue Shield of California also introduced an HMO option in San Francisco County. These HMO plans 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
2018
- Kaiser Permanente Plat 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Chinese Community Health Plan Plat 90 (HMO)
- Chinese Community Health Plan Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Plat Individual (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Plat 90 (PPO)
- Health Net Platinum 90 (EPO)
Total Out Of Pocket Costs (TOOPC) = $6,762
$6,905
$7,273
$7,339
$8,998
$9,375
$12,282
$12,762
$12,688
A vaginal childbirth in San Mateo costs $21,871 on average. A cesarean childbirth costs $29,384.[/jbox]
The most notable difference between 2017 and 2018 in this region are that Anthem Blue Cross is no longer available. The range of price changes from 2017 is -$136 to $1,481.
HMO plans from Kaiser and Chinese Community still dominate in San Mateo County. The best of the PPO plans require that you pay $5,520 more than the lowest cost HMO plan. That is a steep price for the flexibility of having a PPO network.
To see the detailed breakdown of the Total Out Of Pocket Costs for the San Mateo maternity insurance California options, click here.
Top Maternity Insurance In Mariposa, Merced, San Jaoquin, Stanislaus, and Tulare County
2018
- Kaiser Permanente Plat 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Sutter Health Plus Plat Individual MI01 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Blue Shield Platinum 90 (HMO)
- Anthem Blue Cross Plat 90 (EPO)
- Anthem Blue Cross Gold 80 (EPO)
- Blue Shield Gold 80 (PPO)
- Health Net Plat 90 (EPO)
- Health Net Gold 80 (EPO)
Total Out Of Pocket Costs (TOOPC) = $5,569
$5,818
$7,462
$8,083
$8,604
$9,761
$10,077
$10,131
$10,502
$10,710
$11,103
A vaginal childbirth in San Joaquin county costs $17,623 on average, an increase of 9.5% from 2017. A cesarean childbirth costs $21,396, which is a reduction of 1.7% compared to 2017.{California averages}[/jbox]
The big change between 2017 and 2018 is how much the hospital cost to have a baby went up in this San Joaquin Valley region, along with the large health plan rate increases Anthem Blue Cross, Blue Shield, and Health Net had.
As a result, the total cost to have a baby increased between $117 to $2,852. The HMO plans tended to have lower price increases compared to the PPO plans.
Kaiser Permanente is easily the best option if you want to deliver a baby for the smallest cost. Second place is now occupied by Sutter Health Plus. The Platinum Sutter plan actually had a small price reduction in 2018.
The cost to select a health plan with a PPO network is substantial. It will cost you about $4,500 more to select a PPO plan instead of opting for an HMO plan in this area.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Merced maternity insurance California options, click here.
The Best Maternity Insurance In Monterey, San Benito, Santa Cruz County
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Plat 90 MI01 (HMO)
- Blue Shield Plat 90 (HMO)
- Health Net Plat 90 (EPO)
- Health Net Gold 80 (EPO)
- Sutter Health Plus Gold 80 MI02 (HMO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,315
$6,497
$7,359
$7,515
$8,787
$9,338
$10,376
$10,530
$12,677
The average vaginal childbirth in Santa Cruz California costs $17,028, an increase of 5.8% over 2017. An average cesarean childbirth costs $21,396 which is a 1.7% reduction from 2017.{California averages}[/jbox]
The most notable changes in 2018 are that Anthem Blue Cross is gone, and Sutter Health Plus is now providing HMO maternity insurance plans here.
The cost to have a baby in this region changed between -$426 to 2,502 higher in 2018.
Losing Anthem Blue Cross did not materially change the better pregnancy health plan options in these counties because Anthem’s plans were higher priced, and Anthem only offered an EPO network. Both of the remaining PPO networks from Blue Shield and Health Net saw large price increases so they are not very attractive.
The addition of Sutter Health Plus gives you another lower cost option and the ability to go to Sutter doctors and hospitals.
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
- Health Net Platinum 90 (HMO)
- Health Net Gold 80 (HMO)
- Anthem Blue Cross Platinum 90 (HMO)
- Anthem Blue Cross Gold 80 (HMO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $4,484
$4,800
$4,904
$5,400
$6,782
A vaginal childbirth in Riverside county costs $12,623 on average, and a cesarean childbirth costs $14,106.[/jbox]
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
2017
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Western Health Advantage Platinum 90 (HMO)
- Western Health Advantage Gold 80 (HMO)
- Sutter Health Plus Platinum Individual MI01 (HMO)
- Blue Shield Gold 80 (HMO)
- Health Net Platinum 90 (HSP)
- Blue Shield Platinum 90 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Anthem Blue Cross Platinum 90 (EPO)
- Blue Shield Gold 80 (PPO)
- Anthem Blue Cross Gold 80 (EPO)
- Health Net Gold 80 (HSP)
Total Out Of Pocket Costs = $5,972
$6,156
$6,548
$6,660
$7,735
$7,824
$8,077
$8,684
$9,003
$9,607
$10,455
$10,467
$10,775
A vaginal childbirth in Sacramento county costs $20,596 on average, and a cesarean childbirth costs $32,729.[/jbox]
The major difference between 2016 and 2017 Obamacare maternity plans in this region is that the PPO plans had substantial cost increases. For example, the largest increase was the Blue Shield Gold 80 PPO plan at $3,319. While the smallest change happened on the Kaiser Platinum 90 HMO plan with a $216 increase.
In region 3 Blue Shield introduced a new HMO network, and Anthem changed it’s PPO network to an EPO network. The cost of a childbirth in this region is above the average cost for the state as a whole. Therefore, you live in a region with higher than average costs.
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
2017
- Western Health Advantage Platinum 90 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Western Health Advantage Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Health Net Platinum 90 (EPO)
- Blue Shield Gold 80 (PPO)
- Anthem Blue Cross Platinum 90 (PPO)
- Health Net Gold 80 (EPO)
- Anthem Blue Cross Gold 80 (PPO)
Total Out Of Pocket Costs = $5,612
$5,972
$6,252
$6,260
$6,420
10,051
$10,538
$10,603
$10,970
$11,402
A vaginal childbirth in Napa county costs $21,432 on average, and a cesarean childbirth costs $28,335.[/jbox]
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
- Health Net Platinum 90 (HMO)
- Health Net Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
- Anthem Blue Cross Platinum 90 (PPO)
- Anthem Blue Cross Gold 80 (PPO)
Total Out Of Pocket Costs = $4,472
$4,800
$4,976
$5,328
$5,864
$5,932
$5,980
$6,248
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.
Top Maternity Insurance Plans In Ventura
2017
- Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
- Anthem Blue Cross Platinum 90 (PPO)
- Anthem Blue Cross Gold 80 (PPO)
Total Cost = $8,129
$8,219
$8,525
$8,939
A vaginal childbirth in Ventura county costs $15,298 on average, and a cesarean childbirth costs $21,759.[/jbox]
This region of California has few choices for pregnancy insurance coverage. Only Anthem Blue Cross and Blue Shield of California offer plans in this region.
The two carriers rate increases in 2017 made the Blue Shield plans the better maternity choice this year.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Barbara maternity insurance California options, click here.
Top Maternity Insurance Plans In Shasta, Del Norte, Alpine, Siskiyou, Modoc, Lassen, Trinity, Humboldt, Tehama, Plumas, Nevada, Mendocino, Lake, Butte, Glenn, Sutter, Yuba, Colusa, Amador, Calaveras, Tuolumne, and Sierra Counties
2017
- Anthem Blue Cross Platinum 90 (EPO)
- Anthem Blue Cross Gold 80 (EPO)
- Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
Total Cost = $8,599
$9,615
$9,679
$10,083
A vaginal childbirth in Ventura county costs $15,298 on average, and a cesarean childbirth costs $21,759.[/jbox]
This region of California has few choices for pregnancy insurance coverage. Only Anthem Blue Cross and Blue Shield of California offer plans in this region.
The two carriers rate increases in 2017 made the Blue Shield plans the better maternity choice this year.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Barbara maternity insurance California options, click here.
tab 16 :: …..
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.
How To Select The Best California Maternity Insurance
To make sure you get the right maternity plan for your needs, follow the simple steps outlined below. They will make it easy and help you select the right plan and complete your application for coverage.
- Use the maternity plans listed above as your starting point to identify several insurance company options
- Search for your doctor in the provider directory search tools, to determine if they accept the plans you choose. (Or call your doctor and ask if they accept the plans you’ve selected from the above lists)
- Determine if you can qualify for a subsidy
- Run a California maternity insurance quote to see what the price is for the plans your doctor accepts.
- Use the “Apply Now” link in your quote if you do not qualify for a subsidy. If you are subsidy qualified, then go here to get help with your Covered California application.
If you need help determining which Obamacare plans are the best in your region of California, or you are having difficulties checking on the networks your doctor accepts, or you want help with your application, call us and we’ll help you. 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.
- The Prenatal Period
- 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.
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:
- Unlimited Doctor Office Visits for a Copay
- Low Deductible or No Deductible
- Small Out Of Pocket Maximum
- Fixed Copay for Hospital Stays
- Fixed Copay for Lab Tests and Imaging
- Affordable Monthly Premium
You’ll have a $0 copay for these visits in Bronze, Silver, Gold, and Platinum policies.
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.
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.
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.
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.
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.
In the Platinum 90 Select EPO from Oscar is mentioned that birth deliveries costs are covered with 2 days for uncomplicated birth and 4 days for c-section uncomplicated births. My question is who will cover the costs if the stay will take longer or there will be complications with the birth.
Second question – can you fix such insurance also with an existing pregnancy of 5 months
Joachim,
The Oscar Platinum 90 Select plan has a $250 copay that applies for admissions to a hospital.
The standard time is 2 days for a vaginal birth and 3 or 4 days for a c-section. Each day in the hospital is a $250 copayment.
The maximum you would pay for any hospital visit would be $250 x 5 days. After that, Oscar pays for the rest of the costs.
There are no health questions on applications anymore, so Yes, it is possible to enroll in a Platinum plan during open enrollment, even when you
are pregnant.
Tim
Hello, I am hoping to switch to Kaiser 01/01/2021 with my due date being at the end of February. Can you switch plans after delivery if you purchase insurance directly through Kaiser? Or is this only if you have Kaiser through Covered California?
Also, if my husband is also on the plan, the out-of-pocket max would still be the individual amount listed rather than the family amount, correct? (After reaching the individual max for me, the insurance would then cover the remaining costs for delivery).
Also wondering what the difference is between Kaiser’s HDHP HMO plans vs just HMO plans. Thank you so much for your time!
Hi Danielle,
A plan direct from Kaiser will allow you to switch to a different plan once the baby is born. However, the only start date for the new plan is the “date of birth”.
If you apply for the Kaiser plan on Covered CA, then you are able to get a first of the month start date after the baby is born. This is the preferred date to have the baby and mom’s new plan start.
The out-of-pocket maximum is for you and the baby only. Your husband should be on a different plan. Typically we put dads on a Bronze or Silver plan, and Mother-to-be on either a Platinum or Gold plan, depending upon which will result in the lowest out of pocket cost for you.
The HDHP plan is HSA compatible. This plan only makes sense for families that earn a lot and will make use of the Health Savings Account (HSA) to help pay for the cost of medical services. For pregnancy and delivery purposes, I would not recommend an HDHP plan.
One of our brokers can help you with this process, just contact us.
Tim Thompson
Live in Contra Costa County. Wife is currently pregnant and due in July of 2020. Currently have Kaiser Silver, but believe switching her Platinum during current open enrollment would save the most money, but just double checking. I believe once we deliver in July and everything health wise is okay, we can at that point switch back to silver for her and the baby. Does this seem like the best options for us that includes the best coverage while also having the lowest out of pocket expenses for the year? Thank you ahead of time!!!
Kyle,
Switching to the Kaiser Platinum plan will cut the cost of delivering the baby by at least $10k. So I would definitely recommend doing so. Once the baby is born, she and the baby can switch to a lower cost plan, but there are some specific details that are important. Kaiser will only allow a date of baby’s birth start date for any change. Therefore it is usually better to use Covered CA to switch plans when the baby is born. On Covered CA we can get a first of the month after the baby is born start-date for both mom and baby plan changes. If you use the SPF Insurance quote/apply engine to make the change at Kaiser, we will be able to help your family transition once the baby is born. That way you’ll know that everything is being done correctly to minimize the effort and time to changes plans easily.
SPF Quote/Apply Engine
Hope this helps,
Tim
hi there. I live in Riverside county. I’m debating between the Kaiser 90 HMO Platinum plan ($500/month) or the Blue shield Platinum 90 ($375 a month) . Looks like blue shield requires 10% of delivery to be covered. I know kaiser is only $250 per night but higher monthly. Any suggestions or insights on which to go with? I’m 40 and due in April 2020 . thank you!!
Hi Sandra,
The Kaiser Platinum plan will definitely save you a lot of money during the delivery. Once the baby is born, that creates a qualifying event and enables you to put the baby on a plan and change your plan to a lower benefit level to save monthly premiums. That way you are on the Platinum plan from the beginning of the year until the baby is born, and then the rest of the year on a lower-cost plan.
Hope this helps.
Tim
Thank you a million times again!
You are very welcome Sandra.
Hi! I currently reside in Irvine, California and through business the price of the premium is not a factor (very fortunate). For pregnancy and just future concerns, would Kaiser 90 HMO Platinum 0/10 Alt make more sense or Blue Shield Platinum 90 PPO 0/15 + child dental make more sense in terms of costs for delivery, etc
Dan,
The Kaiser 90 HMO Platinum 0/10 Alt plan would be the better option for the delivery of the baby. The reason is that the Kaiser plan has a per admission copayment of $500 when you go to the hospital for the delivery and the Blue Shield Platinum 90 PPO 0/15 would require that you pay 10% of the cost of delivering the baby.
I hope this helps, and good luck!
Tim
Wow I had no idea about all of this. I didn’t have regular insurance during my pregnancies, but if I ever decide to have another, I will definitely do my research!
My Cobra insurance is going to be canceled or terminated soon due to a misunderstanding. (Insurance company had no records of me, which became very confusing). I don’t get my new employer’s insurance until February, it is Gold PPO. $0 out of pocket for preventive care if in network. I live in South Los Angeles. What would be best and affordable for me to sign up with as far as insurance for the month of January? Is Medical better and does it cover everything as far as prenatal care and after? Should I stick with my work insurance once it kicks in or switch altogether?
Ellie,
The key question is what insurance does your doctor accept? Then what is the in-hospital benefit in your company Gold PPO plan? Finally, what will your cost be for the company health plan?
These questions will determine what makes more sense for you long-term in 2018.
As for the month of January, a regular health plan will pay for the prenatal care as a preventive benefit (no out-of-pocket cost to you), so that would be a good idea.
Health Net and Oscar have extended the deadline to Friday 12/22/17 in order to get a Jan 1st start date.
Tim
Hi Tim,
I’m planning on changing my KP plan to a better plan since I am pregnant now and due in August 2018. I’m wondering what is the best plan for me as far as getting the proper care and not too much of an out of pocket expense. Please advice, thank you.
Hi Joy,
The answer to your question depends on where you live.
Tim
Hi Tim,
I live in Northern California.
Joy,
What city do you live in?
Tim
I live in Hayward, CA. Our company pays $400/monthly premium. I want to choose a plan that will cover most of maternity costs. My due date is August 2018. Thank you so much for the response.
Hi Joy,
I’ve updated the Alameda County plans to show the best delivery plans where you live. The Kaiser Permanente Platinum 90 HMO plan would have the lowest out of pocket cost for you. If you do not want Kaiser, then the new Blue Shield Gold 80 HMO would be the next best options. Click on the tab for Alameda County and you will see the results. My recommendation is to use this list as a guide, and then put your name and birthdate into the quote engine to see what the costs would be for you. Based on that you could enroll in the plan you want using the “Add Plan to Cart” button in the quote.
Let me know if you have other questions.
Tim Thompson
Hi,
Are these Kaiser plans only available to women who are currently enrolled with Kaiser insurance but are needing to switch to cover their maternity expenses? I’m a bit confused. I am in Napa County in California without any health insurance and pregnant. Am I eligible for the Plantinum insurance? Or what are my options? I desperately need help and confused with all the information.
Hazel,
You do not need to be currently enrolled in a Kaiser plan in order to apply for a Platinum or Gold plan with Kaiser. During OEP you can enroll in any plan offered by an insurance company. There are no pre-existing condition requirements, so your pregnancy does not affect your ability to enroll.
Since you already know you want a Kaiser Permanente health plan for your delivery, the main question is “can you qualify for premium assistance based on your household Adjusted Gross Income.” Is so, then we’ll want to apply for your Kaiser health plan through Covered CA so you can receive premium assistance. The income limits for assistance are shown here : https://spfinsurance.com/california-health-care-reform/subsidy/
Let us know if you have any questions. We’re always here to help you.
Tim
Hello,
I am pregnant and without health insurance. I’m a bit confused about health insurance and what I’m eligible for. Am I eligible to enroll for the Kaiser Plantinum plan? I’m in California the Napa County. Any help is much appreciated.
Thank you!
Hazel
Hi Hazel,
Getting health insurance can be confusing just by itself, and even more so when you are pregnant and know there is a costly medical event coming in the future when your baby is born.
During this Open Enrollment Period (OEP) you can enroll in any health plan you want. The OEP started Nov 1st and ends on Jan 31, 2018.
Since Kaiser does operate in Napa County, you are eligible to enroll in a Kaiser health insurance plan.
Tim
I got married two weeks ago and my wife is 9 weeks pregnant. We live in santa ana CA. Is a KP. Gold HMO B or a blue shield silver trio 1975/55 better?
Thanks
Josh
Josh,
Between the two options you listed, the Kaiser Gold plan will be far better for 2020. The Gold plan has a $600/day copay for the delivery costs. It will make sense to run quotes to see what the pricing looks like for the top maternity plans in your zip-code. The Health Net and/or Oscar plans may have better costs for your new wife. The analysis I did was for a 30-year-old. If she is a different age, then the results could be different for her.
Tim
Hi Tim,
All your work is very helpful, thank you so much!
I live in Northern California and I am looking at getting kaiser insurance. My husband and I hope to get pregnant in Feb 2018, which means a delivery around end of November or in December.
Since that change might happen before delivery, should I choose a Kaiser platinum HMO plan to ensure the least amount paid over the next year for the pregnancy medical costs?
Any tips would be greatly helpful!
Hi Julie,
If you will deliver in November or December of 2018, then you should enroll in a delivery plan.
The only way to change plans outside of the open enrollment period is if you experience a Qualifying Event.
Unfortunately, getting pregnant is not a qualifying event. So this Open Enrollment is your opportunity
to enroll in a Gold/Platinum delivery plan.
Hope this helps,
Tim
Thank you very much Tim!
Hi there Tim,
I am currently pregnant due in march 2018, as of now i have the KAISER SILVER 94 HMO PLAN. Which is great for now. But should i change my plan when open enrollment is available to a platinum plan?
Brittney,
This is a great question!
In the Silver 94 HMO plan your hospital costs for the delivery are 10% up to a maximum of $1000.
In a Platinum 90 co-pay plan you would pay $250/day with a typical delivery being 2 days, so a total of $500.
If the cost of the Platinum plan is more than $500 higher than the cost of the Silver 94 plan, then you are better off staying in the Silver 94 plan.
Since the price of both plans is based on where you live and your age, I can’t tell you which plan is better. However, my guess is that the Silver 94 plan will be the winner.
Hope this helps.
Tim
We currently have a Silver HMO plan through Health Net (San Diego County).
We are wanting to get pregnant in the next few months, so we should keep our silver plan until open enrollment for 2018 and switch over to a platinum plan for delivery. is this correct?
Derrik,
That is what we recommend.
There are some changes that are happening to the rules for 2018 that could prevent the mother from changing her health plan after the baby is born. The proposed rules are changing the qualifying event of having a baby to mean that only the baby can be enrolled in a plan. The rest of the family must stay in their current plans until open enrollment.
We’ll keep an eye on this and update the information on this maternity insurance page once we know the rules are officially changed.
Do you happen to know if the rules have changed on this yet? I’m due mid January and don’t want to sign up for a Platinum plan if I won’t be able to downgrade after giving birth. Thanks so much!
Angela,
Many of the carriers have switched to allowing only the date of the baby’s birth as the start date for a plan change. They will allow both mother and baby to change plans. However, if you downgrade from a Platinum plan to a Silver plan on the date of birth, the Silver plan may become the plan that the carrier uses to pay your hospital bills.
A key piece of data to look at is the following: what is the delivery cost in a Silver plan versus the added premiums of a Platinum plan and it’s delivery costs. The plan lists above provide the average delivery costs in each area of CA.
In a Silver plan you are responsible for the $2,500 deductible, and then you pay 20% of the remaining delivery costs. If the delivery is $15,000 then you would pay 2500 + .2 * (15000-2500) = $5,000. If you are in a Platinum HMO plan then the delivery cost is $500. You are paying $4,500 more for the delivery in a Silver plan. If the cost difference between the Platinum and Silver plan is less than $4,500 then you will be better off in a Platinum plan.
Right this moment, Covered CA is still allowing Mom and baby to change plans and get a first of the month after the baby is born start date. This can only be done using a broker because the Covered CA application does not provide the option to consumers.
Second option: since you will be giving birth during the open enrollment period, as long as you reapply before the end of January 2018, you can change to any plan and the new plan will start on March 1st.
Hope this helps in your decision. If you have any questions please feel free to call us.
Tim Thompson
Great article and information Tim, thank you. Any updates on the proposed rule changes for 2018? I am currently pregnant and due April 2018. I have Blue Shield Silver PPO now and just want to make sure that if I enroll for Platinum for 2018, that I will be able to switch back after baby is born.
Sorry, forgot to mention that my husband is also on the plan.
Winnie,
Your husband should not be on the same plan as you unless he needs the same level of care.
Tim
Winnie,
See my answer below to Angela. Your situation will be similar to her’s except that you won’t be able to switch back because of the open enrollment period.
If the yearly premium cost difference between a silver and platinum plan is less than the difference in cost for the delivery in both plans, then a “delivery” plan (Platinum) will be a better option. Even if you are not able to downgrade when the baby is born.
As an additional tidbit, the cost numbers in the maternity plan tables above show a full year of delivery plan premiums.
Tim
Thank you for this! It has helped so much. I was hoping to see a Ventura County addition. Do you have any information on that specific county? Thank you!
Hi Jamie,
You are the first person from the Santa Barbara and Ventura county area to request the plans there.
I’ll get to work on it and have the plan analysis published by tomorrow morning.
Let me know if you have any questions.
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?
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.
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!!
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.
This good and thanks for care of mothers.
I am visitor and I am pregnant can I use the Obamascare or maternity insurance.
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.