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Home › Articles › Considering Pregnancy › Insuring a Hassle-free Pregnancy

Insuring a Hassle-free Pregnancy

Know Your Insurance Options Before You Conceive

By Kelly Burgess

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Once you make that contact, here are the questions you need to ask to help you make a financial plan:

  • Does your policy have a co-pay, a deductible or is it free? This question applies to the questions below as well.
  • How many prenatal visits are covered?
  • How many sonograms are covered?
  • Do you have to go to a specific provider or hospital?
  • Is there a preauthorization required for the hospital? What's the penalty if this preauthorization is not obtained?
  • How is the baby covered after birth?
  • How many days are Mom and Baby allowed to stay in the hospital? Does this number vary based upon vaginal birth or Cesarean section?

The take-home lesson here is to never assume pregnancy and maternity benefits are covered. Confirm before you get pregnant.

If You Are Self-insured
One more insurance lesson: Every state has laws pertaining to insurance coverage. Employers are required to abide by them if they meet the criteria, which usually is number of employees. In general, small employers are exempt from state law, as are individuals who are self-insured. In other words, you may think you're covered because it's the law in your state, but the first thing to do if you're self-insured and thinking about getting pregnant is to be doubly diligent regarding what is covered and what isn't. Also, with self-insurance, the definition of a pre-existing condition may be much stricter than with an employer-sponsored plan.

Fatima Mehdikarimi, also known as The Shopping Queen, is self-employed along with her husband. The pair have always been self insured. When they first wanted to get pregnant, they had to wait 12 months, which was the waiting period for any pre-existng conditions, including pregnancy. They also endured large premium increases, something that is a fact of life with private insurance. At one point, Mehdikarimi says, they were paying $900 per month out of pocket for a policy that included pregnancy insurance. They finally dropped the pregnancy option, figuring they could pay for their next pregnancy with what they saved. Which brings us to the following:


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