Maternity in the Individual Major Medical Market

When searching for maternity in the individual market your choices are few and pricey. Still, there are benefits for the planned event.

First some ground rules.

If you are currently pregnant, you cannot get coverage from a major medical carrier. Not just maternity, they won't issue a policy to you or your spouse. If you are pregnant and without coverage, check out your options at Coverage For All

Avoid discount cards including the so-called "maternity cards". Most are overpriced and a few have run afoul of the Attorney General's offices in several states. In other words, don't waste your money.

If you are not pregnant, then there is a good chance you can qualify for the coverage if you have not had prior, complicated deliveries. If you have tried to get pregnant and had problems in the past, you will not find plans that cover fertility testing or IVF.

Currently there are only 4 carriers in the Atlanta area that offer maternity options. Pricing and benefits vary widely.

Most will have waiting periods before benefits kick in but one carrier does not impose any waiting period. Of course you cannot be pregnant with any carrier, including the one with no waiting period, at the time coverage goes into effect.

Other carriers impose waiting periods of 90 days to 12 months. This applies to conception so advance planning is needed.

A normal delivery from a par provider will run about $4500 for everything. Add another $1500 - $2000 for a scheduled c-section.

Complications are covered as any illness under most plans (including those without maternity).

If you do not have maternity coverage and do not qualify for taxpayer funded programs, you can expect to be billed $7,000+ for a normal delivery and pre-payment is required. A scheduled c-section can add another $4,000.

You can (and should) attempt to negotiate with your OB and hospital and get as close as possible to the par figures quoted above. Cash works very well when negotiating. If you are willing to pay 80% or so of the expected cost of a normal delivery up front you should be able to get by on $5,000 or so for the doc & hospital.

Contact us for pricing and details on maternity options.