Your health insurance can pay a substantial amount of what you are billed when giving birth. However, there are things that you could still be billed for during your hospital stay. The cost of childbirth for an individual can range from $460 to $8,224; it will depend on the circumstances and your plan’s benefits. Here is what your insurance broker wants you to understand about giving birth and your health insurance plan.
There are four key terms that your insurance broker wants you to understand. You must first know that there are two typical insurance plans: Health Maintenance Organization, commonly referred to as HMO, and preferred provider organization, or PPO. What kind of insurance plan you have will depend on what sort of coverage you receive. Knowing these four terms will better help you understand what your plan covers.
- In-network means your health insurance plan will provide a network of doctors, labs, specialists, and hospitals. If you go to one of these, you will have more coverage. HMO plans might not cover any costs if an out-of-network provider is used unless it is a potential emergency.
- Out-of-network providers are ones that are not in your network. The services offered by these providers will cost quite a bit more.
- Deductibles are the amount you are required to pay before your health insurance will pay. Many plans have individual and family deductibles, and you will generally need to satisfy your deductible for medical expenses.
- Out-of-pocket max refers to the amount you will pay after your deductible has been made up to this amount.
There are some factors that you will want to take into consideration when looking at health insurance. When looking at plans, look at these four things.
- If the provider you wish to see is considered in-network.
- “What amount of deductible will you be choosing?”
- What the maximum out-of-pocket amounts will be (this is especially important if you are deemed as high risk).
- You may have unique expenses during childbirth, such as a midwife.
Some individuals think about when the best time to get pregnant is. While in certain cases it happens, others will plan their pregnancy out to maximize their health care insurance. Ideally, the best time to get pregnant is in December, as most of your appointments will not be scheduled until you are six to twelve weeks pregnant. This way, all of your appointments and births will occur in the same year.
On the flip side, the worst time to get pregnant is in March or April. This will provide a due date of December to January. If you are admitted to the hospital on December 31 and do not deliver until January 1, you may find you have two deductibles to pay.
While you may not switch insurance due to pregnancy, you are welcome to see if you qualify for Medicaid through income limits. You are only allowed to change insurance if it is a new enrollment period.
If you plan on having a home pregnancy, you should make sure your insurance plan will cover it. Many policies will not cover this type of birth.
Health insurance can be a complicated issue. If you are looking for an insurance broker near Clearwater to answer any questions you have, contact Gemini Insurance Company. They will take the time to help you understand what your plan covers so you are not shocked when you receive medical bills after giving birth.
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