MLM Success Guide

Best Maternity Health Insurance Plans Analyzed:

Posted on July 29th, 2011 by Tim Thompson

A key question couples planning to have a baby should ask is, “What will we pay if we use Maternity Health Insurance plan ‘XYZ’?” In a new report from SPF Insurance, titled ‘Analysis of Best California Maternity Health Insurance Plans’, couples can find a break down of the costs associated with prenatal care and delivery for the best maternity health insurance plans. A key finding from the article shows the tradeoff between the maternity insurance premiums and the out of pocket costs and how both affect the total out of pocket costs the couple will see.

The five pregnancy health insurance plans that were analyzed are the Kaiser 0/1500 HSA plan, the Kaiser 50 Copayment plan, the Anthem Blue Cross Select HMO plan, the Health Net HMO 40 plan, and the Blue Shield Spectrum 5000 plan. After totaling the office visit copays, the lab expenses, the cost of the Amniocentesis and Ultrasound tests, along with the hospital copay or coinsurance delivery costs, we get the Out Of Pocket Cost (OOP). Then we total up the 12 months of pregnancy health insurance premiums for the plans and add that to the out of pocket costs to get the Total Out Of Pocket Cost (TOOP). This is the total amount you would pay to have your baby.

Here is a quick summary of the analysis cost data from the article:

Among these five pregnancy health insurance options, there are a couple of data points that stick out. The Blue Shield Spectrum plan has the lowest premium cost and the Blue Cross Select HMO plan has the lowest out of pocket cost. However, neither of these plans is the lowest total out of pocket cost leader, so having the lowest premiums or smallest out of pocket costs is not a guaranteed winner. If the primary cost goal is to keep the total out of pocket cost low, then both the pregnancy insurance premiums and the expected out of pocket costs have to be considered together in order to find the best plan.

When faced with high copayment and coinsurance costs for various parts of the normal medical services during a pregnancy, it can feel as though you really don’t have pregnancy insurance. Because of this, many people will emotionally pick a plan with simple copays for everything in order to minimize their out of pocket costs before and during the pregnancy. As you can see, paying less for the medical services means you have to pay more each month for the pregnancy health insurance premiums. It’s important to keep emotions out of the decision, and realize that although your costs for the pregnancy are $5,000 to $9,000, the real total cost of all the medical services for prenatal care and delivery are closer to $20,000, so you’re paying less than 50% of the actual cost. Plus if there are complications, the insurance company will pay the rest of the expenses.

For most couples, quality of care is the most important criteria of choosing a maternity health insurance plan. Cost is still a concern, so the best way to select a good maternity insurance plan is to analyze the numbers so you can see which plan will provide quality care at the lowest total out of pocket cost. This way you can prepare for the expected expenses during the pregnancy and delivery period, and not have any financial surprises.

Get the best information regarding Pregnancy Health Insurance, at SPF Insurance. Check out the full analysis of Best Maternity Health Insurance Plans. Also published at Best Maternity Health Insurance Plans Analyzed: Which Cost Is The Deciding Factor.