So here you are, pregnant with no maternity coverage. You start asking yourself, "How am I (are we) going to pay for the maternity bills?" You know they're coming, one way or the other, what are your options?
Logically, you decide that it would be great to get on an insurance plan that would cover your maternity expenses. So your next move is to call different insurance providers. Shortly you will find out that most insurance companies consider pregnancy to be a pre-existing condition and therefore would not cover any expenses relating to pregnancy. If you think about it from the insurance company's point of view, it makes perfect sense. They know that if you are already pregnant, it is a guaranteed expense out of their pocket with all the doctor visits, lab fees, hospital stay and the specialists. God forbid if you have any complications.
What would be your next move? You might be lucky enough to qualify for free maternity coverage through your county's health department. That is if your family's income is below or at the poverty level.
For all the other folks, the issue stays open. What else can you do? There is obviously a self-pay option, where you pay for all the bills yourself. It's scary to you, how much will it be? $5,000, $10,000, $20,000, more?
If you are self-employed, you have the advantage versus someone who is employed by another. Self-employed can qualify for the group insurance plan as long as the company consists of at least two people who would like to get insurance. This is the case for most states, but please check with your local insurance agent for additional details. Having your spouse as an employee should qualify you for group insurance plan.
The companies with more than two employees, might be required to offer group insurance to the rest of their full-time employees. This can significantly raise the cost of your group plan, defeating the original purpose of saving money. I recommend contacting an agent as soon as you find out about your pregnancy since there might be a waiting period before the policy is active. Be prepared to show your state's employer's tax forms showing taxes paid for each employee.
One of the disadvantages of having an employee is that you are required to pay the state and federal unemployment tax, Social Security and Medicare for each of your employee. So if you are thinking of putting your spouse on the payroll in order to get group insurance, consider the costs involved with paying the employment taxes that I listed above, based on his/her wages. If your spouse is already on the payroll, then you can disregard these costs as an additional expense.
Please, don't make a mistake of taking your spouse off the payroll once you receive insurance, just so you can save a buck on taxes. It's actually illegal and if at any time during your pregnancy, you submit a large claim to the insurance company, it can request your current employment records at any time you have the policy. And simply, if you or your spouse is not on the payroll, insurance company will simply deny coverage.
Questions to ask your group insurance provider or insurance agent
Do I have to cover all of my employees (if applicable)?
What are monthly premiums?
Is there co-pay for doctor's visits and hospital admission?
Do you have to pay additional sum when or before the baby is born in order to cover all of the newborn expenses?
Can you cancel your insurance at any time?
Can you start your insurance at any time? (If you don't mind waiting 2 or 3 months after you get pregnant, you won't have to pay as much in premiums)
What documentation is required?
What is the waiting period before the insurance is active?
If you are able to obtain group insurance, you might want to cancel your Individual or Family Insurance plan for the time being. This will save you some money as well. Make sure you check with your current company on whether you will have to pay a higher premium when you re-enroll, and obviously, if you accumulate pre-existing conditions in the time being, your premium may rise or you might be refused for coverage completely.
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