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There is no such thing as Maternity Insurance.
So why are you here again? Don't panic. The Supplemental
Health Plans described on this website cover many different types
of medical hospital stays. Although they cover all kinds of
hospitalizations, they just so happen to also cover maternity -
but only after a 10 month waiting period. The companies that
offer supplemental plans change now and then. Some stop
offering the plans to new clients after a certain date. These
are the most current options available. See the insurance policy
contract for limitations, exclusions and details.
What is "Supplemental
Maternity" Insurance, anyway?
This
is not the real name for this insurance.
There is no such
thing as Maternity Insurance in Utah. It is a supplemental
"hospital indemnity" insurance plan policy. Most individual major
medical plans (SelectHealth, BCBS and Altius) only cover maternity after
you pay the first $5,000 ($7,500 for Altius). The plans then cover 100%.
The supplemental plans are used to cover that maternity
deductible. The money left over is yours to keep. The supplemental plans have to be in force for at
least 10 months before you deliver, and you must be admitted
into a hospital for at least 24 hours to get the benefit. Although
they are often used for maternity, remember that it will cover
other eligible hospitalizations after being in force for 30
days. For this reason many couples purchase the benefit
for both spouses. This is especially attractive if the
male is self employed and has no other disability or hospitalization
benefits.
Supplemental insurance
pays you a flat amount for being admitted into hospital. Some
also pay a flat daily amount for each day you are hospitalized.
Regardless of the actual cost of your medical bills, supplemental
plans only pay that flat amount (ie $2,500 for being admitted
and $400/day). SO, your health plan might pay everything over
$5,000 at 100%. The supplemental plans pay money directly to
you. You can use that money to cover the
$5,000. YES, that means you can have 100% of your maternity
covered or even more than 100%. Any money left over is
yours to keep.
What are the medical Questions I need to answer to get
these supplemental plans? You need to answer the
"dread disease" type questions: Aids, Heart problems,
Cancer type questions. It is much easier to get a supplemental
plan then to qualify for major medical health plans.
What company
in their right mind would take my $200/month and then pay
me $5,500 after 10 months ?
No they aren't excited
to lose money. In fact, many of the companies have
stopped offering their plans in Utah. Go figure. And the
premium you pay is not just for one company. For example this
premium is a combination two different companies. But remember that there are
thousands of people paying for hospital supplemental plans that
will never use them for maternity. That is the same concept
that applies here. They don't want to cover your maternity.
They don't want to cover any hospital stay for any reason. But
they cannot discriminate against you for using it for a maternity
hospitalization. The only limitation is that they exclude
maternity in the first 10 months of the policy. They then have to treat
maternity as any other hospital stay.
Remember, supplemental health policies should be purchased to be
included into your LONG TERM insurance portfolio.
What if my employer has a great maternity coverage plan
that covers most everything. Can I still take advantage of these
plans? Yes. Some of our best clients have
virtually complete coverage through their employer's health
insurance plan. They purchase the maximum benefit possible and
pocket the difference. They use the money for various
things. Some use the money to take longer maternity leaves from
work. Others save it for future expenses. Even others have
used it to got to Maui, etc. Really, it is your choice.
No questions asked.
Why can't
I just purchase the supplemental plan and drop my major medical
insurance?
Major medical insurance will cover medical expenses after a
deductible is paid and a co-insurance is shared (ie the 80/20
split with the insurance company.) After meeting the deductible
and co-insurance, an out of pocket maximum is met (usually $2,000
- $3,000 maximum). Some health insurance plans have a $5,000
maternity deductible but then cover 100% after that deductible
is met. Many do not cover maternity at all. In any case, after the out-of-pocket maximum is
reached, the insurance company might cover 100% of the cost up
to a maximum benefit (usually $1Million, etc). If you had a $500,000 hospital bill, Major
medical would cover you very well. If you only had supplemental
insurance you would be left paying about 98% of the bill all
by yourself! Supplemental insurance should only be used
when you have a major medical plan in force. Supplemental
plans are used to pay for your deductibles and Co-Insurance
that your major medical plans do not cover. Unlike Major
medical plans, money you receive from supplemental plan can be
used for any expenses you choose (like rent, mortgage, car
payments, diapers, Maui... whatever!)
Aren't there
any health plans that include maternity?
Yes, there are a few. (By the way, we would LOVE to
help you with your
health
insurance needs and to be your agent and help you apply for
SelectHealth, Blue Cross Blue Shield, Altius, Humana, etc, etc.) Some companies we represent
offer a separate maternity rider. It allows you to pay a
separate $500 deductible and then cover 50% up to a cap of
$2,500. The Problem?
It can be a little "pricey" and most people find a better option
through our supplemental plans. Although it sounds
like a good option, there may be other options using
SelectHealth and
BCBS.
These two health plans cover 100% after you pay the first $5,000. For
this reason I recommend one of these two plans and add a
supplemental
maternity policy.
What if I
have no health insurance, or a plan that excludes maternity. Can
I still get these plans?
There are
a few things to consider. For example the new Health Savings
Account Plans (HSA) are becoming very popular. However they do
not cover maternity. You have to pay for all maternity
expenses yourself or out of your HSA account. This presents a
problem with discounting. When you go to a hospital with a
health insurance plan you get "in network" discounts. When you
go for a non-covered event, or you have no insurance and are
paying with cash you don't get the discount. This can be a very
big deal. For example, a typical hospital bill for a two
day maternity stay is apx $11,000 plus. Because most
people have insurance the hospitals agree to apply the in
network discount. This drops the bill to around $6,000 or less.
You could owe a whole lot if you have a plan that doesn't cover
maternity or if you are paying cash and don't get the in network
discount. Some have successfully negotiated a "cash discount"
with some providers. This is supposed to be illegal for the
medical profession to charge you one price if you have insurance
and another price if you are paying cash (ie should be $11,000
either way before the in network discount). I just want
you to know these facts before you try to pay for a delivery
yourself or pick a health insurance plan that doesn't cover
maternity. That is why we recommend SelectHealth & Blue Cross
Blue Shield plans. they have a $5,000 maternity deductible and
then cover 100% of the balance. Need a better health
insurance plan? We can help.
Click
Here.
Who is eligible
for supplemental insurance?
Most plans allow anyone to purchase them regardless of
employment situation. (Example is a "stay at home mom" can pay
$183.99/month and would get $5,645 for a two day stay in the
hospital). There are some plans that require you
to be employed over 30 hours a week to be eligible for their
benefit. See agent for details and eligibility.
Why do some of the plans require me to cover dependents
also? The companies have set up guidelines for
their products in each state. In Utah they have established this
requirement in order to get the plans. The good news is that
family members also get a benefit if they happen to be
hospitalized. The 10 month waiting period is only for maternity.
Any other qualified hospital stay would entitle you to receive
the benefit after being on the plan for 30 days.
OK, there must
be a catch to the supplemental plans. How could I mess up?
You
caught me. There are ways to mess up. The following are
6 things you could do to NOT get the benefit even though
you pay each month:
1)
Deliver anytime during the first 10 months of the plan.
You deliver early, you don't get a penny.
2)
Deliver outside of a Hospital. If you deliver at
a birthing center or at home no benefit is paid.
3)
Deliver at a hospital, but check yourself out before 24 hours.
24 hours to trigger the benefit.
4)
Stop paying your premium before your hospitalization. Policy
must be in force when you deliver.
5)
Deliver outside the United
States. You must
deliver in the US to get the benefits.
6)
Enroll in a Government welfare program like Medicaid. All
benefits are then paid to Medicaid, not you.
These
are all ways to not get paid when you have a baby. Make
sure you don't fall in these traps and you will receive a benefit.
Do I have to
use certain doctors or hospitals?
No. You can go to any doctor any hospital. Just use the
facilities that your health insurance plan uses (must be in the USA).
How do I get
my money from the plans?
There
are two ways.
1) Give all of your supplemental insurance plan
details to the hospital when you deliver and sign the papers for
them to claim on your behalf and let them send you any left over
money (do you see any problem with that? I do!). Of
course, we don't recommend this first option. The next option is
better:
2)
Only give the hospital your medical health insurance information
when admitted. Then use the claim forms and a copy of the hospital bills and send
them into the companies yourself (or you can fax them). That way you get the money
paid in a check mad out to YOU. Doesn't that make a little more
sense? It is a little more hassle, but it ends up with you holding
the money.
What if my
hospital bill is less than the supplemental benefit?
This
is a trick question. The supplemental plan doesn't care
if you have insurance or not. It doesn't care if you go
to the most expensive hospital or not (as long as it is in the
USA!). It doesn't matter
how much the hospital bill is, the supplemental plan pays you
a flat amount for being hospitalized for at least 24 hours, and
for each day after that. If you had a $30,000 bill, you
don't get more money from the supplemental plans. If your
bill is less than your supplemental benefit you keep what is left
over.
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