Asus Estimates on Everything

• 13% of pregnant women have no insurance of any kind.
• Of these uninsured pregnant women, 57% receive no medical care for themselves or their babies until the fourth month of pregnancy, or later.
• Of every 100 births, 12 take place before the end of the ninth month.
• 1 out of every 10 newborns is low birth-weight, and thus at an increased risk of disease or deformity for the rest of its life. 
  

The moral of the story is clear.  Pregnant mothers need adequate prenatal care to ensure that they, and their developing babies, stay healthy through pregnancy and birth.   

The problem is that prenatal care is expensive.   A hospital delivery alone can cost up to $8000.  Thus, expectant mothers need one of three things -- (1) comprehensive health insurance that covers the costs of maternity  (2) thousands of dollars in savings to pay the costs of doctors' visits, sonograms, medicine, and delivery; or  (3) a supplemental insurance plan or other discount program that covers only the expenses associated with maternity.  

Expectant mothers with extremely low incomes have access to a federal program known as WIC   (Women, Infants and Children), whose mission is to ensure the good health of poor mothers and their children between 0 and 5.   WIC offices can be found at schools, community centers, hospitals, county health departments, travelling clinics, camps and centers for migrant workers, and public housing projects, and their services include health care referrals, access to cheap and healthy food, and advice on nutrition.    While eligibility requirements differ from state to state, one rule of thumb is that families with a combined income of $30,000 or less are eligible for WIC.   

In addition, low-income expectant mothers may qualify for Medicaid, another federal health program administered by state governments.   Some state programs, such as Medical in California, have special programs for pregnant women.  Like WIC, Medicaid is only available to people with incomes below a certain minimum threshold, which changes from state to state, and the best place to find information is to visit a local Medicaid office.  

Not every pregnant woman can qualify for these two programs, however, because her income may be too high.   For higher-earning mothers, the wisest course of action is to:  (1) enroll in a comprehensive insurance program before getting pregnant, and  (2) select the plan's maternity rider.    Most major medical plans include maternity coverage either for free or for an additional 10% surcharge.     However, this option takes some advanced planning.    Certain insurance plans with maternity riders specify a waiting period of up to 12 months before a mother can collect the benefits related to pregnancy.    It may be impossible or prohibitively expensive for a mother to purchase the same maternity rider once she is several months into her pregnancy.  

There are two other options for women who have access to health insurance through their jobs when they become pregnant.  Firstly, mothers are entitled by federal law to at least six weeks of paid disability leave during the six months immediately preceding and immediately following the birth or adoption of a child.     Secondly, employees who leave a firm for any reason are beneficiaries of the Health Insurance Portability Act, or HIPAA, a federal law that guarantees individual employees the right to maintain group coverage from a former employer, even after they have left their employer or been laid off, and until they obtain another job with health insurance.   Insurance plans of this kind, which are known as COBRA plans, are available only to people who worked for firms with more than 20 employees.   The ex-employees have to pay their own premiums, but at lower group rates negotiated by their former employers rather than the much higher individual rates.   Thus, every one who is between jobs, including mothers, can stay insured while they are unemployed as long as they can afford to pay the premium.  

It's an altogether different story for uninsured women who become pregnant, and then decide to purchase coverage, may have trouble finding a plan they can afford.  Their pregnancy is treated by many insurance firms as a  "pre-existing condition" and is therefore ineligible for coverage.   The fathers of the unborn children are in the same position as the women; they cannot purchase maternity insurance for the child either, because the pregnancy is defined as a condition shared by the mother and the father of the unborn child.

A few alternatives to traditional insurance are available, however, for expectant parents who are uninsured.   The first of these is "Ameriplan,” a private company that offers health care discounts in every American state except Alaska.

"Ameriplan" claims that it can "help you save up to 50% on health care services, with benefits ranging from hospital, physician, and ancillary services (x-rays, lab work, tests)."    Its plans include "no deductibles, no annual limits, no claim forms, and no waiting period."  Since "AmeriPlan" is not insurance, but a discount program, it can offer reimbursement for expenses associated with any pre-existing conditions, including pregnancy and maternity.