If you are a new parent or expectant mother, good health insurance coverage is more important than ever. You will depend on your health insurance for everything from prenatal and maternity care to pediatric visits and immunizations for your baby. To avoid surprise medical bills, it's important to learn the terms of your health insurance coverage right now. You'll also need to take steps to maintain your health insurance coverage if you lose or quit your job.
Before you set up your first obstetrician or midwife appointment, it's smart to figure out what your health insurance will (and won't) cover. Get the answers to the following questions from your company's benefits department or through your health insurance plan's customer service hotline:
If you want to use a certified nurse midwife or deliver your baby in a birth center or at home, find out what coverage your plan provides in these situations. Most plans cover a certified nurse midwife, and some will pay for a delivery at selected birth centers. Very few insurance plans cover home births, however.
With the arrival of a new baby comes the arrival of medical bills from the pediatrician, the nursery, and (in some cases) the neonatal intensive care unit (NICU). In fact, a bill from the hospital may be the first piece of mail your baby receives. Here are some questions to ask to cover your insurance bases before your baby arrives:
Life is rarely predictable, especially when it comes to work. If you happen to lose your job or change jobs during your pregnancy or soon after your baby is born, you'll need to pay careful attention to health insurance issues. Otherwise, you could be left uninsured at one of the most important (and expensive) times in your life.
When you change jobs, you usually give up health insurance coverage through your former employer and sign up for health benefits with your new employer. But expectant parents need to be especially careful when making job-related health insurance changes. This is because some employers impose a waiting period of a few months before you are eligible for health insurance coverage. If your baby is born while you are waiting for your benefits to kick in, you'll be responsible for the bills.
Even if you are immediately eligible for health insurance benefits through your new employer, look before you leap: The terms of your new health insurance plan could be quite different than those of your old plan, and you may be forced to switch physicians at a very inconvenient time -- midway through your pregnancy, for example. You also need to watch out for exclusions for preexisting conditions --your pregnancy could qualify.
The smartest option is often to continue health insurance coverage under your old employer's plan, at least until you deliver your baby. Thanks to a federal law called COBRA, you can keep your health insurance coverage for up to 36 months after you leave your job if you work for an employer with 20 or more employees. (If you work for a smaller employer, your state might have a law similar to COBRA that can help you.)
COBRA coverage will cost you quite a bit more than you're used to paying, however: usually your full premium, plus up to 2% for administrative costs. But the added expense will be well worth it if your new employer imposes a waiting period for health benefits or if the new plan is more restrictive than your current one.
If you happen to lose your job during your pregnancy, COBRA and similar state laws can be a lifesaver. Unless you can immediately sign up for health insurance coverage through your spouse or partner's employer-sponsored plan, it's very important that you sign up for continuation of your current health insurance benefits through COBRA or a similar state law. Without this coverage, you'll have to pay out of pocket for your prenatal and maternity care, and for your child's health bills.
You can find a complete discussion of common health insurance issues for new and expectant parents in Parent Savvy: Straight Answers to Your Family's Financial, Legal & Practical Questions, by Nihara Choudhri (Nolo).