May 15 2008

Things to ask your insurance company before you have a baby


The following is a guest post by Lynnae of Being, a blog about frugal living and smart money management.  If you like this post, consider subscribing to Being via RSS or Email.

Preparing for a baby is an exciting time.  Expectant parents begin to think about how to decorate the nursery, where they can find supplies like cribs and carseats, and whether they’ll need to stock up on pink or blue clothes.

One thing that sometimes gets forgotten is insurance.  Insurance companies vary wildly in what they will and won’t cover as part of maternity coverage.  And as I found out, some of the “rules” don’t make much sense.  It’s always best to look over your policy and ask some questions, so you’re not in for a big surprise.

Do you have maternity coverage?

Believe it or not, this is an important question.  Hopefully you looked into this when you applied for your insurance coverage.  But if you didn’t, look now.  Some companies, especially smaller companies, buy insurance policies without maternity coverage, because maternity coverage is so expensive.

If you find you aren’t covered, don’t panic.  You can call an independent insurance agent or your insurance company to find out if you can get an addition to your policy.  If that’s not possible, your insurance agent will know of other options in your state.  Most states are very liberal about giving maternity coverage to pregnant women.

Is ultrasound covered?

These days it’s pretty standard for a doctor to order an ultrasound around 20 weeks.  However, some insurance companies do not consider this a necessary procedure and won’t cover it.  It’s best to know before the doctor orders the test, so the doctor can write down a compelling reason for the ultrasound to satisfy the insurance company.  Either that or you can decline the test.

Are other tests covered?

This is another important question.  When I was pregnant with my daughter, my doctor wanted to run genetic testing on my husband and I, because my husband had a brother with Cystic Fibrosis.  We opted to get the tests done, because we wanted to be prepared if our baby was going to be unhealthy at birth.

Genetic testing was covered, but the insurance company wouldn’t allow testing on both my husband and I at the same time.  They wouldn’t cover my test, unless my husband tested positive for the CF gene.  It turns out he did, so then the insurance company agreed to pay for my test.  (It turns out I’m not a carrier).

What kind of hospital stay is covered? 

Insurance companies are required to allow you to stay in the hospital for 48 hours following a vaginal birth and 96 hours following a c-section. It’s still important to ask about hospital coverage though.  You will need to find out if the hospital you choose is covered by your plan.  Is a private room covered?

You also need to find out if pre-registration is required at your hospital.  It’s a good idea to pre-register, regardless of whether your insurance company requires it or not.  Trust me, the last thing you want to be doing when you’re in labor is filling out hospital forms.

What about circumcision?

If you are having a boy, and you are planning on circumcising him, make sure it’s covered.  The A.A.P. does not consider circumcision a necessary procedure, so fewer insurance companies are covering it.

Even if they do cover it, you might run into problems.  When my son was born, the insurance company would only pay for circumcision at the hospital following the birth.  My pediatrician only performed circumcision as an in-office procedure when the baby was a week old.  In the end, my pediatrician got the insurance company to pay for the office procedure, but I might have been in for a good surprise if we hadn’t worked it out ahead of time.

Alternative care?

If you’re planning on having a midwife deliver your baby, if you’re going to deliver at a stand alone birth center, or if you want to do anything besides have an obstetrician deliver your baby at a hospital, make sure your insurance covers it.

Midwives and birth centers are becoming more mainstream, but to a lot of insurance companies, they are alternative, and therefore not covered.  Work it out before you get the bill after delivery.

Once you know for sure what your insurance company will cover, you can relax and enjoy your pregnancy, without worrying about the financial ramifications. 

I wish Kacie and her husband the best in their new adventure!

Posted under Uncategorized | 1 Comment »

One Response to “Things to ask your insurance company before you have a baby”

  1. Thanks, Lynnae! These are all great tips, and I’m going to be sure to reference them when the time comes for me. I’m especially concerned about whether my insurance covers a midwife/birthing center, because that will dictate what sort of doctor/midwife I go to from the start.

    Joanna’s last blog post..Dog obedience, week 7

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Hey! I'm Kacie, wife and mother of 3. I write about my family's finance: how we save money, improve our spending, and plan for the future.

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