insurance questions - sorry it's long

[diddlysquat]

I created an AE so in case anyone came across this they wouldn't know it's me. I don't want some people know when we start ttc just in case it doesn't work out right away. I wanted to ask about insurance. I have a family member who works for my provider and therefore I ask them almost all of my questions but I don't want to ask them about maternity coverage. 

How do I get started in figuring that out? I pay my own insurance (it is not through my employer) and am curious as to how I go about getting the coverage I need for pregnancy. 

Should I get coverage before I even get pregnant? Does it matter if I don't get it until after I'm already pregnant?
What kind of coverage do I need?

My husband has his insurance through his employer. If I choose to get onto his insurance, could they potentially give me coverage for it or no?

I know rates differ among plans and providers and states, etc. but could someone give me any indication as to what I should be expecting to pay? Right now I pay $200 for 3 months of basic coverage. Super basic, and I only go to the doctor once a year.

I'm sorry if this is just a pointless post - and sounding incredibly ignorant. Maybe someone could give me a link to figuring out what I need. I've tried looking at my insurance site but it's all jibberish to me because I usually avoid going to the doctor but if/when I get pregnant, I have to consider the health of another individual as well as any potential complications.  

[Deleted]

My insurance is through my employer and it covers having a baby. I think you can check your insurance website or call the number on the back of your card to see what they cover. I didn't know that there were separate policies for maternity coverage. The costs would probably be very dependent on your age, risk, type of coverage..hard to say really. If you do want to get on your H's plan, you might only be able to do it during open enrollment periods which are typically once a year. This is something that needs to be verified with his HR dept. If he has decent insurance and the employers covers some of the cost, this will probably be the best bet imo.

[diddlysquat]

Okay, I'm looking at my plan online and it doesn't have any coverage but I could get a more-than-basic plan.
It states that there is a $3,000 deductible but then goes on to state:
Covered 100 percent after maternity deductible for professional services. You pay 20 percent for facility charges after maternity deductible. You pay $30 copay after maternity deductible for pre- and postnatal exams.

What are professional services vs. facility charges?
Does this plan sound good or not really? Maybe I'll check out Aflac.

[vmars]

Aflac is like supplemental insurance - it pays cash for hospital stays and STD. But you can't get pregnant until you've been on it for 2 months. Ask if husbands employer can add you to their plan - coverage may be better. As long as I stay in network my whole pregnancy costs $15.

[diddlysquat]

Apr 4, 2013 10:36:29 GMT -5 vmars said:

Aflac is like supplemental insurance - it pays cash for hospital stays and STD. But you can't get pregnant until you've been on it for 2 months. Ask if husbands employer can add you to their plan - coverage may be better. As long as I stay in network my whole pregnancy costs $15.

I want to hate you right now because I'm so jealous! That's awesome. Congrats!

I've been looking into Aflac the past 20 minutes and understand it's in addition to regular insurance coverage. I think I'll get it before we start ttc, but ttc may be put on hold longer than I thought. 

[vmars]

Yeah we have insurance through the state...one of the perks of DH's job. I am pretty sure it's the same cost for IVF as well.

[midwest07]

Apr 4, 2013 10:17:46 GMT -5 diddlysquat said:

Okay, I'm looking at my plan online and it doesn't have any coverage but I could get a more-than-basic plan.
It states that there is a $3,000 deductible but then goes on to state:
Covered 100 percent after maternity deductible for professional services. You pay 20 percent for facility charges after maternity deductible. You pay $30 copay after maternity deductible for pre- and postnatal exams.

What are professional services vs. facility charges?
Does this plan sound good or not really? Maybe I'll check out Aflac.

I was going to say I am about 100% sure you don't currently have maternity coverage given what you are paying.  And it looks like you have that figured out.  In addition, insurance varies significantly from state to state, so what I tell you about my experience could be very different from your state.

Regarding private insurance, even if you upgraded your plan, there is usually a waiting period before it will cover maternity.  In my state, it is typically a 2 year waiting period and there is only one insurer that even offers it.  So you pay these extra premiums for 2 years before the coverage even kicks in.  Note that is 2 years prior to delivery, so you can get pregnant before that, but wouldn't want to deliver before that - as most of your cost will occur at delivery.  With a group plan, you often have maternity coverage right away, even if you are already pregnant.

What you state above about maternity coverage if you upgraded your private plan doesn't sound a typical.  Even on my group plan, I have to cover the deductible, which is $2500, before I have any insurance coverage.  After that, my insurance covers 100%.  But it is common for insurance to cover 80% while you cover 20%, up to your out of pocket maximum.  Your plan's deductible would be a bit higher than others, but personally I would rather have lower premiums and a higher deductible because in a typical year, I am nowhere close to meeting my deductible.

In your position, I would check out your husband's plan and the cost/benefits it provides.  Confirm when open enrollment is, and if it would be ok to join the plan if you were already pregnant, and the pregnancy would be covered.  I would also check out upgrading your plan and confirm if there is a waiting period.  Once you know your choices and when you might be looking to TTC, you can make an informed decision.

I personally wouldn't get STD in anticipation of getting pregnant, but some people differ on that.  But I thought Aflac only offered plans to groups, not individuals like you would be.  Maybe it's through your H's employer though, I wasn't sure.