If you're pregnant, you are probably overwhelmed with preparations and very likely don't have a lengthy Q&A with your insurance company at the top of your to-do list. But, the truth is, if you are expecting or trying to conceive (or, heck, even considering the far-off idea of having a baby), understanding the details of your medical coverage is one of the most important preparations you can make.
For many first-time moms in particular, it's difficult to know even what to ask. Because every company and every plan is different in terms of coverage, we've outlined are a few key questions you'll want to run by your insurance provider so you can take advantage of surprising perks, meaning you'll prepared in the event of unanticipated circumstances, and so you're as prepared as possible before unexpected bills start rolling in.
1Do You Offer Any Coverage For Pregnancy Planning?
Believe it or not, some insurance providers offer coverage for women who are starting the process of getting pregnant but have not actually conceived just yet. Prenatal supplements, smoking cessation, STD screening, and other items may be covered, so be sure to ask! Even men or those considering adoption options may be eligible for some benefits as well.
Maternity care is very involved (and very expensive), but luckily there are laws that ensure that prenatal maternity care is covered in some way, so just be sure to ask what exactly is covered under your specific plan. Already pregnant with no insurance? All Health Insurance Marketplace plans cover pregnancy and childbirth — and you can apply for special enrollment if you're having a baby.
There are a battery of tests — from ultrasounds to amnios to gestational diabetes screenings — that both a pregnant woman and her unborn baby will probably be told to take by their doctor. But just because they seem standard doesn't mean they are 100-percent covered. Make sure you know the facts on which are fully paid for by insurance, which are partially covered, and which are the patient's full responsibility.
Some women opt to use a midwife, doula, or other more alternative practitioner, and many insurance companies will cover such care while others will not. Also, if you are choosing a home birth, be sure to ask about those costs as well.
Wanting to go the water birth route? Check with your insurance first. Sometimes these births are covered, but only if done in a hospital or medical facility. As with everything, every carrier is different, so be sure to ask specific questions on the water-birthing process and its coverage.
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6How Do the Coverage of C-Sections Differ From Vaginal Delivery?
Cesarean sections are more and more common — roughly one-third of deliveries go this surgical route. So, even if you plan on pushing your baby out vaginally, be sure to still ask about C-sections and your provider's coverage terms and conditions. Better yet, ask about any other methods of birth interventions that may be confusing to you.
If you have insurance, it's safe to assume your new dependent will be able to join the plan . . . but how? More specifically, what are the procedures for getting your baby enrolled on your plan? Some companies require that you notify them no more than 30 days after the baby is born, so be sure you have the timetable clearly explained.
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8What If a Miscarriage Takes Place or Termination Is Needed?
Sometimes pregnancies that are very much wanted result in a sudden and surprising miscarriage, need to be terminated, or result in a stillbirth. Of course, while no one wants to imagine any of these scenarios happening, it might be helpful to know what is covered, so that if an unforeseen event takes place, you won't have to spend any time calling your insurance company for answers.
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9How Many Recovery Days Are Covered in the Hospital?
These days, this is an important question to ask — the going rate for hospital overnights rival five-star hotels (without any of the luxurious amenities). Check to see if your provider requires that they be notified when you check into the hospital for labor. Also, ask about how many additional days are allowed in the event of a C-section or if there are complications with the delivery or with the baby after birth.
Did you know that most health insurance plans provide breastfeeding support, counseling, and free equipment for the duration of breastfeeding? This benefit is a no-brainer if you plan to nurse, and you can likely order your pump — from a variety of name-brand choices — well in advance of your due date so that you can have it at the ready.
