Maternity Health Insurance

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Maternity Health Insurance

Covering Maternity

For individual/family coverage in many states, Assurant Health¹ has a maternity rider without an upper limit so it can protect against unexpected high maternity costs.

For maternity expenses to be covered, conception must occur after 90 days from the effective date of the policy and the policy and its maternity rider must be continued until the maternity is over.

The rider must be bought at the same time as the policy.

For many states, no other individual/family insurer that we can find has a maternity rider like this. Other insurers have an upper limit such as $2,000 or $4,000, so there is no protection in those plans against a maternity that is unexpectedly difficult and expensive. Some maternities run $10,000, or $20,000, or more, so this is an important consideration.

Most individual coverage in most states does not include maternity coverage. The best maternity coverage is usually in employer group plans and is provided and financed as an employee benefit. There is usually not much maternity coverage for individual/family plans unless state law places the burden on all individual health insurers.

In the Assurant Health plan, unless otherwise noted, the maternity deductible is separate from the policy deductible.

STATES WHERE OTHER MATERNITY COVERAGE MAY BE AVAILABLE:  Florida

Assurant Health Plan and Rider Quotes

Availability

As of 7-10-2007, regular rider choices are available in the following states: AK, AL, AZ, CO, DE, FL, GA, ID, IL, IN, IA, MD, MI, MS, MO, NM, ND, OH, PA, SC, TN, VA, WV, WI, WY. It may soon be approved in NH, and UT. In KS and NV, deductible choice is limited.

It is available with a $10,000 deductible only in the following states: IN, LA, NH, OK, SD, TX.

Assurant Health's maternity coverage shares its deductible with the rest of the policy coverage in NM and ND. It is expected that the maternity deductible will become separate from the policy deductible for policies purchased in those states on and after 9-1-2006.

Maternity is covered the same as benefits for sickness in MT and OR according to state mandate, and in MN in qualified plans i,ii, and iii. (Information was last updated on 7-10-2006)

In some areas in some states there may be other maternity coverage available. If so, we have listed those that we know of on that state page.

Maternity insurance

Plan Design

At a high deductible level, where the company pays little of the normal maternity expenses, the plan acts like true insurance protecting against unexpected high costs, and so the premium is relatively small.

However, if you want a low deductible for maternity and so have the insurance company pay part of the normal, expected expenses of a maternity, the premium is relatively high. That is because enough money must be collected to pay for those expected expenses. At the lower deductible level, the plan acts somewhat like a savings plan.

The maternity deductible is separate from the policy deductible. The maternity rider pays 100% of covered maternity expenses after the chosen deductible.

All the plans with a maternity rider that we see from other insurers, have a cap on the amount of maternity benefits they will pay, e.g., $2,000 or $4,000 or so. That does not protect against the expense of an unexpected, difficult pregnancy. Such costs can be as high as $25,000 or more.

It is important to realize that the clause in many policies, often mandated by state law, that covers "complications" of pregnancy is typically narrowly defined and does not always include all difficulties of pregnancy, no matter how expensive they may be.

Like most health insurance policies, the policy has a lifetime maximum, but there is no cap on maternity expenses less than the lifetime maximum.

Maternity insurance rider

Insurance Itself

The reason that there is not much maternity coverage in individual plans is because a pregnancy is often a desired, planned event, not a financially catastrophic, unexpected event. Consequently, with generous maternity benefits in an individual/family plan, many applicants would buy a plan with maternity coverage so as to save money on the maternity costs, then drop the plan when the pregnancy is over.

The result would be that the insurer operates at a loss for those plans unless it charges a much higher than average premium, which would result in its plans not being competitively priced, leading to a shrinking amount of insurance business, followed by business failure.

Insurance companies do not have the power to levy taxes and therefore are not able to act as social welfare agencies. Insurers cannot stay in business if they are set up to lose money. They must collect more in premiums than they pay in claims or they go out of business.

The basic reason for insurance to even exist is to protect against unusual, unexpected, unavoidable, financially catastrophic events. The big claims are financed by small regular premium payments from insureds who mostly never have any large claims. Insurance was not invented to save people money on expected expenses or on desired, happy events.

Assurant Health Insurance Maternity Rider

It Makes Sense

This rider is not a social welfare benefit, but is designed to act as true insurance, i.e., protection against an unexpected high expense.

For many people, the rider from Assurant Health will allow them to afford the best in maternity care no matter what happens.

This maternity rider provides solid financial protection, and makes sense for the insurer to offer it, and for those who understand what insurance is for, to take advantage of it.

The terms of the maternity rider from Assurant Health is not determined by anything on this website but is determined by the issued policy. The description and information given here may not be accurate or up to date.

The availability of maternity coverage as described here and elsewhere on this site is not necessarily complete. We have provided as much information as we can.

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