Pregnancy is a time, full of excitement and hopes. Parents look forward to welcome their bundle of joy with dreams and wishes. At the same time, parents need to be well prepared for health reasons and upcoming expenses. Maternity expenses may include several doctor visits spread over 9 months as well as few weeks after the baby is born, to different lab screenings and medications. Different plans offer different coverage and therefore, before any purchase is made, plans should be well understood in light of individual needs and budget constraints.

As an insurance agent serving for more than a decade, we have received questions regarding maternity coverage in different types of insurance plans. This article focuses on the coverage of maternity and newborn care in visitor insurance, student, expatriate and domestic healthcare plans.

Visitor Insurance and Maternity Coverage:

Visitorinsurance is a short term medical insurance for people traveling outside their home country. Visitor insurance provides coverage for unforeseen events such as new illness, sickness, and accident. Most of these plans do not cover maternity, pregnancy and childbirth expenses.  Since pregnancy is considered a high-risk period, therefore, visitor insurance companies usually do not provide coverage. There may be risks or conditions that may require medical attention, like, morning or regular pregnancy sickness, premature birth, gestational diabetes, ultrasounds, routine checkups or high/low blood pressure conditions. These expected pregnancy related medical conditions are not covered. However, as of now, Atlas America Insurance plan is one such visitor insurance plan that offers some coverage during first 26 weeks of pregnancy but it is a conditional coverage. Before you set out to buy any plan, it is important to contact your insurance agent to learn about the latest coverage of the plan, since the plans keep on changing or getting updated.

Atlas America insurance plan is a comprehensive visitor insurance plan, and is one such visitor insurance plan that provides coverage for maternity. But it covers only the complications of pregnancy for the first 26 weeks of pregnancy. These complications are different than routine maternity conditions. They are formally defined as: Illnesses whose diagnoses are distinct from Pregnancy, but are adversely affected by Pregnancy or caused by Pregnancy and not associated with a normal Pregnancy. This includes: ectopic Pregnancy, spontaneous abortion, hyperemesis gravidarum, pre-eclampsia, eclampsia, missed abortion and conditions of comparable severity. Complications of Pregnancy does not include: false labor, edema, prolonged labor, prescribed rest during the period of Pregnancy, morning sickness and conditions of comparable severity associated with management of a difficult Pregnancy, and not constituting a medically distinct condition.   Also, all charges related to pregnancy after the 26th week of pregnancy, routine prenatal care, childbirth, postnatal care, and charges incurred by a child under the age of 14 days are excluded from the coverage.

Student Insurance and Maternity Coverage:

There are thousands of students coming to the United States every year, from every part of the world. Many universities require them to have insurance before they can be formally enrolled. If the student is a female or she is the spouse of a student coming to the USA for studies, it is important to get covered for maternity too (healthcare costs as well as pregnancy or childbirth expenses can be quite high in developed countries like the USA). Maternity coverage normally should include benefits for prenatal as well as postnatal care, delivery and newborn care. This also comprises of routine checkups, tests or screenings and ultrasounds.

There are certain student insurance plans that provide maternity coverage. If the conception occurs after the effective date of coverage, student insurance plans provide maternity benefits, including but not limited to pre-natal, delivery, and post-natal care as well as expenses for miscarriage and complications of pregnancy. Routine nursery care of newborns is also covered as per the maximum, described in the master policy documents. Insurance plans, their coverage and premiums change so before making any decision, always speak to an authorized agent for confirmation and latest details.

Expatriate Insurance and Maternity Coverage:

Maternity coverage is available in expatriate insurance plans. Depending on the plan, the coverage is offered in different forms-

• Global Medical Insurance Platinum Plan by International Medical Group (IMG) offers maternity and newborn coverage. There is an $1,000 additional deductible and the plan offers $50,000 lifetime maximum, $200 child wellness benefit for the first 12 months, newborn care & congenital disorders maximum of $250,000 for the first 31 days.
• As an additional coverage or Optional rider: Meridian Basic expatriate insurance plan offers pregnancy coverage as an optional rider- $10,000 Sub-Limit per Coverage Period, $50,000 Maximum Sub-Limit.
• Condition based coverage: Some plans require the expatriate to be insured for at least certain number of months (continuous coverage). For example, Meridian Clear plan offers $10,000 Maximum Limit after 24 months of continuous coverage. Covered Maternity expenses include Delivery/Newborn Care.
• Coverage upto certain amount, depending on how many policy periods have been completed by the insured: For example, Reside Prime insurance plan, covers maternity expense upto $1,000 after completion of 1 policy period, upto $2,000 after completion of 2 continuous and consecutive policy periods etc. The insurance company should be pre-notified within the first 90 days of pregnancy.

Again we would like to mention that these plans may change, so before purchasing any expatriate insurance plan it is important to speak to an authorized and trusted insurance agent or refer the insurance policy documents.

Domestic health Insurance and Maternity Coverage:

Within USA, domestic health insurance or healthinsurance in simple terms, provides full coverage. Health insurance is very important as it helps a person pay for his (as well as his family’s) healthcare costs. Maternity coverage is one of the essential health benefits and requirements that must be necessarily covered by health insurance plans.

Before Obamacare, some plans offered pregnancy coverage whereas others didn’t. However, after Obamacare, maternity coverage is a guaranteed inclusion in all health insurance plans which come under Affordable Care Act (ACA). Domestic plans now offer Maternity benefits which normally includes:

• Prenatal doctor visits
• Postnatal doctor visits,
• Glucose screening for gestational diabetes
• Hospitalization, delivery
• Newborn baby care
• Lactation counseling and rental breast pump

Different medical plans may have different extent of coverage and the premium and policy maximum. They can be chosen according to one’s requirements, health needs and budget.

For any coverage, student insurance, expatriate, visitor or domestic health insurance, speak to the specialized and experienced agents of MCIS. We can be reached at +1 855.444.MCIS, +1 855.444.6247 or contact@multichoiceinsurance.com

Category: Visitor Insurance

February 03, 2017 at 09:50 PM