Long cautions, “You will only find a handful of options before July 1, and you’ll probably find that maternity coverage has a waiting period of six or more months. Until then, I know that three companies currently cover maternity needs: Anthem Blue Cross of California, Blue Shield of California and Kaiser.”
These companies offer maternity benefits through Health Savings Account (HSA) plans, Health Maintenance Organization (HMO) plans or Preferred Provider Organization (PPO) plans. A range of deductible options is available with any of these types of policies. The deductible determines how much the policyholder needs to spend on health care before non-preventive services are covered. Preventive health care is exempt from co-insurance, co-pay or deductible requirements when provided by doctors in a plan’s provider network. For this reason, checking the provider list is essential.
An HSA plan can be either an HMO or a PPO plan, but only an HSA plan allows the policyholder to start a special tax-advantaged savings account. The difference between HMO and PPO plans mainly lies in how policyholders can access health care. HMOs typically require the policyholder to choose a primary care doctor from the network, and that doctor is authorized to control when the patient gets coverage to see a specialist in most non-emergency situations. Women are allowed to choose an OB/GYN in many cases, though.
PPO plans have negotiated discounted care from the doctors and hospitals in their network, but policyholders may also use out-of-network providers. Going out of network does result in higher out-of-pocket costs, though.
Long says to also look ahead for the care a plan will provide after the baby arrives. Preventive care, such as “well baby” and “well child” doctor appointments are exempt from co-insurance, co-pay or deductible requirements, but only through in-network doctors. This is also true for immunizations.
When California health insurance companies are required to offer maternity benefits beginning July 1 of this year, newlyweds will have a larger selection to consider. Maternity coverage is already available, though, from some of the state’s largest insurers. Further information on maternity coverage may be found at www.eCAHealthinsurance.com/
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