California insurers are not required to include maternity coverage in health plans

California insurers are not required to include maternity coverage in health plans

Residents that purchase individual health insurance are left with little options if they wish to have something as basic as maternity coverage.

Due to California law, insurers can make this coverage optional, narrowing the market to only a few high priced plans within major insurer’s portfolios.  In fact, you could be paying on average 30 to 40% higher rates than plans that exclude maternity.

The majority of consumers affected by these higher costs are usually self employed and are left with no other choice but to pick high deductible plans. On average, the costs related to giving birth are $13,000 and with a $5,000 deductible, most are paying for half with high out of pocket expenses – forcing some mothers to look for government aid.

“For women who don’t have access to insurance through their job or don’t qualify for public programs, this is a crisis,” Brigette Courtot stated, senior policy analyst with the National Women’s Law Center.

Once pregnant and looking for insurance, the individual health insurance market can reject coverage for maternity by citing pre-existing condition. Many have tried to change these rules  but have been met with huge resistance from big insurers like Anthem Blue Cross and political giants who point out that it would raise everyone’s rates unfairly by an approximate 28%, per a previous study.

“You have to weigh the benefit of mandating it on everybody against the fact that it might cause people to drop their coverage,” Anne Eowan stated, with the industry trade group, the Assn. of California Life and Health Insurance Cos.

In the meantime, people will have to wait until 2014 when new health care reform will take effect or look for employers specifically offering group coverage that includes maternity. New government reform plans will require insurers to include maternity coverage on all policies sold. One other option explored: look into supplemental health plans that may offer maternity coverage – this can help fill in high out of pocket costs.

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