Você está na página 1de 26

BERNARD HEALTH

Rescuing you
!"#$%
!"
&
'
(
%
)
*
#
(
+
,
%
'
-
(
.

0
%
1
2
)
3
#
4
2
5
%
)
'
6
%
&
2
3
7
8
Table of Contents
About the Authors
Im thinking about having a baby
Im pregnant and my baby is due in 2013
Im pregnant and my baby is due in 2014
My baby is already here!
About Bernard Health
2
6
13
19
23
25
Originally hailing from Oak Ridge, Tennessee, Mallory's
background is in business and sport management.
These days, she's focused on helping people save
money and get peace of mind when they have questions
about health insurance, COBRA, and Medicare. Mallo-
ry earned a BS from Martin Methodist College (where she played volleyball)
and an MS from Middle Tennessee State University. Oh, and when she's
not answering healthcare questions, you can nd Mallory in the gym train-
ing for bikini / gure competitions. Yes, she can probably lift more than you.
Mallory Jones
About the Authors
2
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Originally from the San Francisco Bay Area, Katrin is Ber-
nard's primary source of West Coast avor. However,
since she's an advisor focused on helping individuals
and families save time and money at our healthcare retail
stores, Katrin is more likely to teach you how to apply for
Medicare than teach you how to Dougie (but she can do
that, too). Katrin graduated from University of California, San Di-
ego with a BS in Cognitive Science and a minor in theatre.
Katrin Porcella
Mary grew up in the great state of Louisiana in the New
Orleans area, and so is Nashvillian by choice! Since Day
One at Bernard, she has loved the feeling of satisfaction
she gets from helping clients save money and gain
peace of mind around this big health insurance problem.
Mary specializes in helping individual and family clients with
health insurance, COBRA, Medicare, and medical billing issues.
She wields a business degree with a concentration in Marketing from the
University of Mississippi.
Mary Turner
Pregnancy is an exciting time.
Youre busy taking care of yourself and preparing for the arrival of your
child. Worrying about health insurance and the cost of care is the last thing
you want to do. However, it is one of the most important things that you
should take care of. The cost of a normal pregnancy with no complications
can range anywhere from $7,000 to $20,000. Factors such as the city you
live in, medications, hospital stay, prenatal care, and more can make the
cost of having a baby difcult to estimate.
Maybe youre just thinking about having a baby, or maybe youre due next
month (if thats true, congratulations!)... if that sounds accurate, this is the
guide for you.
You probably have a lot of questions about the
costs of pregnancy and maternity health
insurance.
These days, with all the different health insurance options available, it can
be confusing and overwhelming to nd the right coverage for you. It
doesnt matter if you are uninsured, have an individual policy, or have a
group policy through your employer, you will need help in covering all of
your maternity expenses which can include:
Prenatal visits
Diagnostic x-rays and laboratory charges
Ultrasounds
Delivery (including use of delivery room, hospital bed and board,
physician services, and anesthesia)
Routine newborn circumcision
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
3
The purpose of this guide is to provide an overview of how maternity
coverage works as a result of the changes implemented by health re-
form. We hope that when youre nished reading this guide, youll have
peace of mind that you have answers. If you have additional questions, or
youd like to learn more, you can contact Katrin Porcella, one of the co-
authors of this guide, at katrin.porcella@bernardhealth.com or by calling 1-
800-505-0750.
4
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
This guide is divided into four sections. If youre like us and you LOVE
reading about maternity coverage, we encourage you to read this guide
from start to nish. Alternatively, you can just read the section that applies
to you.
This guide includes four sections, ranging from someone who is just think-
ing about having a baby to someone whose baby is already here. Each
section is broken down into three perspective, ranging from the person
who has no health insurance at all right now to someone who has a plan
through their employer.
Specifically, here is how it breaks down:
Im thinking about having a baby
I dont have health insurance right now
I have an individual plan
I have an employer plan
Im pregnant and my baby is due in 2013
I dont have health insurance right now
I have an individual plan
I have an employer plan
Im pregnant and my baby is due in 2014
I dont have health insurance right now
I have an individual plan
I have an employer plan
My baby is already here!
I dont have health insurance right now
I have an individual plan
I have an employer plan
Then, well wrap things up with a conclusion section!
Here we go...
5
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Section 1: Im thinking about
having a baby
Starting a family is an exciting time that requires a lot of thought and
change. Depending on your current situation, maternity costs may already
be covered, or you may have to pay out of pocket if you dont take the
time to plan.
Were going to look at this from three perspectives:
I dont have health insurance right now
I have an individual plan
I have an employer plan
First Perspective: I dont have health insurance
right now
If youre thinking about getting pregnant and you dont have health insur-
ance yet, there are four scenarios to consider.
Scenario #1 - Pay for your pregnancy out of pocket:
If you choose to pay out of pocket, it is helpful to be upfront with your OB/
GYN and let them know your situation. Some offer cash prices that can be
negotiated at the beginning of your pregnancy if you dont have another
way to cover the costs. This would help cover appointments, necessary ul-
trasounds, and normal vaginal delivery. Call your OB/GYN as soon as you
nd out you are pregnant to see if they offer any type of maternity pro-
gram, which might entail lower out of pocket expenses for you, or offer
payment plans.
To give you an idea of what a pregnancy might cost if youre uninsured,
lets look at a breakdown of the different costs we mentioned earlier. Ber-
6
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
nard Health happens to be headquartered in Nashville, Tennessee, so
were going to use Nashville pricing as an example. Costs can vary from
state-to-state, and you can look up the average prices of these proce-
dures in your own zip code by visiting www.healthcarebluebook.com.
Prenatal visits (average of 8) - $108 per visit
Diagnostic x-rays and laboratory charges - $40 each
Ultrasounds - $159 each
Delivery (including use of delivery room, hospital bed and board, physi-
cian services, and anesthesia) - $6,034 vaginal, $8,725 cesarean
Routine newborn circumcision - $200
Question: What do I pay if I choose option 1?
Answer: All in, the total cost can range from $7,695 - $10,386 for a rou-
tine pregnancy. The cost can increase to more than $20,000 if there are
complications. Hospitals are willing to work with you to set up a payment
plan after-the-fact, and you cant be denied care if youre in labor.
Scenario #2 - Get Individual Health Insurance:
You also have the choice of buying an individual health insurance plan, but
these rarely cover maternity. You can purchase an additional maternity
rider, which will cover pregnancy while increasing your premium.
However, these usually have a waiting period of at least six months. If you
become pregnant during the waiting period, you will have no pregnancy
coverage. In 2014, the Affordable Care Act will require all health plans to
cover pregnancy. If you buy an individual health insurance plan today, it
will start to cover maternity costs one year from now.
7
Question: What do I pay if I get an individual plan
without a maternity rider?
Answer: Since maternity coverage isnt included in individual plans until
2014, the cost will be similar to if you didnt have any health insurance at
all. The total cost can range from $7,695 - $10,386 for a routine preg-
nancy. If there are complications, your health insurance will cover those
costs, including neonatal intensive care for your new baby if you add your
new baby to the plan when they are born. Also, hospitals are willing to
work with you to set up a payment plan, and you cant be denied care if
youre in labor.
Question: What do I pay if I get an individual plan
with a maternity rider?
Answer: If you buy a maternity rider, youre still respon-
sible for your pregnancy costs, but they will count to-
ward the deductible and out-of-pocket maximum
on your plan. For example, lets say your pregnancy
bills total $10,000. If your plan has a deductible of
$2,000 and 80% coinsurance until you reach an
out-of-pocket maximum of $5,000, youd pay the
the rst $2,000 out-of-pocket, then youll pay 20% of
the remaining $8,000 (or $1,600) for a total of $3,600.
Scenario #3 - Get Group Health Insurance through an
Employer:
If you can enroll in group coverage through your employer or your
spouses employer, the insurance company is required to have maternity
benets. This is your best option if you dont have insurance already. There
is usually a waiting period before benets start, so make sure you plan
carefully.
8
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Question: What do I pay if I have coverage
through an employer?
Answer: Youll pay your deductible, and then any cost sharing until you
reach your out-of-pocket maximum. For example, lets say your preg-
nancy bills total $10,000. If your plan has a deductible of $2,000 and 80%
coinsurance until you reach an out-of-pocket maximum of $5,000, youd
pay the the rst $2,000 out-of-pocket, then youll pay 20% of the remain-
ing $8,000 (or $1,600) for a total of $3,600.
Scenario #4 - Get a Government Plan:
Depending on your income, being pregnant may qualify you for Medicaid
coverage until 2 months after the baby is born. Medicaid is a government-
sponsored health insurance program for low income families who have no
medical insurance, or inadequate insurance. Contact your local Depart-
ment of Health and Human Services ofce, and be prepared to provide all
the necessary information to prove identity and nancial situation, such as:
Proof of pregnancy
Proof of citizenship, if a legal US resident
Proof of non-citizenship if not a US resident
Proof of income
Depending on income, most pregnant women without health insurance
qualify for coverage. Medicaid benets for pregnant women include:
All care related to the pregnancy
Delivery
Any complications that may occur during pregnancy
Up to 60 days postpartum care
9
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
In addition, you may also qualify for care that is received for your preg-
nancy before you apply and receive Medicaid. Talk with your local Depart-
ment of Health and Human Services ofce to nd out if you qualify.
Question: What do I pay if I have coverage
through Medicaid.
Answer: If you qualify for Medicaid benets, your pregnancy and delivery
care will be paid for almost entirely by Medicaid. You may have small co-
pays, but the total cost of your pregnancy will be very low. Some state
Medicaid plans will not pay for circumcision, however, so you may need to
pay for that out-of-pocket if you choose to have the procedure done.
Second Perspective: I have an individual plan
Most individual healthcare policies dont cover pregnancy costs. One
choice you have is to purchase a rider, which will cover maternity while in-
creasing your monthly premium. However, riders have a waiting period of
at least six months for maternity care. If you get pregnant during the wait-
ing period, your pregnancy costs will not be covered, and you will have to
pay out of pocket. If you need help guring out how to get maternity cover-
age through your current provider, call the customer service number on the
back of your insurance card.
You also may be able to work something out with your OB/GYN. It is help-
ful to be upfront with them, and let them know your situation. Some offer
cash prices that can be negotiated at the beginning of your pregnancy.
This would help cover appointments, necessary ultrasounds, and normal
vaginal delivery. Call your OB/GYN as soon as possible to see if they offer
any type of maternity program, which might entail lower out of pocket ex-
penses for you, or offer payment plans.
10
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
The Affordable Care Act requires all health insurance policies to cover preg-
nancy starting in 2014 if you purchased your plan after March 23, 2010.
These new laws will affect your health care after your policy anniversary
date in 2014. So if your health insurance policy effective date is August 3,
2012, pregnancy coverage will start for you on August 3, 2014.
Question: What do I pay for pregnancy
if I get an individual plan?
Answer: Since maternity coverage isnt included in indi-
vidual plans until 2014, the cost will be similar to if you
didnt have any health insurance at all. The total cost
can range from $7,695 - $10,386 for a routine pregnancy.
The cost can increase to more than $20,000 if there are
complications, although most complications are often cov-
ered by your health insurance. Hospitals are willing to work with
you to set up a payment plan, and you cant be denied care if youre in
labor. If you have a maternity rider, then all of these costs would count to-
wards your deductible and out of pocket limit.
Third perspective: I have an employer plan
If you have an employer plan through your or your spouses employer, you
will most likely have maternity coverage.
However, if you begin a new job during pregnancy, it is possible that you
might have to wait up to a couple of months for coverage. Try to avoid
switching jobs if you are pregnant and currently have coverage with your
group plan. Otherwise, you will have to deal with COBRA or another pro-
gram to cover you during the gap.
Pregnancy cannot be considered a preexisting condition if you enroll in
your employer plan. They cannot decline your enrollment based on preg-
nancy, or exclude it from coverage. Even if you did not have previous
11
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
health coverage, HIPAA rules forbid employer plans from excluding preg-
nancy as a preexisting condition.
For more information on how your employers plan works, ask your Human
Resources department. Another resource would be the insurance broker
for your employers plan, or support personnel that work at the brokerage.
You may want to reach out to these people, even if only to get an under-
standing of what changes the employer is thinking about making to the
plan.
Question: What do I pay if I have coverage
through an employer?
Answer: Youll pay your deductible, and then any cost sharing until you
reach your out-of-pocket maximum. For example, lets say your preg-
nancy bills total $10,000. If your plan has a deductible of $2,000 and 80%
coinsurance until you reach an out-of-pocket maximum of $5,000, youd
pay the the rst $2,000 out-of-pocket, then youll pay 20% of the remain-
ing $8,000 (or $1,600) for a total of $3,600.
12
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Youll pay your
deductible, and
then any cost
sharing until
you reach your
out-of-pocket
maximum.
Section 2: Im pregnant and
and my baby is due in 2013
First off, Congratulations! This section has great informa-
tion to help you plan if your baby is due on or before De-
cember 31, 2013.
Were going to look at this from three perspectives:
I dont have health insurance right now
I have an individual plan
I have an employer plan
First perspective: I dont have health insurance
right now
If youre pregnant but you dont have health insurance, the rst thing to
point out is that youre not alone! Hundreds of thousands of women are in
the same position every year, and there are steps you can take to help you
save time, save money, and get peace of mind that your pregnancy will be
a happy time for you and your baby. To give you an idea of what a preg-
nancy might cost if youre uninsured, lets look at a breakdown of the differ-
ent costs we mentioned earlier. Bernard Health happens to be headquar-
tered in Nashville, Tennessee, so were going to use Nashville pricing as an
example. Costs can vary from state-to-state, and you can look up the aver-
age prices of these procedures in your own zip code by visiting
www.healthcarebluebook.com.
Prenatal visits (average of 8) - $108 per visit
Diagnostic x-rays and laboratory charges - $40 each
Ultrasounds - $159 each
13
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Delivery (including use of delivery room, hospital bed and board, physi-
cian services, and anesthesia) - $6,034 vaginal, $8,725 cesarean
Routine newborn circumcision - $200
All in, the total cost can range from $7,695 - $10,386 for a routine
pregnancy.
As you can see, babies arent cheap! Dont worry, there are ways to help
lower the cost.
For example, its helpful to be upfront with your OB/GYN and let them
know your situation. Some offer cash prices that can be negotiated at the
beginning of your pregnancy. This would help cover appointments, neces-
sary ultrasounds, and normal delivery with no complications. Call your OB/
GYN as soon as possible to see if they offer any type of maternity pro-
gram, which might entail lower out of pocket expenses for you, or offer
payment plans.
14
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
All in, the total
cost can range
from $7,695 -
$10,386 for a rou-
tine pregnancy
It is possible that your pregnancy will qualify you for Medicaid coverage.
This is a government sponsored health insurance program for low income
families who have no medical insurance, or inadequate insurance. Contact
your local Department of Health and Human Services ofce, and be pre-
pared to provide all the necessary information to prove identity and nan-
cial situation, such as:
Proof of pregnancy
Proof of citizenship, if a legal US resident
Proof of non-citizenship if not a US resident
Proof of income
Depending on your income, most pregnant women without health insur-
ance qualify for coverage. Medicaid benets for pregnant women include:
All care related to the pregnancy
Delivery
Any complications that may occur during pregnancy
Up to 60 days postpartum care
In addition, if you may also qualify for care that is received for your preg-
nancy before you apply and receive Medicaid. Talk with your local Depart-
ment of Health and Human Services ofce to nd out if you qualify.
Some states have additional programs to help people get health insurance
even though they have pre-existing conditions. And believe it or not,
health insurance companies consider pregnancy a pre-existing condition.
In Tennessee, for example, Tennessee has programs called AccessTN and
CoverKids that may help you cover the cost of pregnancy. To research the
coverage options available in your state, visit www.coverageforall.com and
select your state.
15
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Question: What do I pay if I have coverage
through Medicaid.
Answer: If you qualify for Medicaid benets, your pregnancy and delivery
care will be paid for almost entirely by Medicaid. You may have small co-
pays, but the total cost of your pregnancy will be very low. Some state
Medicaid plans will not pay for circumcision, however, so you may need to
pay for that out-of-pocket if you choose to have that procedure done.
Second perspective: I have an individual plan
Pregnancy is not covered by most individual health policies. Many women
do not know this until it is too late. They are shocked to nd out that they
must purchase a special rider for the coverage, which would not cover a
current pregnancy. If you are pregnant and without health insurance then
you will want to see if you can obtain coverage through a group health in-
surance plan, see if you are eligible for a state sponsored health insurance
program (if you have very low income), or at the very least speak with an
independent health insurance agent that is knowledgeable about maternity
options in your state.
You may be able to work something out with your OB/GYN. It is helpful to
be upfront with them, and let them know your situation. Some offer cash
prices that can be negotiated at the beginning of your pregnancy. This
16
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
would help cover appointments, necessary ultrasounds, and normal vagi-
nal delivery. Call your OB/GYN as soon as possible to see if they offer any
type of maternity program, which might entail lower out of pocket ex-
penses for you, or offer payment plans.
Question: What do I pay if I get an individual plan
without a maternity rider?
Answer: Since maternity coverage isnt included in individual plans until
2014, the cost will be similar to if you didnt have any health insurance at
all. The total cost can range from $7,695 - $10,386 for a routine preg-
nancy. If there are complications, your health insurance will often cover
those costs, including neonatal intensive care for your new baby if you add
your child to the plan after birth. Also, hospitals are willing to work with
you to set up a payment plan, and you cant be denied care if youre in la-
bor.
Question: What do I pay if I get an individual plan
with a maternity rider?
Answer: If you buy a maternity rider, youre still responsible for your preg-
nancy costs, but they will count toward the deductible and out-of-pocket
maximum on your plan. For example, lets say your pregnancy bills total
$10,000. If your plan has a deductible of $2,000 and 80% coinsurance un-
til you reach an out-of-pocket maximum of $5,000, youd pay the the rst
$2,000 out-of-pocket, then youll pay 20% of the remaining $8,000 (or
$1,600) for a total of $3,600. Bear in mind, however, that maternity riders
generally have a waiting period, so they would not cover these normal
pregnancy costs if purchased after one is already pregnant.
17
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Third perspective: I have an employer plan
If you have an employer plan through your or your spouses employer, you
will most likely have maternity coverage.
However, if you begin a new job during pregnancy, it is possible that you
might have to wait up to a couple of months for coverage. Try to avoid
switching jobs if you are pregnant and currently have coverage with your
group plan. Otherwise, you will have to deal with COBRA or another pro-
gram to cover you during the gap.
Pregnancy cannot be considered a preexisting condition if you enroll in
your employer plan. They cannot decline your enrollment based on preg-
nancy, or exclude it from coverage. Even if you did not have previous
health coverage, HIPAA rules forbid employer plans from excluding preg-
nancy as a pre-existing condition.
For more information on how your employers plan works, ask your Human
Resources department. Another resource would be the insurance broker
for your employers plan, or support personnel that work at the brokerage.
You may want to reach out to these people, even if only to get an under-
standing of what changes the employer is thinking about making to the
plan before your babys due date.
Question: What do I pay if I have coverage
through an employer?
Answer: Youll pay your deductible, and then any cost sharing until you
reach your out-of-pocket maximum. For example, lets say your preg-
nancy bills total $10,000. If your plan has a deductible of $2,000 and 80%
coinsurance until you reach an out-of-pocket maximum of $5,000, youd
pay the the rst $2,000 out-of-pocket, then youll pay 20% of the remain-
ing $8,000 (or $1,600) for a total of $3,600.
18
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Section 3: Im pregnant and
my baby is due in 2014
First off, Congratulations! This section has great information to help you
plan if your baby is due on or after January 1st, 2014.
Were going to look at this from three perspectives:
I dont have health insurance right now
I have an individual plan
I have an employer plan
First perspective: I dont have health insurance
right now
There are more options than ever for women whose baby is due after Janu-
ary 1, 2014. The good news is that, based on current healthcare reform
guidance, in October 2013 you will be able to get a health insurance policy
to start in January and cover pregnancy costs you incur after that date.
The bad news is that youll be responsible for any pregnancy-related costs
incurred before January 1, 2014.
To give you an idea of what a pregnancy might cost if youre uninsured,
lets look at a breakdown of the different costs we mentioned earlier. Ber-
nard Health happens to be headquartered in Nashville, Tennessee, so
were going to use Nashville pricing as an example. Costs can vary from
state-to-state, and you can look up the average prices of these proce-
dures in your own zip code by visiting www.healthcarebluebook.com.
19
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Prenatal visits (average of 8) - $108 per visit
Diagnostic x-rays and laboratory charges - $40 each
Ultrasounds - $159 each
Delivery (including use of delivery room, hospital bed and board, physi-
cian services, and anesthesia) - $6,034 vaginal, $8,725 cesarean
Routine newborn circumcision - $200
Between now and January 1, 2014 some states have additional programs
to help people get health insurance even though they have preexisting con-
ditions. And believe it or not, health insurance companies consider preg-
nancy a preexisting condition. In Tennessee, for example, there are two
programs called AccessTN and CoverKids that may help you cover the
cost of pregnancy. To research the coverage options available in your
state, visit www.coverageforall.com and select your state.
And remember, healthcare reform guidance indicates that in October 2013
you will be able to purchase a policy that would cover any maternity-
related costs incurred after January 1, 2014. With those policies, your ma-
ternity costs would generally count towards your deductible and out-of-
pocket limit.
Second perspective: I have an individual plan
If you are currently pregnant and have individual coverage, but maternity is
not part of that coverage, you have two options:
1. Keep your individual insurance plan and when it comes time for the pol-
icy to renew, maternity benets will be added automatically.
2. Keep your current individual insurance policy until January 1st, 2014. In
October of 2013, begin exploring other options on the new Health Insur-
ance Exchanges that have maternity coverage built in. When January ar-
rives, you can have a new plan that includes maternity benets.
20
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
With Option #1, the best approach is keep your current coverage in case
something happens unexpected that is not related to the pregnancy. De-
pending on the due date of your baby and your policy renewal date, it may
make sense to keep your current policy and ensure that maternity cover-
age will kick in on the renewal date. For example, if your policy anniversary
date is February 1st and maternity coverage kicks in on that date, in most
cases that would be plenty of time before, say, a May 1st due date.
With Option #2, if your baby is due May 1st, but your renewal date is not
until November 1st, then your baby is going to be born before your policy
renews and maternity kicks in. That is a scenario where you would proba-
bly want to get a new policy so that you would have that maternity cover-
age in place.
Third perspective: I have an employer plan
If you have an employer plan through your or your spouses employer, you
will most likely have maternity coverage.
However, if you begin a new job during pregnancy, it is possible that you
might have to wait up to a couple of months for coverage. Try to avoid
switching jobs if you are pregnant and currently have coverage with your
group plan. Otherwise, you will have to deal with COBRA or another pro-
gram to cover you during the gap.
Pregnancy cannot be considered a preexisting condition if you enroll in
your employer plan. They cannot decline your enrollment based on preg-
nancy, or exclude it from coverage. Even if you did not have previous
health coverage, HIPAA rules forbid employer plans from excluding preg-
nancy as a preexisting condition.
For more information on how your employers plan works, ask your Human
Resources department. Another resource would be the insurance broker
for your employers plan, or support personnel that work at the brokerage.
You may want to reach out to these people, even if only to get an under-
21
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
standing of what changes the employer is thinking about making to the
plan before your babys due date.
Question: What do I pay if I have coverage
through an employer?
Answer: Youll pay your deductible, and then any cost sharing until you
reach your out-of-pocket maximum. For example, lets say your preg-
nancy bills total $10,000. If your plan has a deductible of $2,000 and 80%
coinsurance until you reach an out-of-pocket maximum of $5,000, youd
pay the the rst $2,000 out-of-pocket, then youll pay 20% of the remain-
ing $8,000 (or $1,600) for a total of $3,600.

22
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
Pregnancy
cannot be con-
sidered a preex-
isting condition
if you enroll in
your employer
plan
Section 4: My baby is already
here!
First off, Congratulations! This is such a special time that also opens up
new concerns. By taking the proper steps you can save money and ensure
you and your family have the best coverage and opportunity for care.
First perspective: I dont have health insurance
right now
Depending on your familys income, your child might qualify for assistance
offered through state programs, such as Medicaid or CHIP. To research the
coverage options available in your state, visit www.coverageforall.com and
select your state.
Second perspective: I have an individual plan
If you have an individual health plan, you have 30 days from your childd
birthdate to add him or her to your plan. Contact your health insurance
company immediately after the baby is born to ll out the appropriate pa-
perwork and get your child added. One thing to note: your plans premi-
ums will increase when adding your child.
Third perspective: I have an employer plan
Many employer plans are affordable when just the employee is on the
plan. When a spouse or dependent is added, though, the price can jump
by a lot. If this is the case for you, then another option would be to look at
the individual health insurance market. One option is for the parent who is
not the employee to get an individual policy and add the baby to that pol-
icy. Two things to bear in mind:
Until 2014, pregnancy is considered a preexisting condition and an expec-
tant mother will generally not be able to get an individual policy.
23
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
If the father has an individual policy, it must be in
force prior to birth or the father and the baby
will be subject to medical underwriting.
Another alternative would be for the entire
family to get off the employer plan and get
a private family policy on the individual
market.
For some families, this strategy is benecial
because it would mean there is just one deducti-
ble to reach. For example, if the mother were to
stay on her employer plan with a deductible of $2,500 dol-
lars and the father and baby were on a plan with a deductible of $5,000,
then if something happened to the whole family there would be deducti-
bles of $7,500 to reach. If the mother switched to the private family plan,
then she would be included in the $5,000 deductible, a deductible savings
of $2,500.
Taking some time to evaluate your options can mean a lot of savings.
24
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
About Us
Pregnancy is an exciting time for you and your family. Knowing your health
insurance options and rights will help save you money and let you receive
the best care possible for you and your baby.
Whether youre already expecting, or just starting to think about getting
pregnant, you have options for how to pay for it. If you questions about
how the information in this guide applies to you, or youd like to learn
more, visit us at www.bernardhealth.com or contact us by email at
retail.bernie@bernardhealth.com or by calling 1-800-505-0750.
25
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
asdj
kfhkj
sdhf
BERNARD HEALTH
Rescuing you
For More Info Call
1-800-505-0750
Click Here
To Request a Free Consultation
sdkjfhgklasdklasdjfksadjfklsdajfkljasdkfj
sadklfjklsadjfklsadhfklsadjfklshdgkljasdi
gjoiaepjgiaevpmpoerjlajdklgjadklgjklaejg
oiajgiafdjglijadgjadghadklghkladfhgk;l
adfhgkladfhgkladhgkladhjgklhadklghskl

Você também pode gostar