May 2022 | Maximixe your HSA e-Newsletter | Vol. 18, Issue 9 |
Paying for Maternity Care When You Don’t Have an Insurance Plan [Healthshare Maternity Benefits]
In 2021, the average cost of bringing a child into this world was somewhere around $30,000. For most people, their health insurance plan would likely cover the expenses. But for the uninsured, this $30K is coming right out of pocket.
And by the way, if there are even minor complications while giving birth, that $30K could become a whole lot more.
[Not planning on having a child? If you know someone that is, kindly forward this along or invite them to subscribe. We might be able to save them some money]
Paying for Maternity with a Health Share Plan: Is it Enough to Pay the Bill?
Because ACA health plans pay for maternity costs, most people choose to stick with traditional insurance when growing their family. But more and more, American families are having hard times meeting their monthly premiums, or finding metal-tier plans to be too restrictive.
Fortunately health sharing organizations are happy to help with the cost of childbirth. As it is with insurance, even if maternity is covered, there will still be an amount that needs to be paid out of pocket. But once this amount is met (like a deductible), your remaining bills can be paid by your health sharing community (up to your plan’s limit, if there is one).
As you’ll see in the comparison section below, some healthshare plans offer full cost-sharing for maternity. Others will pay out according to a pre-set rate, and some may have a lifetime sharing maximum. If your healthshare community is faith-based, there could be a marriage requirement as well.
Q: Can I Use Healthshare to Pay for Maternity if I am Already Pregnant?
A: If you are already pregnant and not yet enrolled in a health sharing program, then you will not be able to access maternity benefits. Most healthshare companies require that the conception occur some period after the effective date of the plan. (See below for plan-by-plan waiting periods).
How Healthshare Companies Handle Maternity Benefits: Quick Comparison
Altrua
Offers Maternity Cost-Sharing: YES
Eligible Memberships: Diamond and Emerald-Level Only
Waiting Period: 90 days from membership start
Member’s Out of Pocket Responsibility: $5,000
Annual Sharing Limit: $12,000 in year one, $25,000 per year after that
netWell
Offers Maternity Cost-Sharing: YES
Eligible Memberships: Elite + option only
Waiting Period: 6 months from membership start
Member’s Out of Pocket Responsibility: None
Annual Sharing Limit: $15,000
OneShare Health
Offers Maternity Cost-Sharing: YES
Eligible Memberships: Classic Crown, Complete Basic, Complete Enhanced, Complete Crown only
Waiting Period: Conception must occur after plan effective date
Member’s Out of Pocket Responsibility: $5,000
Annual Sharing Limit: $5,000 for natural delivery, $8,000 for c-section, $50,000 for birth with health-threatening complications
MediShare
Offers Maternity Cost-Sharing: YES
Eligible Memberships: $3,000 AHP options and above
Waiting Period: Conception must occur after membership start date. Conception must also occur within marriage.
Member’s Out of Pocket Responsibility: Between $3,000 and $12,000 per household
Single Pregnancy Sharing Limit: $125,000
HSA Secure / Zion
Offers Maternity Cost-Sharing: YES
Eligible Memberships: Secure, Care +
Waiting Period: 60 days after start of membership
Member’s Out of Pocket Responsibility: Double your plan’s standard Initial Unshared Amount (IUA) before maternity is included
Annual Sharing Limit: None
More Ways to Save Money on Maternity Costs / Lower Your Delivery Bill
1.) Shop Around for the Best Hospital Costs
Price transparency is your RIGHT as a healthcare consumer. Hospitals are required to provide pricing information on over 200 common items including maternity.
2.) Know Your Health Plan’s Maternity Benefits
Estimate what your total out-of-pocket delivery costs will be before your plan starts paying / sharing. Start saving early to cover these costs.
3.) Negotiate Prices / Ask for Discounts Up Front
You don’t have to wait until the bill arrives to start negotiating. Communicate your needs early and you’ll have more payment options and discounts available. For example, offering to pay a bill in full and up front can get you a 10-20% discount at many hospitals.
4.) Get Your Payment Plan Setup Ahead of Time
Alleviate the financial stress of childbirth by arranging a payment plan with the hospital or care organization. Hospital administrators can also provide information about applying for financing and payment help if you need it.
5.) Research Surprise Costs
For example, an epidural can cost between $2,000 and $3,000 on top of your delivery bill!
6.) Always Review Your Medical Bill for Errors
Hospital bills are notorious for erroneous charges, double billing, and incorrect coding. Reviewing your delivery bill item-by-item is perhaps the easiest way to save.
Health Insurance Isn’t the Only Option for Maternity Care
For most people, a marketplace ACA health insurance plan will provide the most comprehensive coverage for maternity care. And with new expanded subsidies, many Americans are qualifying for much lower premiums than they’ve ever had access to.
But traditional health insurance isn’t the only option. The health sharing organizations we looked at above can provide cost-sharing, but you have to be enrolled before conception, and in most cases, be enrolled for a few months or more.
Planning on starting or growing your family? Let’s make sure you have the right plan. Know a family that still needs coverage? I hope you’ll send them our way.
Looking for more resources on pregnancy, childbirth, and beyond? Visit the Office on Women’s Health Pregnancy Resource Center,
Click here to schedule an appointment, or call 800-913-0172 to get started.
To your health and wealth,
Wiley P. Long, III
President - HSA for America
The HSA for America Maximize Your HSA Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.
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