Pregnancy can be very expensive. “Simple” deliveries can run $10K while C-sections usually start at around $20K. If there are complications, costs can quickly escalate to $50k, $60k or more. Maternity is one of the few health cost that you can plan for.
The individual Nevada health insurance market has changed significantly over the last decade with the introduction of many plans that do not cover maternity at all. For a young male or an older person in their 50's or 60's, this might not be an issue but for a female in her 20's or 30's, it can be an important consideration.
Individual and family health insurance is very different from Small Group (benefits provided by your company) in that it is medically underwritten. This means that we need to be in good health in order to qualify for coverage, or changes. Some people simply assume that they will switch plans when the get pregnant or before the need for maternity coverage arises. If already pregnant, the Nevada health insurance carriers will not approve a new application or a request to change to a plan that does cover maternity. It's better to plan ahead (perhaps years ahead) and choose a plan that covers maternity. The main plan the we recomend is Health Plan of Nevada, but there are still details about this plan that you need to know, please give us a call to find out the VERY specific details about pregnancy and health care in Nevada. (888)268-4421
Maternity is very expensive because the actual delivery occurs in a hospital. Hospital or facility care is extremely expensive in Nevada and the plan's max out of pocket or copay maximum becomes the critical issue. The max out of pocket essentially lets you know at what point the carrier takes over for covered benefits "In-Network". Even if a plan requires you to pay more for office and prescription, a lower-priced plan with a lower max out of pocket can work out better for maternity coverage. The HSA or Health Savings Account plans typically work well in this regard.
Group coverage is typically richer in benefits but also tends to be much more expensive. If you are looking at a new health insurance plan or considering changing health coverage prior to a future pregnancy, you want to make sure there is plenty of time between the effective date and the date of conception. You want to make sure that there is no grey area between these two events. You must be able to correctly answer the pregnancy question on the application. The carrier can decline or defer coverage for other issues not relating to pregnancy so again, it's best to choose the right health plan up front.
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