Look at most of the affordable individual health insurance plans available in California and you will notice that virtually ALL of them EXCLUDE maternity coverage. The California health insurance companies (e.g., Anthem Blue Cross of California, Pacificare of California) say that consumers demand "affordable" health insurance policies. One way to reduce the cost of insurance is to reduce the benefits policies provide. Obviously, the cost of having a baby is huge. A normal delivery might cost about $5,000 including pre-natal and post delivery medical charges. The big risk from the insurance companies' and uninsured patient's point of view is the enormous cost of care for pre-mature baby delivery, breech babies, cesarean sections, and all of the thousands of other complications that can arise from child birth. Any time a new born baby is in the neonatal intensive care section of a hospital, the medical expenses rise quickly. So, by removing the risk of paying for these potentially $100,000 plus cases, the insurance companies are able to offer lower cost health plans. The down side is that those who wish to have a baby must purchase coverage at a higher cost because the maternity risk is spread over few people. Ostensibly, only women and couples will ever purchase a health insurance plan that includes maternity coverage. In addition to excluding maternity coverage, California health insurance companies are also limiting coverage to a "single member only." The consequence of this is that if a woman covered by a health insurance plan without maternity coverage delivers a baby and pays for the delivery herself, the new born baby will not be covered under the mother's health insurance plan. Effectively, the insurance companies have precluded new born babies with health problems from enrolling. Accordingly, affordable California health insurance is made available by limiting insurance company coverage, i.e., shifting the burden of payment back onto patients. Proving the truism that with health insurance, when you push down an expense in one place (lower premiums with no maternity coverage) the expense bulges some place else (individuals who must pay their own maternity costs.) Make sure you understand what your health insurance plan covers and does not cover. Your plan may be cheap for a reason. |
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California Health Insurance |
Group Health Insurance in California |
Health Savings Accounts | |
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