The short answer is perhaps, because there are three insurance options you might qualify for, and two state assistance programs. It’s hard to get health insurance when you are already pregnant because insurance companies view being pregnant as a “Preexisting Condition,” and the costs for a normal prenatal and delivery are much greater than the total monthly premiums you would pay for a California maternity health insurance plan. Additionally, if there are complications then the costs climb at an exponential rate (premature babies can use over $30,000 – $85,000 in medical costs in the first weeks of life, and more than 1 in 10 California babies are premature or underweight). Because of these costs and risks, Health insurance companies will decline applications from women that are pregnant when they apply, so other strategies will have to be explored by the mother to be, in order to get maternity coverage.

The first alternative is to join a group health insurance plan at the company you work for or your spouse’s company. Almost all group health insurance plans offer maternity coverage. This is not an a slam-dunk however, because group health insurance plans have open enrollment periods during which employees and dependents can be added to the company health insurance plan. If your pregnancy occurs within a few months of the open enrollment period, then you can use this option and simply pay for the cost of the early prenatal visits out of pocket, until you are on the group plan.

Insurance option number two applies to women that have their own medical without maternity care. In this case, you should ask the insurance company if you can transfer to a plan that offers maternity care. Blue Shield of California will allow this kind of transition, but other health insurance companies in California will not.

The third insurance option is to apply for the Pre-Existing Condition Insurance Plan (PCIP) that was created by the Affordable Care Act and took effect on 1/1/11. This plan requires that you have been uninsured for a least 6 months, and been declined by a medical insurance company. This plan offers rich PPO benefits that will provide coverage for the prenatal care and delivery costs. The premiums for the plan will be less than what you would pay to get an equivalent medical insurance plan, and in many cases, this plan is one of the top 3 maternity insurance plans, in terms of minimizing your overall out of pocket expenses throughout the pregnancy.

If the above options don’t help you, you do have other choices. Depending upon what state you live in, there are government programs to provide care for pregnant mothers to be, so check with your State Department of Insurance to determine what your local options are. In California, there is the state Medi-cal program (Medi-cal is the California version of Medicaid), and the Access for Infants and Mothers (AIM) program.

Your state Medicaid program, or Medi-cal in California, should be your starting point. If you meet the income limits for Medi-cal you can apply for this no-cost health plan that provides benefits for pregnant women. Medi-cal is intended to provide coverage for low income families and women that are below the federal poverty level. If your income is above the Medi-cal qualification levels, then you should apply for the AIM program.

The AIM Program is low-cost health care coverage for pregnant women, and is provided for middle-income families who don’t have health insurance and whose income is too high for no-cost Medi-cal. AIM is also available to women who have private health insurance plans with a maternity-only deductible or co-payment greater than $500. To be eligible for AIM a single mother’s monthly household income must be between $2,453 to $3,679 (there is a table with income ranges for families with other children at http://www.aim.ca.gov/Costs/Income_Guidelines.aspx). The AIM program is funded by the State of California, and although funding is usually available, if the program is filled up, then no additional mothers will be enrolled.

Individual health insurance with maternity coverage is not usually available after a woman becomes pregnant, but not having maternity coverage can be a financial disaster due to the cost of maternity care and baby delivery. The five options outlined here, joining a company health insurance plan at your workplace or your spouse’s, transferring to plan with maternity coverage, applying for the PCIP plan, or applying for State programs such as Medi-cal or AIM, will usually provide a solution for all mothers to be. With these solutions, having a baby can be a time of joy and new beginnings.

Tim Thompson writes about the insurance industry. To find out more about California Maternity Health Insurance, then visit SPF Insurance Services to get instant quotes on California Health Insurance Quotes for your needs.

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