Here is a sample case that we ran for a individual with a maternity consideration.
Good afternoon Jody Doe,
I understand that you were inquiring into receiving information on individual maternity options. Individual health insurance policies do not automatically include maternity benefits, but rather only cover any complications due to pregnancy. In order to receive any coverage for routine maternity benefits you would need to enroll in a medical plan that offered maternity coverage as an optional benefit since Aetna does not offer maternity benefits. Below you will find the list of insurance carriers in Florida that offer maternity as an optional benefit, the waiting period until benefit becomes effective on your policy and the amount of coverage offered respectively.
Please note that even when you have an optional maternity benefit rider on your policy, complications will still be covered as a medical benefit under the regular schedule of benefits. For instance, if you had paid the first $1000 in your maternity deductible for routine maternity services rendered and then you had some kind of complication due to the pregnancy then the medical services for that condition would be covered with your normal benefit schedule. So if you had Plan 597 with a 2500 deductible and only copays applicable in doctor visits then you would be subject to just the respective copays at doctor visits and subject to the 2500 plan deductible instead of the maternity deductible if applicable.
Florida Health Insurance Maternity Plan Information Chart
|Insurance Carrier||Waiting Period||Level of Benefit|
|Vista||15 months||$1000 Copay and a one time est. $40 copay for all prenatal services|
|United HealthOne||Effective Immediately||You pay 20% and UHC pays 80% up to a maximum benefit level of $2000 for the first two years that the benefit is effective on your policy|
|AvMed||12 Months||$5000 Maximum benefit amount|
Please review the attached material and feel free to contact me should you have any questions, require any additional information or should I be of any further assistance at all!
Caroline L Ehrenthal
East Coast Health Insurance, Inc.