Here are some terms you should be aware of before we get to our options: URC. URC refers to Usual, Reasonable, and Customary. These levels of coverage are based where you live so are not set national standards. It used to be that some companies offered URC coverage for a pregnancy which basically means it is 100% covered (unless you have someone charging you overmuch; but then you can ask why and not use that provider or sort it out with them). That is not really the case anymore. Most policies only cover a percentage of costs; 80% in their network and lower out of network. You pay what is called “coinsurance” or the rest of the bill, usually 20%. The "network" in these cases are groups of hospitals and physicians that the insurance company works with (sometimes called PPOs for "Preferred Provider Organization"). You are never required to use a specific doctor or hospital, but while using those networks, you not only get the advantage of negotiated pricing, but also better coverage for some medical expenses, most relevent to this article, maternity and pregnancy coverage. So it is definitely worth your time to check out the network providers near you as you come close to choosing the right plan. This can be done by clicking on the "Network" or "PPO" or "Doctors/Hospitals" hotlinks found all over our website. You then put in your zip code and can search for nearby providers. Also, almost all plans have a maximum or lifetime maximum that they will pay for maternity costs, so please be aware of those limits on a policy you are considering.
Already pregnant?Coverage for someone who is already pregnant is for complications of pregnancy only. Costs of delivery and prenatal care of the mother would have to come out-of-pocket. Also, be aware that most visitor policies will only cover a person 14 days and older, so initial health care of the infant will also have to be paid for out-of-pocket. Here are some Visitors maternity insurance policies which cover complications of pregnancy where the pregnancy has begun before the start of the policy:
- Atlas and Atlas Essential plans cover complications of pregnancy up to the maximum chosen for the plan for the first 26 weeks of gestation. The coverage begins after the deductible is paid and covers either 100% (in network) or URC (out of network) of medical expenses.
- INF Advantage with coverage of pre-existing conditions chosen (which must be purchased for at least 30 days) will also cover complications of pregnancy up to the maximum of the plan subject to the higher pre-existing condition deductible. The plan pays 80% after the deductible of all costs.
- Similarly INF Elite (which must be purchased for at least 90 days) will also cover complications of an on-going pregnancy and there is not a separate deductible for pre-existing condition coverage.
Planning to get pregnant?The best coverage is for students or spouses of students (sorry everyone else!). Some of these policies have no wait period (if they cover maternity; please be careful here). Conception, however, must occur after the start date of the plan and some do have a waiting period after the start of the plan. Many institutions require coverage for maternity, so this can be useful to know even if you are not considering getting pregnant (or are a guy; apparently the requirement is still there — go figure). Not all policies allow a spouse to be covered, so if the person is on F2 visa and not a student themselves, this can be extra tricky. Since this sort of immediate coverage is only available for students, it may be worth purchasing a policy for both the F1 and F2 in order to get coverage for the F2 spouse since otherwise, the coverage is not nearly as good (read on past student options for details). The policy for the primary F1 person will act as a "secondary" insurance to whatever they already have, so it will not hurt the situation, but it will allow coverage for the spouse. However, many international maternity insurance plans cost more for the dependent spouse than the primary insured. The prices I have put on this blog are for a 25 year old for one month just by way of an example figure.
Student Plans - Maternity insurance plans for StudentsStudy USA Insurance plans offered by TravelInsure are options which allow a spouse on the policy with no limitation on the maximum for the spouse. The plans are Study USA (SUSA for short) Standard, Study USA Preferred 300, and Study USA Preferred 500. Note that the Basic plan does NOT cover maternity at all. The SUSA Standard has a maximum of $200k, SUSA Pref 300 is $300k and SUSA Pref 500 is $500k. The maternity coverage on this plan is 80% in network and URC out of network inside the US but 100% outside the US to the overall maximum limit of the plan. Study USA Standard will cost about $77 per month for a 25 yr old, the Preferred 300 plan will cost $100, and the Preferred 500 plan is $113. However a spouse of the same age on the plan will be an additional $463 on the SUSA plan, $469 on Preferred 300, and $440 per month on the Preferred 500. Unfortunately, they charge more for dependent than the primary on the policy. However, the person holding the F1 visa must be primary on the policy since they are the full-time student and the spouse only qualifies as a dependent on the policy.
Seven Corners recently revamped their Liaison Student Insurance plans. These plans can cover students and their dependents. Conception must occur no sooner than 180 days after coverage begins and you must notify the insurance company within the first 90 days of the pregnancy or they will reduce your benefit by 25%. There are three tiers of plans and coverage differs between their use outside the US and inside the US. For students outside the US, coverage for the Economy plan is up to $500, for the Choice plan, they pay 80% up to $10,000 total, and for the Elite plan, they pay 100% up to $25,000 total. For persons using the plan in the US, the maximum coverage is the same, but for the Choice and Elite plans, they pay 80% if in network and 60% if out of network. In addition, the plans will pay $250, $500, and $750 respectively for routine newborn care per child. Cost per month for a policy with a $100 deductible and a $250,000 maximum are: for Economy, the F1 student will cost about $66 and the spouse the same, for the Choice plan, the F1 student is $104 and the spouse $310, and for the Elite plan, the F1 is $143 and spouse is $554.
Finally, another student plan which covers maternity is the Student Secure Insurance offered by HCC/TokioMarine. This plan has NO coverage for dependents or spouses, so this can only be purchased for an F1 visa holder. This plan comes in several levels: Elite, Select, Budget and Smart. The Smart level has no maternity coverage. The Budget level only covers up to $5,000. The Select plan covers up to $10,000 and the Elite up to $25,000. The cost per month for a 25 year old will be $87 for the Budget plan, $201 for the Student Secure plan, and $338 for a Student Secure Elite plan.
Non-Student Plans - International Maternity Insurance for Visitors and TravelersFor the INF plans which cover maternity, conception must occur after the start of the plan. The INF Premier insurance is a fixed plan which must be purchased for at least 3 months. The plan with $100,000 maximum will cover up to $5,000 for childbirth while the $150,000 maximum plan will cover up to $5500. This plan also offers “full” coverage for pre-existing conditions which has a separate deductible of $1000 or $5000. The following prices are for a policy deductible of $250. The plan with a $100,000 maximum and $1000 pre-ex deductible will cost about $79 per month while the $150,000 policy will cost $89 per month.
The INF Choice insurance is another fixed plan which varies in coverage of childbirth from $4,250 (for the plan with the lowest maximum of $25,000) to $6,000 for the highest ($250,000 maximum). It includes coverage for acute onset of pre-existing conditions. With the lowest deductible offered of $500, the plan will cost $42 for the lowest maximum to $95 for the highest.
INF Standard is another fixed plan offered by INF. It does not cover pre-existing conditions at all, but has coverage for pregnancy and childbirth in the amount of $4,500 for the plan with $50,000 maximum, $5000 for the plan with the $100,000 maximum and $5,500 for the plan with the $150,000 maximum. This plan with a $250 deductible will cost about $47 for the $50k max policy, $61 for the $100k max policy, or $68 for the $150,000 max policy.
Inbound Immigrant has a 90 day wait period for maternity coverage. It is a fixed plan and only covers up to $2,800 for childbirth. This plan is guaranteed and can be purchased for a little as 5 days and up to a year at a time. It will cost a 25 yr old about $64 per month with a $130,000 maximum and a $100 deductible.
International Long-Term PlansLong-Term insuranceplans are ones that you sign up for a year at a time. You can choose, at the time of purchase, to pay monthly, semi-annually, bi-annually or annually. The cost is slightly less to purchase maternity insurance USA plans annually (that is, with a single payment per year). These plans, unlike short-term or student plan, are not guaranteed, so an extensive application must be submitted to the company's underwriting. They can do several things with an application. They can:
- accept the application (ideally),
- deny the application, or
- accept the application,but add riders to exclude coverage of certain conditions or additional premium to have coverage of certain medical conditions.
The best coverage we have for maternity coverage is offered by Global Medical Platinum which has a 10 month wait period for maternity coverage. That means, that conception cannot occur until you are 10 months or more into the plan. This plan is not guaranteed and an application must go through underwriting. Starting the 10th month of the policy, it will cover URC (usual, reasonable, and customary) charges relating to a pregnancy as any other illness with a $50,000 maximum lifetime maximum and an additional $2,500 deductible. This plan will cost about $268 per month for a 25 yr old with a $1000 deductible.
Well, that's it, folks! That summarizes the coverage for pregnancy that we offer for students and visitors both coming to the US and traveling abroad. Whatever your plans, we wish you well and hope you have found this article useful! Do check out some answers to the queries about maternity coverage options asked by our customers which may be similar to yours. Thanks for letting me think happy spring thoughts through the dreariness of winter!
As ever, we wish you safe and healthy travels!