Is there a baby on the way? Congratulations!

Spring feels just around the corner when I get call after call asking questions about insurance to cover maternity costs. It warms my heart a bit and makes the cold of winter a little easier to bear! Since many companies have recently cut or reduced their coverage for maternity, I thought it timely to write something on this topic! Since we focus on short term policies on our website, I'll start with those, but in this case, the best coverage comes from long term, international plans which I will list at the end. Here are some terms you should be aware of: 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. 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" hotlines found all over our website. You then put in your zip code and can search for nearby providers.

Now, on with maternity coverage options: The best coverage is for students or spouses of students (sorry everyone else!). 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. 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 of these 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 just by way of example and ballpark figure.

Student Plans

The best coverage comes from Liaison Student offered by SevenCorners. Plans A-F are for US citizens studying abroad and B-F cover 100% of costs incurred outside the US. Plan A only covers 80% of expenses up to a maximum of $5,000. Plans G, H, and I are for non US citizens studying in the US. Plan G, is like Plan A in only covering 80% of expenses with a cap of $5,000 total. Plans H and I, however, cover 80% of costs in network and 60% out of network up to the medical maximum for a covered pregnancy. Note that while this plan allows for coverage of a spouse, the spouse (as dependent on a policy has a maximum of only $100,000. Plans G, H and I offer maximum coverage for the primary insured of $250k, $500k and $1 million respectively. Clearly, if the woman is the F1 student she can get better coverage than if she is on the policy as a dependent. Plan G will cost a 25 yr old only $83, but a spouse $351. Plan H will cost the primary $104 and the spouse $440 with Plan I costing $168 for the primary and $651 for the spouse.

Study USA plans offered by TravelInsure is another option which allows a spouse on the policy with no limitation on the maximum. The plans are Study USA (SUSA for short), Study USA Preferred 300, and Study USA Preferred 500. The basic plan, SUSA 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 70% out of network. This may be a better option than Liaison Student if the female spouse is an F2 dependent, so they can take advantage of a higher maximum coverage. I suspect most normal pregnancies will not cost more than $100k, but a pre-mature birth can cost over $200k (remember that couple from UK who gave birth to a pre-mee baby while on vacation in NYC?), so keep that in mind as you choose your plan. Study USA will cost about $93 per month for a 25 yr old, the Preferred 300 plan will cost $99, and the Preferred 500 plan is $117. However a spouse on the plan will be an additional $495 on the SUSA plan, $588 on Preferred 300, and $700 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.

Finally, another student plan which covers maternity is the Student Secure plan 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 80% up to $5,000. However, the Elite and Select options both cover 80% of costs in network and 70% of costs out of network up to the medical maximum of the policy.

Non-Student Plans

The policy with the shortest waiting period (90 days) for maternity is Inbound Immigrant. It is a fixed plan and only covers up to $2,800 subject to the plan's sublimity as out lined in the brochure. 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 $66 per month with a $130,000 maximum and a $100 deductible.

The only policy that will cover an existing pregnancy is called Atlas America and it only covers complications of pregnancy in the first 26 weeks of gestation. So it is coverage you hope you do not need, but may give you peace of mind for part of your term. It will cost a 25 yr old about $65 per month with a $200,000 maximum and a $100 deductible. It is a good comprehensive plan and will offer good coverage in the event of sudden illness or accident.

International Long-Term Plans

Long-Term insurance plans 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 these plans annually (that is, with a single payment per year). These plans, unlike short-term or student plan, are not guaranteed, so the extensive application must be submitted to the company's underwriting. They can do several things with an application. They can:
  1. accept the application (ideally),
  2. deny the application, or
  3. accept the application,but add riders to exclude coverage of certain conditions or additional premium to have coverage of certain medical conditions.
In any case, you have 10 days after their acceptance to cancel your application for a full refund. Any additional riders will have to be signed by you in order to accept the policy with their conditions. The applications asked extensive medical questions of your entire medical history, so be prepared for that to take some time and have as much information on hand before you start out. Also, they may ask for a check up by your primary care physician and/or your medical records. You will have to sign a waiver to allow them access to your medical records given the laws surrounding protecting this information. A great advantage of these plans is that after you are accepted on, you are guaranteed coverage year after year, usually up to a maximum age. The only increase in cost will be due to your changing age and increases in cost in health care; so your rates don't go up of you get sick or are diagnosed with a condition.

The best coverage is offered by Global Medical Platinum which has a 10 month wait period for 50% coverage and 12 month wait period for full coverage of a pregnancy. That means, that conception cannot occur until you are 10 months or 12 months into the plan. Like the plan above it is also not guaranteed and an application must go through underwriting. The second year of the policy, it will cover URC (usual, reasonable, and customary) charges relating to a pregnancy as any other illness. This plan will cost about $324 per month for a 25 yr old. There is also an additional $2,500 deductible for maternity charges.

We have a new product which just came available to us called Maestro Insurance. It is only for residents of Latin America or the Caribbean. However, it offers $10,000 coverage per pregnancy with no deductible if your plan deductible is $1,000, $2,000, or $3,000 and no additional deductible if higher. You should also not reside in the US more than 6 months per year, but the coverage will be good worldwide including in your country of residence. This may be a great options for expats who may want to fly home to deliver or have options of coverage where they reside. It also has a 12 month waiting period for maternity coverage. This plan will cost about $167 per year for the most expensive region for a 25 year old with a $1000 deductible. Cost varies by residence region, age, and deductible chosen.

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!

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