What to Ask Your Insurer Before Pregnancy

What to Ask Your Insurer Before Pregnancy: Healthy Pregnancy

There is no better time to think about health insurance than now, whether you’re expecting your first baby or hope to in the future.

You may want to update your coverage with your current provider or look around for the best deal to suit your family’s growing needs.

This quick guide will help you to ask the right questions and get the best deal.

Medicare in Australia will cover your pregnancy and delivery care at any publicly-funded hospital or birth center, including homebirth programs. If you prefer private obstetrics, you’ll need to cover all costs yourself or purchase a health insurance plan that covers pregnancy.

Before you Buy, Ask Yourself These Important Questions.

The Commonwealth Ombudsman suggests that you ask the following questions before signing up for a health insurance plan:

1. What Services Related to Pregnancy and Childbirth (Obstetrics), Are Covered Under the Policy?

Some cheaper policies will not cover obstetrics or may have restrictions like only covering you if you’re a private patient at a public facility. You could end up with a large bill if you choose to have your baby delivered in a hospital that is not public.

2. Does the Policy Cover my Baby?

Check that your hospital insurance covers dependent children, without any waiting period. If your baby needs hospital care right away, you want to make sure they are covered. Admission to intensive care units and special care nurseries can be expensive, but they may be necessary if your child is born prematurely with certain congenital disorders. Check if additional costs are associated with multiple births, such as twins and triplets.

3. What are the Excess Payments for Mom and Baby?

You must understand the charges you will be responsible for. Some policies may require an excess payment or co-payment to cover hospital admissions for both mum and baby. Check if there are any extra charges if you require a c-section or epidural.

4. What’s not Covered?

It is important to know what your policy does not cover. Many insurers boast about the great things they promise you. Private hospital health insurance does not cover certain costs, such as a portion of hospital fees, specialist check-ups, consultations, or pediatrician appointments. Be aware of them to avoid unexpected budget blows later.

Understand the Difference Between Must Haves and a ‘Nice-to-Have’

You don’t want to waste money on unnecessary extras. You want to ensure that mum and baby are well looked after, before, during, and even after birth.

It pays to compare health insurance policies to find one that suits your needs and circumstances. Some people may think that pregnancy massage is a luxury, but for others who have chronic muscular problems, it might be essential. List what’s essential for your coverage and what you can live without. Everyone is different.

Consider Restrictions, Extras, and Limitations.

Consider these other factors when selecting the best private healthcare insurance for your pregnancy.

5. Waiting Periods

All health funds in Australia have a 12-month waiting period before obstetrical services are covered. This means that you must have this level of coverage for at least a year before being admitted to the hospital.

6. Treatment for Infertility and IVF

Policies for natural births and obstetrics do not cover infertility treatments, such as in-vitro fertilization (IVF). Those that do will only cover certain aspects of these treatments, like hospital admissions. These benefits are also subject to a range of waiting periods, ranging from 12 months up to 3 years.

7. After Pregnancy, Dental Work is Recommended

It is important to understand the level of coverage for dental care included in your policy when you consider that pregnancy hormonal changes can cause dental problems, such as gum disease or an increased risk of decay.

Save Money on your Insurance and Get the Most Out of It

It may be difficult to negotiate the price of health insurance, but there are still ways to ensure you get the coverage you need.

• Join a health insurance fund that offers basic hospital coverage before your 31st Birthday to avoid the lifetime health cover loading.
• Pay attention to the fine print, and only buy what you need.
• Compare multiple policies before selecting one. Some companies compare policies in bulk, but you should be aware that they may favor certain providers.
• Be realistic and don’t think you need to cover all of the extras.
• If you decide to pay more for your excess or copayment, you can reduce the premiums you pay.
• Review your policy regularly because the market is always changing.

When You Start a Family, Ask Yourself These 5 Questions About Health Care.

Before I even knew I was pregnant, I thought about what to call the little one and how long I would wait before finding out its gender. I then realized that my most important questions concerned the health coverage of my future pregnancy and newborn. By researching your options for insurance before becoming pregnant, you will know what to look out for when open enrollment comes around. These are the top maternity insurance concerns you should be focusing on:

1. Which Doctors Will I Consult During My Pregnancy and Why?

You should take a close look at your relationship with your OB/GYN if you are trying to conceive. After all, this is the person who will deliver your baby. It’s helpful to ask family and friends for recommendations when you are looking for a new midwife or obstetrician. You can also look for recommendations on mom-focused Facebook pages or on websites that offer doctor reviews.

Find out if any of these doctors are in the network of your prospective plans. You’ll save on maternity and delivery costs if you choose a doctor in your network. Aetna Members can Use Docfind to view patient ratings and reviews of in-network physicians. The same process can also be used to choose a pediatrician.

2. Which Hospital or Birthing Center Will I Deliver My Child To?

You’ll need to know which hospitals your midwife or OB/GYN has admitting privileges at after you choose them. If an obstetrician does not have these privileges, the hospital may refuse to accept you for treatment. Ask the office or check their website to see if they have any affiliations with hospitals. Visit the website of your health insurance company to determine if those hospitals are part of your plan. Aetna DocFind lets you search for hospitals in your network, and also for those with special awards for breastfeeding support or baby safety.

You’ll have to choose which option you prefer if you are lucky enough to be able to make a choice. For this reason, many hospitals offer tours of the maternity ward. Ask yourself these questions during the tour:

• Clean? Secure?
• Are the rooms large? Will you be sharing a room with a new mother? Will your insurance cover a private bedroom if that’s what you prefer?
• Does your partner have the right to share a room with you?
• Will your baby share a room with you, or will it be in a separate nursery from the rest of the family?

3. What Coverage is Provided By My Health Insurance Plan for Maternity?

You’ve chosen the health professional and facility that you’d like to visit, and you’ve checked if they are in your insurance network. Check with your insurer to determine what services related to pregnancy and delivery are covered. You should know about basic services like prenatal testing, and special offers such as acupuncture to treat morning sickness. Aetna’s Member Payment Estimator allows you to compare the costs of vaginal birth versus c-section. It may seem far off, but if you plan to breastfeed, now’s the time to look into breastfeeding-related benefits such as coverage for breast pump purchases and lactation consultant services.

4. When Should I Inform My Insurance Company About My Pregnancy?

It’s not necessary to inform your insurer immediately that you are pregnant… but it is worth doing when you’re ready. Insurance companies provide pregnant women with free resources (learn about them below) that can help you prepare for motherhood and take care of yourself. You’ll need to inform your insurance company of the birth of your child if you want your baby’s medical expenses covered. Aetna’s plans cover newborns automatically for the first 30 days following birth. You’ll need your benefits administrator to officially add your newborn.

5. What Other Resources are Available Through My Plan for Me?

You can get free and helpful resources from your health insurance provider. Aetna’s Starting Right Maternity program provides information about everything from dental care during pregnancy to preparing fathers for a new baby. The nurse case manager assigned to women with specific risks during pregnancy will monitor these risks. Smokers are encouraged to enroll in a special smoking cessation program for mothers-to-be. Text4Baby is a service that provides three texts a week, each with a baby care tip. The March of Dimes also has a website full of valuable information about prenatal and postpartum health.

What Happens at a Preconception Consultation?

“The first appointment is your chance to be heard, and ask questions, DO, a family physician with Banner Health. We discuss your medical history to create a healthcare plan that is tailored to your needs.

This is the ideal time to ask all of your questions. Here are some questions you might want to ask during your one-on-one appointment, along with your ones.

1. What Lifestyle Changes Should I Make Before Becoming Pregnant?

You will most likely receive a physical examination and your provider may suggest that you undergo pre-pregnancy testing, such as urine or blood tests.

You may discuss your weight, diet, medical history, and lifestyle changes during this appointment to increase your chances of conception. The importance of limiting coffee, quitting smoking/nicotine and marijuana, as well as avoiding illicit substances.

Other steps include:

• Maintaining a healthy weight and a balanced diet: Being overweight or underweight can decrease fertility, and cause pregnancy complications such as gestational diabetes, hypertension, and miscarriage.
• Regular exercise can improve fertility.
• Relaxing and reducing stress: Stress can’t be the cause of infertility, but it can impact your health and well-being. Take part in activities that reduce stress, such as yoga and deep breathing. Consider speaking to a licensed mental health specialist if stress overwhelms you.

2. When Should I Stop Taking Birth Control or Other Medications?

Some people will experience ovulation within a couple of weeks of stopping birth control. Some hormonal methods, such as NuvaRing and birth control pills, can affect your cycle over a few weeks. Discuss with your provider when you should remove an IUD if you own one.

Some over-the-counter (OTC), and prescription medications may also interfere with your ability to become pregnant. Speak to your doctor about any safety concerns. They may adjust your medication or recommend that you avoid certain herbal supplements and vitamins to ensure a healthy pregnancy.

3. When Should I Begin Taking Prenatal Vitamins?

Begin taking prenatal vitamins two months before trying to conceive.

Folic Acid is an important nutrient during early pregnancy. It is also helpful in reducing the risk of neural tube defects and certain birth defects.