Medical Insurance And Pregnancy In Texas

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    Function

    • Maternity insurance provides a certain dollar amount or percentage of a covered procedure relating to prenatal care and childbirth. This can cover care in hospitals, birthing centers and midwives at home. The main goal of maternity insurance, whether private or government funded, is to reduce out-of-pocket expenses incurred by the individual, and to increase the quality of care received by mother and infant.

    Types

    • In Texas, there are several forms of maternity insurance available. Most larger employers offer group rate insurance, which may include maternity care. Individual maternity plans in Texas can have a maternity "add-on" plan which will cover part of the care. There is also the federal and state funded programs for low-income families such as Medicaid, Children's Health Insurance Programs or CHIP, and CHIP perinatal. Also for qualifying veterans, the Department of Veterans Affairs offers maternity coverage to honorably discharged veterans with certain periods of active duty service or a disability.

    Benefits

    • Obtaining adequate prenatal and maternity care helps to greatly reduce complications. Receiving adequate prenatal care is vital to the health of both mother and child. According to the U.S. Department of Health and Human Services "babies born to mothers who received no prenatal care are three times more likely to be born at low birth weight, and five times more likely to die, than those whose mothers received prenatal care."

    Government

    • The federal government has made some moves to increase the availability of medical insurance, including maternity. Texas has not made any legal changes that would require individual insurance plans to cover maternity care, or restrict their ability to deny coverage to pregnant women. Texas has, however, created CHIP Perinatal, a health insurance program that provides coverage to certain women who make too much to be covered by Medicaid, but the costs of health insurance premiums is still too high.

    Considerations

    • The most common restriction to maternity insurance is it's being considered as a pre-existing condition. Though group insurance providers cannot consider pregnancy a pre-existing condition if there is no gap in coverage, individual plans usually have a 12-month waiting period before pregnancy will be covered. So it is important for a woman who wishes to become pregnant to carefully consider her coverage options and ensure that she is aware of any waiting period and to know how much of the costs the plan will cover.

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