Complications of a Birth in Texas

[mminsurance]

Any help would be appreciated!

I have a client that I am putting on a HSA plan and will be paying for his routine maternity costs with the money he puts into the account. He understands the complications goes towards the major medical deductible but he said that one of his friends a couple of years ago had a plan with Aflac that would pay him a per day benefit for the maternity to help with those costs in case there were complications.

Does anyone have any suggestions?

 

[Frank Stastny]

I would say if he "will be paying for his routine maternity costs", money will not be a problem. He will most likely become independently wealthy.

Sorry, I just couldn't resist. The goats made me do it.

 

[STIBROKER]

Sorry, I just couldn't resist. The goats made me do it.

you do have a tough work environment.....

 

[TXINSURANCE]

Complications are covered by state law, but the definition of complication is grey at best. If a female has a scheduled C section, this is unlikely a complication. I certainly wouldn't get into what is or is not a complication of pregnancy as every company may try to wiggle out somehow.

Keep in mind on that HSA you do not even get negotiated rates, as maternity is NOT a covered service, however you can use HSA account money to pay for services.

 

[DS4]

Vaginal delivery= Not covered
Non-Vaginal delivery=Covered

 

[mminsurance]

Thanks for the posts so far!

I understand how the insurance works. My question is if anyone deals with a policy like Aflac that will pay a stated benefit for maternity or hospital visit related to maternity?

 

[TXINSURANCE]

Vaginal delivery= Not covered
Non-Vaginal delivery=Covered

This is not always the case.

I had one carrier deny because the C section was "scheduled" and therefor not a "complication".

I am not sure AFLAC offers that plan any longer and / or it has a maternity exclusion these days. It was a hospital indemnity supplement, so much per day.

 

[kheyknee]

Both Colonial and Aflac have hospital indemnity programs that cover normal delivery - 9 month exclusion. There are product versions that are HSA compliant - a lump sum of cash based upon days in the hospital only.

Both will pay an additional benefit if the child requires medical attention - 12% of babies are born premature and may spend time in the NICU.

You should also get your client into a short term disability policy as well. Normal delivery is covered after 9 months in the policy.

 

[TXINSURANCE]

FYI Medicaid is available if pregnant in Texas with no income question. Free babies for everyone!

 

[MzRSmith]

Yes i bleieve-in Tx, if there is no other option for coverage on maternity-medicaid is picked up-even in an emergency situation, however, I always believed, complication caused by a pregnancy were covered either way....no exclusion-when I was pg a few yrs ago without insurance, I negotiated a private pay rate with the doc hospital and anesth. -it cost between 4-5k-if you try and negotiate a deal for possible complications..you can do that as well...which isn't much more...