The Blue Cross Blue Shield individual policy is somewhat similar to a prepayment plan through a hospital, as the premiums for adding the maternity rider are fairly substantial. However, the benefit of the policy is that, in the event of a pregnancy that involves complications, your costs are much more predictable. Pregnancies with complications are often significantly more expensive than normal deliveries, so this option is more desirable than a straight prepayment plan.
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Blue Cross Blue Shield's maternity plan uses the deductible and coinsurance of the plan it is attached to, so it is important to evaluate the varying cost of maternity riders within the context of the deductible and coinsurance of each plan. For example, suppose the maternity rider for a plan was $350 per month. Suppose this plan has a $2,500 deductible with 100% coinsurance. Now the total cost for the pregnancy over the course of a year is $350 times 12 months = $4,200 + the $2,500 deductible = $6,700 for the pregnancy. Now, suppose a second plan had a maternity rider for $450 per month. Suppose this plan has a $1,500 deductible with 100% coinsurance. Now the pregnancy would cost $450 times 12 months = $5,400 + the $1,500 deductible = $6,900. With this hypothetical scenario, the first option is better even though the deductible is higher. The purpose of this example is to illustrate the importance of paying attention to how much it may cost to lower your deductible.
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With Blue Cross Blue Shield's maternity plan, it is also important to plan the timing of the pregnancy. The individual deductible resets every January 1st, so it is best to start a maternity policy at the beginning of the year and start trying to get pregnant at that point. Otherwise, the pregnancy will overlap calendar years and you may have to meet your deductible more than once.
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4. Prepayment plans. If you are already pregnant, a prepayment plan is a last resort. In this case, you should contact the prenatal and delivery caregivers to negotiate a prepay rate. Many hospitals offer discounts for paying out of pocket in advance. When conducting prepayment negotiations it is important to be very specific about what is covered by the arrangement and if the price includes complications of pregnancy, or only normal delivery.
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Summary
Overall, from a financial perspective, Medicaid is typically the least expensive option, followed by group insurance. Individual maternity with Blue Cross Blue Shield is the third most desirable as a measure to minimize the cost of unexpected complications of pregnancy. The fourth option is the prepayment plan negotiated directly with the provider.
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NC Maternity Pregnancy Insurance Coverage
1. Average charges submitted to BCBSNC for maternity services, professional and hospital etc. in 2007. Your charges may vary
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