Hellobee Boards

@lawbee11: Something to consider is that you likely won't be covered by your new employer's plan until you have worked there for 90 days. And if you get pregnant right away they may not cover maternity care if the pregnancy begins before coverage begins. So check into that.

@lawbee11: We are able to look up our benefits and coverage online, under our insurance providers website. Can you do something like that?

Also looking at maximum out of pocket is critical! My MOP is 3k with 100% coverage after deductible met, but after I add the baby on mine it goes up to 6k out of pocket until deductible is met. Had I picked the wrong plan, it would have been 9k MOP!

@MamaMoose: Insurance plans are not allowed to consider pregnancy as a pre-existing condition, according to HIPAA. Also, usually if there is no gap in coverage between plans, pre-existing conditions are not an issue, even if going from group to individual.

Some group plans do have a waiting period for other allowable pre-existing conditions, before they will cover it, if there was a gap in coverage. But mine stated in the literature that that was the case, and I had no waiting period for my pre-exes.

I agree with others. It's important to find out what your deductible, max out of pocket, and percentage covered will be with both insurances.

For example, one individual plan might have a $400 deductible with a $2,400 out of pocket max and cover 80% of your prenatal care. Another family plan might have a $800 deductible with a $4,000 out of pocket max and cover 90% of your prenatal care. So depending on how much your prenatal care costs, you'll have to figure out which one is actually cheaper.

Let's pretend it costs $10,000 to have a baby.

With the first plan, you'd have to pay the $400, but after that, the plan will pay 80% and you pay 20%, until you reach the max. So that's:
$10,000 - $400 = $9,600
$9,600 x 20% = $1,920
$1,920 + $400 = $2,320
Since $2,320 is less than the out of pocket max, that's how much you would end up paying.

Now the second plan:
$10,000 - $800 = $9,200
$9,200 x 10% = $920
$920 + $800 = $1,720

So even though the second plan has a higher deductible and out of pocket max, you still end up paying less because of the percentage that's covered.

Keep in mind, I have no idea how much it costs to have a baby. It's more or less based on where you live, so you'll want a better estimate when you try to figure out which plan will actually cover more for you. I also just made up these numbers - I have no idea what the numbers look like for you. You'll also want to take into account how much it costs you and your husband each month for each plan, because that might be a factor in overall costs. Although once you have a baby, adding a child to an existing family plan might not be much, whereas turning an individual plan into a family plan and still having another individual plan might not make sense.