This article takes a look at California maternity insurance plan. As you may know maternity is not a stand alone insurance. What this means is that you cannot go and buy a maternity only insurance from say Kaiser Permanente. But some health insurance plans allow you to add maternity cover as an added benefit. Lets take a detailed look at various California maternity insurance plans and their pros and cons. But before that let’s see what California laws say about maternity coverage.
Maternity Coverage Must Under California Law
Group health insurance plans offered by employers always covered maternity care. But this was not the case with individual or family health insurance plans. In 2012 California mandated that all health insurance plans must offer maternity cover. From June 1, 2012 all health insurance plans are required by law to offer coverage for maternity care.
It means that all individually purchased health insurance plans have maternity coverage by default. So the insurance plan you purchased already has maternity coverage. The best way of getting assistance with your health insurance is by calling the carriers 800 number.
Quality of Maternity Coverage In California
In this section we will look at which California PPO offers the best maternity coverage in terms of quality of care. Every year California Department of Insurance carries out an extensive survey of PPOs for quality of care.
Rating Methodology
The PPOs are rated on a four point scale (Poor, Fair, Good, and Excellent). The ratings includes customer satisfaction and expert review. The expert review is based on a detailed analysis of patients’ records. Experts analyze patients’ records rate the quality of care. 2013 PPO ratings include the big six California PPOs. Out of the six two PPO United Healthcare and Aetna are exiting the individual health insurance market. So we are left with Anthem Blue Cross, Blue Shield of California, CIGNA, and Health Net.
PPO Rating 2013 for Maternity Care
On the four point scale Health Net PPO and CIGNA were rated as “Good” (3 out of 4). Anthem Blue Cross and Blue Shield of California received “Fair” rating (2 out of 4).
Rating for maternity care is further divided into two parts.
Visits during pregnancy. Health Net PPO received 99% score, CIGNA 96%, Anthem 94%, and Blue Shield 82%. The national average for this category is 97%. These ratings reflect how effective the maternity coverage is in getting prenatal care within the first 13 weeks of pregnancy.
Visits after giving birth. This rating shows how effective the maternity insurance plans were in getting the new mom a medical check up 21-56 days after the baby’s birth. CIGNA received a score of 87%, Health Net 83%, Blue Shield 76%, and Anthem Blue Cross 74% against national average of 88%.
A Note of Caution
You should not choose a carrier on a single parameter. A carrier with higher quality maternity coverage may have a lower quality coverage for some other medical condition. Check the complete ratings of California PPO here. It is advisable to consult an insurance advisor before buying health insurance. You may also want to read my blog post on getting help with health insurance.
Comparison Of California Maternity Health Insurance Plans
In this section we will look at individual health/ maternity insurance plans offered by the big four carriers. We will assume a family of two. The age of husband is assumed as 32 and age of wife as 28.