Insurance for childbirth

amother

Wed, Oct 28 2020, 9:43 am

Im currently pregnant and looking to buy insurance from the marketplace now in NJ.

My previous birth I had to pay over 3k for delivery.

Are there any plans that would cost me less?
Also, I read that having a baby is a life changing event. Does that mean I can choose an expensive plan with low deductible till I have my baby and afterwards change to cheaper plan?

Amarante

Wed, Oct 28 2020, 1:10 pm

A good broker can be helpful in providing you with the best advice based on your specific medical projections.

Are you going to be eligible for a premium subsidy based on income? That would need to be figured into the cost of your total medical expenses.

Are there specific doctors or hospitals that you want to use. You should verify that any plan would have those in their network.

However the way you figure out the best plan for you is to figure out what the actual cost would be based on your projected needs. You create a simple spread sheet in which you put down premium; co-payments and deductible. You then do an estimate of what your actual out of pocket expenses would be for plan - e.g. amount of co-payment multiplied by estimate of doctor visits. Also project what the costs for drugs are and if there are specific drugs you should check the specific formulary.

Hopefully it won't be a factor but plans have a cap on total annual out of pocket costs depending on the plan so if there is some expensive medical catastrophe your expenses are capped at various rates.

It is pretty easy to figure out approximate costs - plans are Bronze, Silver, Gold and Platinum. Platinum is most expensive with lowest co-payments and often no or very low deductible. Bronze plans are the least expensive premium but generally have high co-payments and high deductible. And of course an HMO is generally less expensive even within the same tier - the larger the network and your choice of providers generally the more expensive the plan. And sometimes the most desirable providers will not be on the less expensive plans.