Covering pregnancy: Does it matter if you're married?

The other day I came upon this LiveJournal post by a woman who was incensed to discover that while using eHealthInsurance.com to find health insurance online it seemed to be common for health carriers to cover maternity benefits only to people on a "Family Plan", not to people who bought an "individual plan."

Of course this has come up before on this blog...mainly me realizing that I ought to get a plan that doesn't cover maternity benefits to save money. But kittymel's point is that there seems to be discriminatory practice going on - or moralistic practice at the very least.

Even though it really isn't eHealthInsurance.com's problem or a complaint against them, I forwarded it along to my EHI buddy to get her take. As always she surprised me with a lengthy reply that actually included her doing research on plans in kittymel's area.

Learn what she discovered...

Per Emily, the zealous advocate for people seeking health care:

"Here's a great example of how health insurance varies from state-to-state and carrier-to-carrier -- benefit levels vary by insurance company and by state. I wasn't sure if this blogger was looking for
quotes in Wisconsin (UWM) or Georgia. So we pulled quotes for both.

For Wisconsin we used the UWM zip code: 53201 and a single woman age 30 to generate quotes. To compare maternity benefits for a family, we used a 30 year old man and a 30 year old woman and a 3 year old child. The maternity benefit details from each carrier, Golden Rule, Humana, AMS, BCBS of WI were identical for the single woman and the family. (To get the additional cost information, I called the eHealth call center at 1.877.eHealth or 1.877.343.2584). Please note: the HSA-eligible plans do not offer maternitybenefits to either singles or families (I'm curious about this and will follow up with some people in-house who should be able to tell me why).

Wisconsin Findings:

Golden Rule: Optional Maternity Benefit additional cost
TWO TIERS: $66.50 for a $2,500 benefit or $106.40 for a $4,000 benefit

Blue Cross Blue Shield of Wisconsin: Optional Maternity Benefit additional cost
$96.82

Humana: Optional Maternity Benefit additional cost
$177

Georgia Findings
For Georgia, we chose an Atlanta zip code: 30303 (same DOBs)

The blogger's information is correct for one carrier in Georgia: Blue Cross Blue Shield only offers maternity benefits on Family Plans.

However, Kaiser includes maternity for everyone and Humana offers the option to add maternity benefits when you sign up. So, she has options to choose a more liberal carrier like Kaiser or Humana over BCBS of GA and get a plan with maternity coverage.

The ability to choose the benefits that you need is what helps make individual health insurance more affordable. If she believes she may need maternity benefits, she has the option to choose a plan that
provides this coverage if she lives in Atlanta. I have no idea in which part of Georgia she lives, nor do I know if Kaiser and Humana offer the same plans in all counties in Georgia. She can check that out back on our site, and/or she can use our Customer Care Center to help answer specific questions about carriers in her area.

The point here is that the individual health insurance market does offer choice. If this woman knew that she didn't need to worry about having kids, then she wouldn't want to pay the extra cost for the
maternity care. If she thinks she may need it, then it is an extra cost. It's kind of like buying so many other things in the world, where there is a base price for a product, and then if you want more
features and benefits, you can pay for them...and if you don't want them or don't want to spend the money, you don't have to.

I hope this help. Thanks for letting us know about this woman's issue. Please let me know if you need anything else on this."

So, there you go. So many choices sometimes obscures the full picture. Now if kittymel lived in New York City where they have exactly one plan they offer to individuals...oh, yeah...that wouldn't be so cool either!