Being self-employed can be amazing. It can also be amazingly difficult at times. You run the ship, which means you may not have access to the support staff you had when you worked for a larger company. You also don’t have access to some of the benefits many larger companies offer, such as health insurance.
With a little research, you may be able to find an affordable individual health insurance plan. But you may or may not be able to find one that offers a maternity care coverage rider. When we moved from Ohio to Illinois, we were only able to find one individual health insurance provider that offered maternity care coverage.
And I consider our situation to be lucky. I have a self-employed friend who lives in Texas who wasn’t able to find a single individual health care plan that offered maternity care coverage.
What You Need to Know About Maternity Care Coverage and Individual Health Insurance
As I quickly learned, not all individual health insurance plans offer maternity care. Unlike many group health care plans which provide maternity care coverage as part of the standard policy, most individual policies that offer maternity care usually only offer it as a rider, and with certain limitations.
For example, most plans require a 12-month waiting period before the maternity care coverage kicks in. This is understandable. Otherwise, people would never buy the coverage until they got pregnant and needed it.
You need to pay special attention to that 12-month waiting period. My wife and I were insured under a group health care plan when we had our first child. About six months later, I switched to an individual health care policy because I knew I was going to be leaving my day job and would need to obtain my health insurance on my own.
It was also open season, and our rates had increased enough that making the switch before I became self-employed was a good move. My wife and I knew we wanted to have at least one more child, but we weren’t sure when, so we purchased the maternity rider (these vary in cost; I believe ours is around $140 a month).
We paid for maternity care coverage for well over the 12-month waiting period before we moved from Ohio to Illinois. Here is the kicker: health insurance doesn’t transfer with you when you move. Health insurance policies are regulated at the state level, and unfortunately, you can’t take them with you when you move.
There are a lot of reasons for this, which are laid out quite well in the following article featured on Forbes: Will Buying Health Insurance Across State Lines Reduce Costs?. (I’m not a health insurance expert, but I believe standardizing health insurance requirements and breaking down the barriers for insurance providers to operate in any state would bring down insurance costs).
Back to our move to Illinois: One of the first things we did upon arriving in Illinois was to look into buying health insurance. As I mentioned in the opening paragraph, we were only able to find one plan that offered a maternity care rider. We found it through eHealthInsurance (which is the same place we found our health insurance plan when we lived in Ohio).
We also looked at several other websites that aggregate health insurance policies, we visited individual company websites, and I contacted several independent insurance agents who specialize in self-employed health insurance plans. We left no stone unturned. In the end, we went with the only option available to us.
New policy, new 12-month waiting period. When we talked about maternity care coverage with the IL insurance company, we were told we would have to go through another 12-month waiting period. This was discouraging since we had already been paying for a maternity care rider for about a year and a half and were hoping to expand our family.
Thankfully, we asked a bunch of questions, did our research, and asked our customer service rep to do some digging on his end. Our story has a happy ending. We had Anthem Blue Cross Blue Shield in Oh, and Blue Cross Blue Shield of IL. I’m not sure exactly how it works, because I believe that technically, they are different companies. But because they are both in the Blue Cross family, the time we spent in the 12 month waiting period in OH transferred with us to IL.
However, there were some problems getting the paperwork to transfer correctly. It all worked out in the end, but for a while I thought I was going to have to take a part-time job at Starbucks or another company that offers health benefits to part-time workers, just so I wouldn’t have to pay $20 grand out of pocket (or more) for our child’s birth. With health care, it’s not the known costs that scare me, but the unknown.
Each State and Policy Are Unique
I wish I could tell everyone who needs a maternity care policy to go to eHealthInsurance or another insurance shopping site, compare a few plans, then buy the best plan for their needs. This works for many people, but not everyone. State laws and health insurance requirements vary. And you may find yourself in a similar situation as I did – you move after you already had coverage under your previous policy, and the clock may start over for you.
Getting maternity care coverage when self-employed can be a tricky situation and one that doesn’t always have easy or sometimes affordable solutions.
Will the Affordable Care Act (Obamacare) Fix This?
I honestly don’t know. I’m not sure there is an answer yet, but I hope the answer is yes. There are mixed reviews regarding the Affordable Care Act, but at the end of the day, most people are less concerned about politics and more concerned about having access to affordable health care. I count myself among that group.
Hopefully, the health care exchanges will make it easier for people who don’t currently have access to these plans to get the coverage they need.
I consider us to be lucky, even with the troubles we had. I know people in other states who can’t find maternity care coverage through individual health insurance plans.