If you live in Arizona and want to become pregnant, you should be aware that a normal delivery, meaning a delivery in which no medical complications arise, can cost you more than $10,000.
The large majority of health insurance plans available in Arizona do not include maternity benefits. By law, they all do include “complications of maternity” benefits, but that does not mean you have maternity coverage if you are on one of those plans. Today, a c-section (or cesarean section, which is a surgical procedure used to deliver your baby through an incision in your abdomen) is not considered a complication of maternity, and in all likeliness, a c-section would have to be paid by you, not your insurance company. A c-section can add an additional $5000 to that $10,000 figure mentioned above.
Here in Arizona, there are three major health insurance companies that offer health plans with maternity coverage — Blue Cross Blue Shield of Arizona, Cigna and Health Net. If you are a female, 25 years old and live in Phoenix, the monthly premium for you for the Blue Cross plan is $591 (they have a second plan with maternity that is even MORE expensive, at $743 per month- so high we usually don’t even quote it). The comparable plan from Cigna is $376. At Health Net, the monthly premium is $458. The Blue Cross plan is available statewide, as is the Health Net plan. The Cigna plan is only offered in select Arizona counties.
With all three plans, you must be on the plan for 12 months before you become pregnant. Prenatal care and delivery costs are not covered unless you deliver your baby 21 months after your policy starts. On all three plans, you are responsible for some of the costs. With Blue Cross, you have a deductible of $1,000 which you have to pay, then you pay 20% of your maternity bills, and the 20% that you have to pay stops once you’ve paid $3,500 over and above your deductible. So your total costs to have a baby, if you are on the Blue Cross plan, are as follows: 21 months of paying the monthly premium of $591 comes to $12,411. Add another $4,500 that Blue Cross makes you pay, and your total out of pocket costs to have your baby becomes $16,911.
At Cigna, the deductible is also $1,000, but the 20% that you have to pay stops at $3,000, for a total of $4,000. Multiply the monthly premium of $376 times 21 months, and you’ll pay Cigna total premiums of $7,896. Add these two together, and you’ll find your expenses to have a baby while on the Cigna plan to be $11,896.
On the Health Net policy, you have the same deductible of $1,000, with your 20% the same as Blue Cross, which is another $3,500, for a total of $4,500. Add this to the total 21-month premium outlay of $458 per month, or $9,618. The grand total to have your baby if you are on the Health Net plan comes to $14,118.
Obviously, you have the lowest out of pocket costs if you are on the Cigna plan. However, at Lehrman Group, we offer another solution to these extremely high costs that works very well for many people. A lot of Arizona hospitals, especially those located in Phoenix and Tucson, offer steeply discounted rates to cash-paying customers that use their birthing centers. We know of a hospital in Phoenix that charges you a total of $3,000 to have your baby at their birthing center. If you have a health insurance policy that does not include maternity benefits, your monthly premium costs are much less than those that include maternity benefits. As an example, a very good Blue Cross policy for a female at age 25, living in Phoenix, is just $151 per month. That’s $440 per month less than the Blue Cross plan that comes with maternity benefits! You could purchase the $151 plan, have your baby ten months later, pay cash to the birthing center, and win every way you look at it — you DON’T have to wait 21 months to have a baby, and you don’t have to pay over ten thousand dollars out of pocket to have your baby. You can pay $151 for ten months, for a total premium cost of just $1,510. You pay the birthing center $3,000, and your total out of pocket costs to have your baby comes to just $4,510. If anything goes wrong during your delivery at the birthing center, you don’t need to be concerned with emergency costs, because your policy, even though it does not provide maternity benefits, DOES have “complications of maternity” benefits.
The non-maternity coverage scenario does not work for everyone, particularly those women that have had difficult deliveries or pregnancies in the past. But odds are in your favor that it will work for you. Talk with us. Call us at (800) 600-9663, and we’ll try to give you the best advice for your circumstances. Click here if you’d like us to send you a quote of your different health insurance options in Arizona.
