Maternity Coverage in Illinois

Happy Holidays and Merry Christmas!

I hope that the readers of my postings, which are few, had a great holiday weekend :)

As of the past month there have been quite a few inquiries on obtaining maternity coverage in the private market.  Unfortunately, there is only one private health insurance carrier that offers an optional Maternity benefit, Blue Cross and Blue Shield of Illinois (BCBSIL).  This optional benefit must be elected at time of application or on the anniversary date of a current BCBSIL plan.

The benefit is payable after a 12 month waiting period with continual monthly premium payments.  All pre-natal care will be covered after the waiting period to then include delivery and post-natal care.  After the waiting period all covered care will be subject to your plans coverage.  Once post-natal care is completed you will then request to remove the Maternity benefit.

If a plan member with the maternity benefit delivers by Cesarean C- Section and removes the benefit, and is to add the benefit again at plan anniversary, there will be complications.

When applying for the benefit at anniversary, all members of the plan must go through medical underwriting, and until January 1st, 2014 (health care reform), BCBSIL can place condition specific exclusion riders.  For example, BCBSIL would offer the optional Maternity benefit but will place an exclusion on future C- Sections, not covering it at all.

Now...the final thing to mention is the Maternity Benefit that is available with the Illinois Comprehensive Health Insurance Plan (ICHIP).  ICHIP is the state high risk pool and the benefit is available with their Traditional coverage option.  To qualify for this coverage you must not be insurable in the private market or have a private policy that is more costly than the ICHIP.  The optional Maternity benefit has a 9 month waiting period.

For additional information on Maternity coverage please contact the shoppe.

Best,

The Shoppe