About Maternity Health Insurance in California

If you are not covered by your employer's group insurance plan, getting maternity insurance coverage can be a challenge. Fortunately, the California government provides several options to poor and middle-income families, which allow them to get maternity coverage after they get pregnant at free or affordable rates. Those who like to plan ahead and are not yet pregnant can easily get affordable coverage from private insurance companies.

HMO option

• If you are from a middle-income family and are not yet pregnant, you can get affordable coverage from health maintenance organizations (HMO) like Kaiser Permanente and Health Net. Kaiser Permanente has several plans for people on a budget. If you know that you could be getting pregnant soon, it is better to buy a zero-deductible, zero-coinsurance plan, although they have slightly higher premiums. The deductible plans have lower premiums but the deductible and coinsurance can add up and prove to be more expensive.

PPO option

• Unlike HMOs that require that patients see only the contracted doctors, the preferred provider organization (PPO) plans allow you to see any doctor and visit any hospital in their network. If you prefer the flexibility of a PPO plan, Blue Shield of California and Anthem Blue Cross both provide maternity coverage in California. Unfortunately, PPO plans are much more expensive. For example, as of 2010, The Shield Spectrum PPO Plan 5000 from Blue Shield of California has low premiums but a $5,000 deductible and 30 percent coinsurance. Anthem Blue Cross plans are more expensive.

Medi-Cal

• Once you are already pregnant, you have several options to get insurance, depending upon your household income. If your household income is below 200 percent of the federal poverty level (FDL), you may be eligible for no-cost prenatal and postnatal care. The Medi-Cal income limit for pregnant women is higher than the income limit for other Medi-Cal program and also has a share of cost requirement.

The Healthy Families Program

• The Healthy Families Program is for children under 19 years who are not eligible for no-cost Medi-Cal coverage. Depending on the county of your residence, you can choose from several HMO plan options. Under the Healthy Families Plan, these plans are available at low monthly premiums. Although the program is designed especially for children under 19 years of age, you can also get coverage if you are pregnant and your child will be eligible for the program after its birth. A child is eligible for the Healthy Families Program if the family is not covered by employer's group insurance, is living in California, is not eligible for no-cost Medi-Cal and meets the citizenship requirements.

AIM Program

• The Access for Infants and Mothers (AIM) Program is a health insurance program for pregnant women who are not covered for other health insurance. To be eligible, a woman must be pregnant, a California resident, not eligible for Medi-Cal or any other program, not covered by a private health insurance and have income within the AIM guidelines. The total premium for AIM for the entire pregnancy is 1.5 percent of your total annual income which has to be paid in 12 installments. Also, there are no co-pays and no deductibles under the AIM program.