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New Year Brings New Maternity Changes for Individual Health Insurance in Colorado

January 6th, 2011 – Starting on January 1st, 2011, all health insurance carriers are required to cover pre-natal and delivery expenses for pregnancy on NEW individual health insurance policies issued in Colorado.

Please note that carriers are NOT required to offer maternity on individual policies that were issued before 2011.  Some carriers are offering this benefit older policies and others are not.  Anthem Blue Cross Blue Shield, Colorado’s largest health insurance carrier, has said they will offer maternity on existing policies issued prior to 2011.  We have not seen anything in writing to this point yet, but we have little reason to doubt this.

The new maternity benefit means that pregnancy will be treated much like an illness would; meaning that if your plan has copays for office visits then the copays typically should cover prenatal doctor office visits.  Delivery should typically be covered subject to the plan’s deductible and/or coinsurance.

While this is good, it is worth noting that most plans operate on a calendar year deductible where the deductible resets to zero on January 1st. This means that for families with babies born near New Year’s Day it could be costly if a hospital stay is required that spans the current and upcoming year.

Carriers for individual health insurance plans in Colorado (i.e. NOT an Employer Sponsored Health Insurance Plan) can still treat a current pregnancy as a pre-existing condition, so if you have to buy your own health insurance policy it is critical to get health insurance coverage BEFORE one becomes pregnant.  Please follow the link for more information on getting a new Colorado health insurance plan with maternity coverage.

If you would like to read the law itself, you’ll find it in this article.

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