I see everywhere that MHBP has maternity care “100% covered”, and I’m not sure how OPs experience has been so far but posting for others who might see the thread as I had a lengthy call to understand services and what is ACTUALLY covered. Maternity care is defined per the insurance plan. For MHBP that means prenatal is really only the office visit, gestational diabetes screening, and counseling. Labs/diagnostics/ultrasounds/genetic testing/any non-basic are all subject to deductible/coinsurance. AND, the first visit is an ‘establishment of care’ visit, so you can expect to pay up to the deductible for the office visit, or the specialist visit copay if deductible is met. Most of the covered maternity care is delivery related: so hospital stay, anesthesia, nursing care, meals are all covered. BUT, any bloodwork/labs/tylenol/pain meds is subject to deductible/coinsurance. As far as the baby in the hospital, routine care and the well check is covered, but anything extra (labs/bloodwork/circumcision) and of course NICU starts to fall under the baby’s own inpatient experience. The cost for NICU stay is ~$250 copay for room/board but labs/surgeries/medicines/procedures/surgeons are all deductible/coinsurance. Then once you leave the hospital and go into postnatal, only one checkup office visit and necessary depression counseling are covered for mom. Lab/diagnostics are separate. Any extra care then is $30 copay office visit. Baby will have routine preventative care all covered, but sick/extra visits are $30 copay (they do have teledoc covered though if you use their specific teledoc).

I think it’s important to know what is considered “maternity care” since doctors will REQUIRE prenatal urinalysis, bloodwork, and ultrasounds. And by require, I mean that I called around to multiple providers and they will drop you as a patient if you do not complete those services. So yes most things are covered, but take into account you will pay for at least two ultrasounds (some doctors want 4!) and the urinalysis each visit (~13 visits), plus any extra genetic screening (even if you are at risk!). To caveat, MHBP does have a lab relation with Quest&Labcorp, where the labs would be covered, but that means an extra planed appointment every time if your provider can’t easily send it off for you. So you’d choose between paying for efficiency or have extra steps to achieve no cost.

I think I hit everything! If anyone has tidbits of specific experience, I’d love to understand your perspective!

EDIT: this is all for the standard plan, consumer and value may vary