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Every plan in California now provides maternity coverage. But some plans are better at reducing your costs. We'll show you which ones. Picking the right plan is now very important. Although health care reform (Obamacare) is supposed to reduce costs, most thought they would see the reduction in lower monthly premiums. We'll briefly cover the key benefits you'll want in good maternity insurance, then we'll show you the Best California Maternity Insurance Plans, and we'll review how Obamacare has affected maternity care options in California. Finally, we'll give you a simple step by step process to find the right health coverage for your pregnancy and delivery, and show you a simple trick to reduce the overall cost of your baby by timing when you give birth. |
See the Top Pregnancy Health Plans in San Diego
All Obamacare health insurance provides maternity coverage, but that doesn't make ANY plan a good option. We analyzed all the California health insurance options and show you which are the Best California Maternity Insurance plans. The best pregnancy coverage for you is the one that reduces your total out of pocket costs, including the monthly premiums and any costs associated with the prenatal care and delivery. To get the top maternity insurance, California mothers need to talk to the experts. At SPF Insurance we are your maternity insurance experts. Because of the regional differences in which plans are available in California, the best plans in San Diego might not be the best plans in Fresno or San Francisco. Ask us and we'll do the analysis for your region and show you which plans are your best options.
Best Maternity Insurance In California Post Obamacare
The best insurance for pregnancy is typically, but not always, a Co-Payment Platinum 90 HMO plan. We've analyzed the health insurance plans in each region of California and determined what the top plans are for you. The top plans are different in each region. This happens because many of the smaller insurance companies only operate in a few of the 19 regions. Plus some of the major companies are not available in every region.
Select the tab with the name of your county/region to see the best maternity choices for the birth of your baby.
We've started working on updates for 2019. If you see "2019" above the list of plans in your region, that means it's updated to 2019 plans/rates.
- San Diego
- Contra Costa County
- Orange County
- Fresno, Kings, Madera Counties
- Los Angeles (South)
- Los Angeles (North)
- Alameda County
- Santa Clara County
- San Francisco County
- San Mateo County
- Mariposa, Merced, San Jaoquin, Stanislaus, and Tulare
- Monterey, San Benito, Santa Cruz Counties
- Riverside & San Bernadino Counties
- Sacramento, Yolo, Placer, El Dorado Counties
- Napa, Sonoma, Marin, Solano Counties
- Kern County
- San Luis Obispo, Santa Barbara and Ventura Counties
- Northern Counties
- tab 16
Best Maternity Plans In San Diego County
2020
- Sharp Health Plan Platinum 90 (HMO)
- Health Net Gold 80 (HMO)
- Sharp Health Plan Gold 80 (HMO)
- Health Net Platinum 90 (HMO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO Trio)
- Molina Healthcare Gold 80 (HMO) CoveredCA Only
- Blue Shield Platinum 90 (HMO Trio)
- Health Net Gold 80 (ECPPO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $5,392
TOOPC = $5,755
TOOPC = $5,938
TOOPC = $5,964
TOOPC = $6,300
TOOPC = $6,540
TOOPC = $6,692
TOOPC = $6,757
TOOPC = $7,270
TOOPC = $8,197
TOOPC = $9,811
TOOPC = $10,296
TOOPC = $11,125
Total Out Of Pocket Cost in San Diego California
is based upon a 30 year old woman living in Encinitas, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery.
The average 2019 vaginal childbirth in San Diego County increased less than 1% to $16,030. The average cesarean childbirth costs $20,709.
There is a pretty significant shuffling of the top childbirth plans in San Diego County for 2020. Sharp Health Plan moved ahead of Health Net for the top spot. The previous top plan, Health Net's Platinum 90 HMO, fell to fourth place. These changes are the result of significant price reductions by Sharp and a smaller price reduction for the Health Net Gold 80 HMO plan.
Overall, the best maternity plan for 2020 has a lower cost than the top health plan in 2019.
HMO plans continue to dominate the top of the lists.
If you have to have a PPO plan, then the best options are from Blue Shield. Although the Health Net Gold 80 EnhancedCare PPO plan has a slightly lower total cost, the network for the Health Net ECPPO is very small, so the Blue Shield PPO plans will be a better option for most of you. The Blue Shield Gold 80 PPO plan is actually a lower cost option than the Blue Shield Platinum 90 PPO. This is because the monthly premium of the Platinum 90 PPO plan is so high.
To see the detailed breakdown of the Total Out Of Pocket Costs for the San Diego California maternity insurance options, click here.
Top Maternity Plans In Contra Costa County
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Sutter Health Plus Platinum MI01 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Gold MI01 (HMO)
- Blue Shield Platinum 90 (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
- Health Net Platinum 90 (EPO)
TOOPC = $6,165
TOOPC = $6,362
TOOPC = $8,569
TOOPC = $8,984
TOOPC = $9,693
TOOPC = $10,974
TOOPC = $10,797
TOOPC = $11,333
TOOPC = $13,317
Total Out Of Pocket Cost in Concord California
is based upon a 30 year old woman living in Walnut Creek, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
The average vaginal childbirth in the Bay Area costs $18,550. The average cesarean childbirth costs $25,881.
There were significant price increases for maternity plans in Contra Costa County in 2018 and this resulted in significant cost increases to have a baby. Kaiser Permanente plans experienced the smallest changes, with increases of only $200, while Blue Shield and Health Net had cost increases of $1,016 to $3,494.
Sutter Health Plus is making a big move in this region to gain market share. The Sutter Health Plus Platinum plan is now the 3rd best option and the Gold plan is number five. Blue Shield and Health Net both fell back in the standings due to their cost increases. Contra Costa County is definitely Kaiser country and Sutter Health is trying to keep Kaiser from running away with everything.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Contra Costa California maternity insurance options, click here.
Top Maternity Plans In Orange County
2019
- Health Net Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Oscar Health Insurance Gold 80 (EPO)
- Health Net Platinum 90 (HMO)
- Blue Shield Gold 80 (HMO Trio)
- Kaiser Permanente Gold 80 (HMO)
- Oscar Health Insurance Platinum 90 (EPO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Molina Healthcare Gold 90 (HMO) CoveredCA Only
- Blue Shield Platinum 90 (HMO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,046
$6,404
$6,432
$6,507
$6,579
$6,617
$7,069
$7,309
$7,989
$8,455
$9,094
Total Out Of Pocket Cost in Orange County California
is based upon a 30 year old woman living in Irvine, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
The average vaginal childbirth in Orange County costs $15,712 in 2017, down 0.01% from 2017, and the average cesarean childbirth costs $19,704, down slightly from 2017.
The most notable change from 2018 is that many plans experienced significant rate increases. Having a baby in Orange County is now $280 to $848 more expensive than last year.
Health Net kept the top maternity health insurance spot with their CommunityCare Gold HMO plan. Most of the top plans in Orange County changed, and Gold plans now tend to be better than the Platinum plans.
Blue Shield's Gold HMO plan had the smallest rate increase and climbed up to the 5th spot in the list.
If you will only be in the delivery plan for a small number of months, remember to check the price difference between Gold and Platinum to see if a Platinum plan would be lower cost for you.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Orange County California maternity insurance options, click here.
Best Maternity Insurance Plans in Fresno, Kings, and Madera Counties
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $5,331
$5,601
$7,105
$8,029
Total Maternity Insurance Cost in Fresno California
is based upon a 30 year old woman living in Fresno, CA, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
The average vaginal childbirth in California costs $17,028, up ~1% from 2017. The average cesarean childbirth costs $21,396, a 1.7% decrease from 2017.
A difference between 2018 and the 2017 Obamacare maternity plans is the price to have a baby has gone up on average $409 in this region. The biggest change is that Anthem Blue Cross and Health Net are no longer offering coverage in this region of California.
The 2 HMO offerings from Kaiser Permanente are the lowest cost in this region. If you choose to have your baby using Blue Shield you will pay at least $2,554 more.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Fresno, Kings, and Madera California maternity insurance options, click here.
Best Maternity Plans In Los Angeles California South
2019
The South Los Angeles region (Region 16) includes the following ZIP codes:
90001 – 90510
91301 – 91499
91601 – 91618
- LA Care Platinum 90 (HMO) CoveredCA Only
- LA Care Gold 80 (HMO) CoveredCA Only
- Health Net Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Health Net Platinum 90 (HMO)
- Oscar Health Insurance Gold 80 (EPO)
- Blue Shield GOLD 80 (HMO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Oscar Health Insurance Platinum 90 (EPO)
- Molina Healthcare Gold 80 (HMO) CoveredCA Only
- Health Net Gold 80 (EC PPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs = $5,069
$5,224
$5,840
$5,915
$6,168
$6,251
$6,485
$6,756
$6,787
$7,136
$7,549
$9,320
$9,625
Total Out Of Pocket Cost in Long Beach California
is based upon a 30 year old woman, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
The average vaginal childbirth in Los Angeles costs $15,712 in 2018, down 0.01% from 2017, and the average cesarean childbirth costs $19,706, down slightly from 2017.
The cost to have a baby in South Los Angeles is increasing $181 to $1,223 in 2019. LA Care maintains the top spot in the 2019 list. The LA Care Platinum 90 had an increase of $181, while Health Net Platinum 90 HMO had the largest price increase ($1,223) in the region.
PPO plans have almost fallen completely out of the list, but we've kept Blue Shield on the list, along with the new Enhanced Care PPO network plan from Health Net. Oscar offers an EPO plan which functions like a PPO, and it is priced much lower than the other PPO options in Los Angeles. If you need a PPO/EPO I suggest you check out Oscar.
The domination of the list by HMO plans is going to continue for the foreseeable future.
To get the detailed breakdown of the Total Out Of Pocket Costs for the South Los Angeles maternity insurance options, click here.
Top Maternity Insurance Los Angeles North
2019
The North Los Angeles region (Region 15) includes the following range of ZIP codes:
90601 – 91226
91501 – 91526
91702 – 93599
- LA Care Health Plan Platinum 90 (HMO) CoveredCA Only
- LA Care Health Plan Gold 80 (HMO) CoveredCA Only
- Health Net Gold 80 (HMO)
- Health Net Platinum 90 (HMO)
- Blue Shield Gold 80 (Trio HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Oscar Health Insurance Gold 80 (EPO)
- Blue Shield Platinum 90 (Trio HMO)
- Molina Healthcare Platinum 90 (HMO) CoveredCA Only
- Oscar Health Insurance Platinum 90 (EPO)
- Molina Healthcare Gold 80 (HMO) CoveredCA Only
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs = $4,764
$4,954
$5,218
$5,480
$5,524
$5,672
$5,945
$6,374
$6,402
$6,891
$6,996
$7,637
$8,309
$8,477
Total Out Of Pocket Cost in Los Angeles California
Is based upon a 30 year old woman living in Glendale, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
in Los Angeles California the average vaginal childbirth costs $15,712, and the average cesarean childbirth costs $19,706.
In 2019 the Los Angeles market pregnancy insurance price increases range from $406 to $1,838. The largest increases came in the PPO plans. This is similar to what is happening to all PPO plans in California.
HMO policies still dominate the top of the list. The best PPO plan is from Oscar Health in the 8th spot, although Oscar uses an EPO network which excludes out of network providers.
To see the detailed breakdown of the Total Out Of Pocket Costs for the North Los Angeles maternity insurance California options, click here.
The Top Maternity Insurance In Alameda County
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Platinum MI01 (HMO)
- Blue Shield Platinum 90 (HMO)
- Sutter Health Plus Gold MI02 (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,315
$6,498
$7,560
$8,944
$9,058
$10,396
$10,995
$11,042
Total Out Of Pocket Cost in Oakland California
Based upon a 30 year old woman living in Berkeley, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
The average vaginal childbirth in the Bay Area costs $21,871 up 2% from 2016. The average cesarean childbirth costs $29,384 up 3.7% from 2016.
Blue Shield is introducing a new HMO network option in Alameda County, and these plans will offer a lower cost option to women who don't want to use Kaiser for their childbirth.
The biggest change between 2017 and the 2018 Obamacare maternity options is that the cost to have a baby went changed by $-87 to $1879. This is a large increase. Sutter actually reduced the price of their Platinum plan, and Blue Shield has the largest premium increase.
In Alameda County, you are forced to decide between Kaiser Permanente or using your OB/GYN at the hospital of your choice for a much higher price. The difference between Kaiser and the lowest alternative (Blue Shield Gold HMO Trio) is $1,062.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Oakland maternity insurance California options, click here.
Top Maternity Insurance In Santa Clara County
2018
- Valley Health Plan Gold 80 (HMO) CoveredCA Only
- Valley Health Plan Platinum 90 (HMO) CoveredCA Only
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Platinum Individual MI01 (HMO)
- Blue Shield Platinum 90 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Anthem Blue Cross Gold 80 (EPO)
- Anthem Blue Cross Platinum 90 (EPO)
- Health Net Platinum 90 (EPO)
- Health Net Gold 80 (EPO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,107
$6,124
$6,315
$6,498
$7,728
$8,710
$9,284
$9,641
$10,263
$10,346
$10,376
$10,742
$11,355
Total Out Of Pocket Cost in San Jose California
Based upon a 30 year old woman living in Santa Clara county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in Santa Clara costs $16,948 on average, a reduction of almost 4% from 2017. The average cesarean childbirth costs $26,2224, which is an increase of 3.2% from 2017.
The biggest change between 2017 and 2018 is that the Anthem Blue Cross HMO plans are no longer available. The price increase between 2017 and the 2018 Affordable Care Act maternity plans is between $108 to $1,768.
The price gap between the top HMO plans and the lowest cost PPO plan is now $4,156. This gap has been widening for the last several years. Therefore the flexibility of a PPO network is costly for maternity purposes. Determining which networks your OB/GYN accepts is critical in Santa Clara County.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Clara maternity insurance California options, click here.
Top Maternity Insurance Plan In San Francisco County
2018
- Kaiser Permanente Plat 90 (HMO)
- Chinese Community Health Plan Plat 90 (HMO)
- Chinese Community Health Plan Gold 80 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Oscar Health Gold 80 (EPO)
- Blue Shield Gold 80 (HMO)
- Oscar Health Plat 90 (EPO)
- Sutter Health Plus Plat Individual MI01 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Blue Shield Gold 80 (PPO)
- Health Net Plat 90 (EPO)
- Blue Shield Plat 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,762
$6,771
$6,884
$6,910
$8,320
$8,480
$8,896
$9,661
$11,034
$11,750
$11,931
$12,051
Total Out Of Pocket Cost in San Francisco California
Based upon a 30 year old woman living in San Francisco, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in San Francisco costs $21,871 on average. A cesarean childbirth costs $29,384.
In 2018, Chinese Community Health and Kaiser Permanente still hold the top spots in San Francisco County.
Oscar Health offers the lowest cost EPO plan in this area. Their Gold EPO plan will cost $1,558 more than the lowest cost HMO plan. The trend of PPO/EPO rate increases being greater than HMO increases is continuing. The smallest EPO/PPO cost increase was $916 and the largest was $1,864. Meanwhile, the HMO cost increases ranged from $150 to $413.
Blue Shield of California also introduced an HMO option in San Francisco County. These HMO plans are lower cost than Blue Shield's PPO plans, but the network is also smaller. You will need to check to see if your OB/GYN is in the Blue Shield HMO network.
Obamacare requires you make a choice between staying with your Obstetrician and paying a higher price for PPO/EPO coverage, or opting to pay less by selecting a physician from a smaller HMO network.
To see the detailed breakdown of the Total Out Of Pocket Costs for the San Francisco maternity insurance California options, click here.
Best Maternity Insurance Plan In San Mateo County
2018
- Kaiser Permanente Plat 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Chinese Community Health Plan Plat 90 (HMO)
- Chinese Community Health Plan Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Plat Individual (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Plat 90 (PPO)
- Health Net Platinum 90 (EPO)
Total Out Of Pocket Costs (TOOPC) = $6,762
$6,905
$7,273
$7,339
$8,998
$9,375
$12,282
$12,762
$12,688
Total Out Of Pocket Cost in Daly City California
Based upon a 30 year old woman living in Daly City, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in San Mateo costs $21,871 on average. A cesarean childbirth costs $29,384.
The most notable difference between 2017 and 2018 in this region are that Anthem Blue Cross is no longer available. The range of price changes from 2017 is -$136 to $1,481.
HMO plans from Kaiser and Chinese Community still dominate in San Mateo County. The best of the PPO plans require that you pay $5,520 more than the lowest cost HMO plan. That is a steep price for the flexibility of having a PPO network.
To see the detailed breakdown of the Total Out Of Pocket Costs for the San Mateo maternity insurance California options, click here.
- Kaiser Permanente Plat 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Sutter Health Plus Plat Individual MI01 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Blue Shield Platinum 90 (HMO)
- Anthem Blue Cross Plat 90 (EPO)
- Anthem Blue Cross Gold 80 (EPO)
- Blue Shield Gold 80 (PPO)
- Health Net Plat 90 (EPO)
- Health Net Gold 80 (EPO)
Top Maternity Insurance In Mariposa, Merced, San Jaoquin, Stanislaus, and Tulare County
2018
Total Out Of Pocket Costs (TOOPC) = $5,569
$5,818
$7,462
$8,083
$8,604
$9,761
$10,077
$10,131
$10,502
$10,710
$11,103
Total Out Of Pocket Cost in Merced California
Based upon a 30 year old woman living in Stockton, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in San Joaquin county costs $17,623 on average, an increase of 9.5% from 2017. A cesarean childbirth costs $21,396, which is a reduction of 1.7% compared to 2017.{California averages}
The big change between 2017 and 2018 is how much the hospital cost to have a baby went up in this San Joaquin Valley region, along with the large health plan rate increases Anthem Blue Cross, Blue Shield, and Health Net had.
As a result, the total cost to have a baby increased between $117 to $2,852. The HMO plans tended to have lower price increases compared to the PPO plans.
Kaiser Permanente is easily the best option if you want to deliver a baby for the smallest cost. Second place is now occupied by Sutter Health Plus. The Platinum Sutter plan actually had a small price reduction in 2018.
The cost to select a health plan with a PPO network is substantial. It will cost you about $4,500 more to select a PPO plan instead of opting for an HMO plan in this area.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Merced maternity insurance California options, click here.
The Best Maternity Insurance In Monterey, San Benito, Santa Cruz County
2018
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (HMO)
- Sutter Health Plus Plat 90 MI01 (HMO)
- Blue Shield Plat 90 (HMO)
- Health Net Plat 90 (EPO)
- Health Net Gold 80 (EPO)
- Sutter Health Plus Gold 80 MI02 (HMO)
- Blue Shield Gold 80 (PPO)
Total Out Of Pocket Costs (TOOPC) = $6,315
$6,497
$7,359
$7,515
$8,787
$9,338
$10,376
$10,530
$12,677
Total Out Of Pocket Cost in Santa Cruz California
Based upon a 30 year old woman living in Monterey County or Santa Cruz County, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
The average vaginal childbirth in Santa Cruz California costs $17,028, an increase of 5.8% over 2017. An average cesarean childbirth costs $21,396 which is a 1.7% reduction from 2017.{California averages}
The most notable changes in 2018 are that Anthem Blue Cross is gone, and Sutter Health Plus is now providing HMO maternity insurance plans here.
The cost to have a baby in this region changed between -$426 to 2,502 higher in 2018.
Losing Anthem Blue Cross did not materially change the better pregnancy health plan options in these counties because Anthem's plans were higher priced, and Anthem only offered an EPO network. Both of the remaining PPO networks from Blue Shield and Health Net saw large price increases so they are not very attractive.
The addition of Sutter Health Plus gives you another lower cost option and the ability to go to Sutter doctors and hospitals.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Monterey maternity insurance California options, click here.
Best Maternity Insurance Plans In Riverside & San Bernadino Counties
2017
- Health Net Platinum 90 (HMO)
- Health Net Gold 80 (HMO)
- Anthem Blue Cross Platinum 90 (HMO)
- Anthem Blue Cross Gold 80 (HMO)
- Blue Shield Platinum 90 (PPO)
Total Out Of Pocket Costs (TOOPC) = $4,484
$4,800
$4,904
$5,400
$6,782
Total Out Of Pocket Cost in Palm Springs California
Based upon a 30 year old woman living in Riverside county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in Riverside county costs $12,623 on average, and a cesarean childbirth costs $14,106.
In 2017 the best maternity plans have HMO networks in Region 17. Because of this, finding a good pregnancy PPO plan that your doctor accepts might be challenging.
The best PPO options are from Blue Shield of California. The Anthem Blue Cross and Health Net PPO networks are more than $1,000 more than the Blue Shield's PPO.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Riverside maternity insurance California options, click here.
Top Maternity Insurance Plans In Sacramento, Yolo, Placer & El Dorado Counties
2017
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Western Health Advantage Platinum 90 (HMO)
- Western Health Advantage Gold 80 (HMO)
- Sutter Health Plus Platinum Individual MI01 (HMO)
- Blue Shield Gold 80 (HMO)
- Health Net Platinum 90 (HSP)
- Blue Shield Platinum 90 (HMO)
- Sutter Health Plus Gold Individual MI02 (HMO)
- Anthem Blue Cross Platinum 90 (EPO)
- Blue Shield Gold 80 (PPO)
- Anthem Blue Cross Gold 80 (EPO)
- Health Net Gold 80 (HSP)
Total Out Of Pocket Costs = $5,972
$6,156
$6,548
$6,660
$7,735
$7,824
$8,077
$8,684
$9,003
$9,607
$10,455
$10,467
$10,775
Total Out Of Pocket Cost in Sacramento California
Based upon a 30 year old woman living in Sacramento county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
A vaginal childbirth in Sacramento county costs $20,596 on average, and a cesarean childbirth costs $32,729.
The major difference between 2016 and 2017 Obamacare maternity plans in this region is that the PPO plans had substantial cost increases. For example, the largest increase was the Blue Shield Gold 80 PPO plan at $3,319. While the smallest change happened on the Kaiser Platinum 90 HMO plan with a $216 increase.
In region 3 Blue Shield introduced a new HMO network, and Anthem changed it's PPO network to an EPO network. The cost of a childbirth in this region is above the average cost for the state as a whole. Therefore, you live in a region with higher than average costs.
the cost difference between the best HMO and PPO pregnancy plans is now $1,435. This is a heavy price to pay for the flexibility of being able to pick your own doctor using a PPO plan.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Placer maternity insurance California options, click here.
Top Maternity Insurance Plans In Napa, Sonoma, Marin, & Solano Counties
2017
- Western Health Advantage Platinum 90 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Western Health Advantage Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Health Net Platinum 90 (EPO)
- Blue Shield Gold 80 (PPO)
- Anthem Blue Cross Platinum 90 (PPO)
- Health Net Gold 80 (EPO)
- Anthem Blue Cross Gold 80 (PPO)
Total Out Of Pocket Costs = $5,612
$5,972
$6,252
$6,260
$6,420
10,051
$10,538
$10,603
$10,970
$11,402
Total Out Of Pocket Cost in Santa Rosa California
Based upon a 30 year old woman living in Sonoma county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
A vaginal childbirth in Napa county costs $21,432 on average, and a cesarean childbirth costs $28,335.
The most notable difference between 2015 and 2016 Obamacare maternity plans in this region is that the PPO plans had substantial cost changes while the HMO plans had small changes. For example, the largest increase was the Blue Shield Platinum 90 EPO plan at $1,680, and the Health Net Platinum 90 EPO plan had the largest cost decrease of $1,176. The HMO plans in this region had much lower cost increases, ranging from $156 to $288.
In region 2 the cost difference between the best HMO and PPO pregnancy plans is now $1,740. This is a heavy price to pay for the flexibility of being able to pick your own doctor using a PPO plan.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Napa maternity insurance California options, click here.
Top Maternity Insurance Plans In Kern County
2016
- Health Net Platinum 90 (HMO)
- Health Net Gold 80 (HMO)
- Kaiser Permanente Platinum 90 (HMO)
- Kaiser Permanente Gold 80 (HMO)
- Blue Shield Gold 80 (PPO)
- Blue Shield Platinum 90 (PPO)
- Anthem Blue Cross Platinum 90 (PPO)
- Anthem Blue Cross Gold 80 (PPO)
Total Out Of Pocket Costs = $4,472
$4,800
$4,976
$5,328
$5,864
$5,932
$5,980
$6,248
Total Out Of Pocket Cost in Bakersfield California
Based upon a 30 year old woman living in Kern county, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more)
The most notable difference between 2015 and 2016 Obamacare maternity plans in this region is that the PPO plans had larger cost changes while the HMO plans had small changes. For example, the largest increase was the Blue Shield Platinum 90 PPO plan at $732, and the Health Net Platinum 90 HMO plan had the largest cost decrease of $1,020. The HMO plans in this region had much lower cost increases, ranging from $156 to $288.
In region 14 (Kern County) the cost difference between the best HMO and PPO pregnancy plans is now $1,392. This is a heavy price to pay for the flexibility of being able to pick your own doctor using a PPO plan. However, the total out of pocket cost for the best PPO plan ($5,328) is still significantly lower than in northern regions of California.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Napa maternity insurance California options, click here.
Top Maternity Insurance Plans In Ventura
2017
- Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
- Anthem Blue Cross Platinum 90 (PPO)
- Anthem Blue Cross Gold 80 (PPO)
Total Cost = $8,129
$8,219
$8,525
$8,939
Total Out Of Pocket Cost in Ventura County California
Based upon a 30 year old woman living in Oxnard, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in Ventura county costs $15,298 on average, and a cesarean childbirth costs $21,759.
This region of California has few choices for pregnancy insurance coverage. Only Anthem Blue Cross and Blue Shield of California offer plans in this region.
The two carriers rate increases in 2017 made the Blue Shield plans the better maternity choice this year.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Barbara maternity insurance California options, click here.
Top Maternity Insurance Plans In Shasta, Del Norte, Alpine, Siskiyou, Modoc, Lassen, Trinity, Humboldt, Tehama, Plumas, Nevada, Mendocino, Lake, Butte, Glenn, Sutter, Yuba, Colusa, Amador, Calaveras, Tuolumne, and Sierra Counties
2017
- Anthem Blue Cross Platinum 90 (EPO)
- Anthem Blue Cross Gold 80 (EPO)
- Blue Shield Platinum 90 (PPO)
- Blue Shield Gold 80 (PPO)
Total Cost = $8,599
$9,615
$9,679
$10,083
Total Out Of Pocket Cost in Ventura County California
Based upon a 30 year old woman living in Oxnard, including 12 months of premiums, a full 9 months of regular prenatal care, and a standard hospital delivery (C-section delivery would cost more).
A vaginal childbirth in Ventura county costs $15,298 on average, and a cesarean childbirth costs $21,759.
This region of California has few choices for pregnancy insurance coverage. Only Anthem Blue Cross and Blue Shield of California offer plans in this region.
The two carriers rate increases in 2017 made the Blue Shield plans the better maternity choice this year.
To see the detailed breakdown of the Total Out Of Pocket Costs for the Santa Barbara maternity insurance California options, click here.
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We've switched from using a generic $10,000 delivery cost estimate to more detailed Childbirth estimates provided by Guroo.com. Using this tool we can get average costs in various regions of California, and use those costs in the total cost estimates shown in the tables above.
The overall effect of Obamacare on maternity health insurance in California has mostly been neutral. The new health care reform offerings with the lowest total cost are typically HMOs. This makes searching to see if your doctor is in an HMO network very important.
There are few low-cost PPO options, and many Ob/GYNs are in only one or two PPO networks (or none of the HMO networks), so the selection of a good plan is more important than ever.
How To Select The Best California Maternity Insurance
To make sure you get the right maternity plan for your needs, follow the simple steps outlined below. They will make it easy and help you select the right plan and complete your application for coverage.
- Use the maternity plans listed above as your starting point to identify several insurance company options
- Search for your doctor in the provider directory search tools, to determine if they accept the plans you choose. (Or call your doctor and ask if they accept the plans you've selected from the above lists)
- Determine if you can qualify for a subsidy
- Run a California maternity insurance quote to see what the price is for the plans your doctor accepts.
- Use the "Apply Now" link in your quote if you do not qualify for a subsidy. If you are subsidy qualified, then go here to get help with your Covered California application.
If you need help determining which Obamacare plans are the best in your region of California, or you are having difficulties checking on the networks your doctor accepts, or you want help with your application, call us and we'll help you. If you have any questions contact us.
Planning Tips For Pregnancy Health Insurance
If you are planning to have a baby and can "time" when you have the baby, there are some ways you can reduce your overall costs for health insurance with maternity coverage in California. We do this by considering the full pregnancy as being composed of two time frames.
- The Prenatal Period
- Delivery Time
During the Prenatal Period, you will primarily have multiple office visits. Each doctor visit will require some lab tests to check on the health of you and the baby. In Bronze, Silver, Gold, and Platinum coverage, these prenatal visits and the labs are covered as preventive care. Therefore it does not make a difference which plan you choose if you have a normal prenatal period.
If there are any complications or abnormal health issues that arise during the prenatal period, the extra tests and medical services will be covered based on the standard benefits of your health coverage.
Therefore, Silver is the ideal coverage for the prenatal period.
At Delivery Time we know there will be a large cost associated with delivery in a hospital. Ideally you want a plan with NO deductible, and a fixed co-payment for the hospital costs. Therefore, Gold and Platinum HMO maternity plans are best. Usually Platinum plans will have a better "benefit versus cost ratio" than the Gold plans.
Therefore, Platinum plans are the best maternity health insurance California plans for delivery.
From a timing standpoint, if you know that you can wait until at least April or May to get pregnant, then you can select a Silver plan at the beginning of the year. During the next year's open enrollment period in the fall, you can then move into a Platinum plan for delivery the next year.

Once the baby is born, that creates a Special Enrollment Period. During the 60 days after the baby is born you can switch from the higher cost Platinum delivery plan to a lower cost Silver or Bronze plan (depending upon your needs).
This way you can take advantage of the full benefits of the Affordable Care Act rules.
In Summary: You get to use Platinum benefits for the delivery, and then immediately move back into a lower cost plan.
Need Maternity Insurance? Already Pregnant California Woman Are Saved By Obamacare
In the last 12 years, we have received thousands of calls from women who were pregnant and looking for health insurance. Until Obamacare we've had limited ability to help them get coverage. Obamacare changed that.
The Affordable Care Act removed the "pre-existing condition" exclusion so that pregnant women can get California health insurance with maternity coverage. During the yearly open enrollment periods you can select any policy you want. Even if you are pregnant at that time.
You must make sure to sign up for a plan during the open enrollment periods. Outside of open enrollment, getting pregnant is not a "qualifying event" that would allow you to apply for coverage. If you become pregnant without insurance, you will either have to qualify for Medi-Cal or Access For Infants & Mothers (AIM), or pay for your care until the beginning of the next year when you can enroll for pregnancy insurance.
Maternity Insurance Plans Need These Key Benefits
A standard pregnancy has 14 prenatal office visits, various lab tests performed during each office visit, amniocentesis, and 1 or 2 ultra-sound. In California, these prenatal services are now considered "preventive."
After the prenatal period the next big cost is the actual delivery. A typical delivery is a 2 day hospital stay that can cost between $8,000 to $12,000, and a C-section requires 3 days. With these standard services in mind, the key benefits that a good maternity plan will provide, are the following:
- Unlimited Doctor Office Visits for a Copay
- Low Deductible or No Deductible
- Small Out Of Pocket Maximum
- Fixed Copay for Hospital Stays
- Fixed Copay for Lab Tests and Imaging
- Affordable Monthly Premium
You'll have a $0 copay for these visits in Bronze, Silver, Gold, and Platinum policies.
At some point, your baby will be born, and when that time comes, you have to reach the deductible before your insurance company begins paying for any part of the delivery costs if you have a PPO plan. HMO plans do not have a deductible.
Once you meet the deductible, you begin sharing costs (co-insurance) with the insurance company until you reach your out-of-pocket maximum. All the Bronze, Silver, and Gold policies have a $6,350 out-of-pocket maximum. Only the Platinum plan has a lower limit at $4,000.
Some plans, HMOs, require a co-payment for inpatient care at a hospital while others, PPOs, require the co-insurance mentioned above. The HMO co-payment is usually on a per-day basis. An HMO maternity plan with a lower per-day co-pay will minimize your costs more than a PPO policy.
During each prenatal office visit your doctor will order lab tests to check on your health and the health of your baby. As long as your pregnancy is normal, then the lab tests will be considered preventive and no additional cost regardless of your plan.
If there are potential issues, then diagnostic tests will need to be covered. Bronze plans make the diagnostic lab tests part of your deductible, while Silver, Gold, and Platinum plans offer co-pays for lab tests.
The monthly premium is a big part of the total out of pocket cost to have a baby. Having a lower premium can help, but only if you are comparing similar plans. All Platinum Co-payment plans have the same benefits, so the lowest cost Platinum Co-payment plan that your doctor accepts could be the best plan for you.
These benefits are all important, but the largest reduction in overall costs can typically be obtained by picking a plan that reduces the delivery costs to a co-pay. This makes HMO plans the best option in most areas.
If having the flexibility of a PPO plan is important, then you must pick a plan with the lowest out-of-pocket maximum, co-insurance percentage, and deductible. PPO plans are typically used when a specific doctor is wanted, and that physician is not part of a major medical group.
Depending upon what time of the year you plan to begin trying to get pregnant, there are some strategies that can help lessen the insurance costs. See the section titled Planning Tips For Pregnancy Health Insurance Plans below.
Finally, the maternity insurance plans and prices are different in most regions of California, so analysis of the specific maternity plans in your area is important.
Source: https://spfinsurance.com/california-maternity-insurance-obamacare/
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