Family & Maternity Health Insurance Guide: What’s the Best Family Health Insurance?

For people with families or for those who want to start their own, healthcare is often a top priority. Pregnancy and childbirth require additional healthcare considerations, so both mother and newborn get the care they need before and after birth.

If you’re wondering what the best family and maternity health insurance is in Arizona, this guide explains what to consider to get family health insurance that protects your family. 

Types of Family & Maternity Health Insurance Plans

There are several ways to secure a health insurance plan for your family. Even if you’re not offered one through your or your spouse’s employer, you have other options to get coverage now and for future family additions. 

• Employer health insurance: First, your and/or your spouse’s employer might offer group health insurance coverage. Some employers cover the full health insurance premium, while others will share expenses with employees. Employer health insurance can be a convenient option, but there are also some considerations. You’ll want to make sure your preferred providers are covered under an employer plan, or else you’ll have to pay out-of-pocket for those expenses. In some cases, you may be able to get more value for less money by opting for a government health insurance plan or a private health insurance plan. 
• Affordable Care Act (ACA) health insurance: The Affordable Care Act (ACA) Marketplace is the federal government’s offering of health insurance to individuals and families. Individuals and families can only typically sign up for an ACA plan during open enrollment, which is typically November 1 through January 15 every year. However, there are special qualifying events, including having a baby, that enable you to enroll in an ACA plan during a special enrollment period. A benefit of ACA plans is that you can shop the ACA Marketplace to find the exact plan you want, rather than be restricted to a single plan your employer offers. However, the most affordable ACA plans tend to be health maintenance organizations (HMOs), which will limit what healthcare providers you can see under the plan and which generally require referrals from a primary care physician (PCP) in order to see a specialist. If you want a preferred provider organization (PPO) plan, which offers more healthcare provider choice, those ACA plans tend to be more expensive. 
• Private health insurance: Private family health insurance offers lots of benefits for families who want to customize their health insurance plans. You can work with a health insurance broker for free, who will present plan options based on exactly what you’re looking for and your budget. You can sign up at any time of year and match your plan to your preferred providers, prescriptions and other healthcare needs. 

The good news is, you always have an option to get health insurance whenever you need it, even outside of open enrollment dates for plans like ACA Marketplace offerings. If you need family health insurance outside of ACA open enrollment, and you don’t get health insurance through work, contact AZ Health Insurance Brokers for other family health insurance options. 

Key Features to Look for in Family Health Insurance

Your family’s health is important, so it’s helpful to try to compare health insurance options considering the following factors.

• Network adequacy: You may have preferred pediatricians, family practitioners and specialists you like to see or want your family to be able to see under your insurance plan. Look at potential networks for what doctors are covered. Generally, a PPO provides more flexibility for provider choice. 
• Prescription drug coverage: If members of your family currently have prescriptions, that should be another consideration. You’ll especially want insurance coverage for expensive medications, so check that an insurer covers the prescriptions you need. 
• Preventive care benefits: Do you want health insurance coverage for well-child visits, immunizations and screenings? If you do, as you compare insurers, look for providers that cover these services. 
• Maternity and newborn care: Some health insurers offer comprehensive benefits for soon-to-be and new moms, such as medical device coverage for breast pumps. If you’re seeking family healthcare coverage specifically for pregnancy coverage and growing a family, learn about this type of coverage as you compare plans. 
• Mental health services: According to the CDC, mental health is closely related to physical health. For example, depression increases risk of conditions including stroke, heart disease and diabetes. Some health insurance plans will offer coverage for services like counseling. Look for mental health coverage if you’re interested in it. 
• Emergency services and hospitalization: Generally, health insurance plans with lower deductible and out-of-pocket maximums will absorb costs for emergency services and hospitalization better than plans with higher deductibles and out-of-pocket maximums. Keep in mind, if you’d rather pay less each month in premiums, you may pay more for emergency services.
• Dental and vision coverage options: Like mental health, dental health is also linked to overall health. Low-cost dental health plans typically cover routine annual cleanings and services. You may also be interested in vision coverage if anyone in your family needs glasses/and or prescription lenses, or you want the option to get annual eye exams for your family members covered by insurance.

Beginning a family means you’ll want to evaluate the health needs of those in your family, from a pregnant mom to a growing child. Your healthcare needs could change periodically depending on the developing health needs of your family members, so keep these factors in mind for what to look for in family and maternity health insurance.

Cost Considerations for Family Health Insurance

Adding new members to your family can also mean changes to your health insurance costs. Ideally, you want to keep costs low while also getting the exact healthcare coverage you need. The following are some family health insurance cost factors to consider.

• Premium costs versus estimated out-of-pocket expenses: Health insurance plans typically require a monthly payment, also called a health insurance premium. How much you pay in a premium will impact your out-of-pocket expenses. Generally, the higher you pay in a premium, the less you’ll pay in out-of-pocket expenses when you actually get treatment. If you pay a lower monthly premium, that can save you money if your family stays relatively healthy, but you may pay more out-of-pocket when you seek treatment.
• Deductible structures for family coverage: A deductible in health insurance is the amount of money that’s paid before healthcare coinsurance activates, meaning the insurance company covers most or all of the costs of treatment. With family health insurance plans, typically the entire family shares one deductible. That means, for every family member that receives treatment, however much is paid for that treatment goes toward the one deductible. In some cases, such as in some HMO plans, a family plan may have separate deductibles for each family member, or no deductible whatsoever. The deductible structure can be a factor worth comparing when you’re considering plans. 
• Family out-of-pocket maximums: An out-of-pocket maximum is the limit you’ll have to pay for covered services before a family health insurance plan covers all of the covered service expenses. Similar to deductible structures, some plans will apply out-of-pocket maximum terms once a total out-of-pocket maximum has been reached via contributions from various individual family member health expenses. For other plans, all members may be covered once a certain number of family members (two family members, for example) reach their individual maximum out-of-pocket. Ask providers you’re considering for these details to compare.
• Cost-sharing subsidies and tax credits for families: Families who enroll in health insurance through the ACA Marketplace may be eligible for cost-sharing subsidies and tax credits. The premium tax credit lowers monthly payments for insurance coverage for families who qualify. There are also cost-sharing reductions (CSR), which lower deductibles and other out-of-pocket costs. If your family is eligible for these, you can lower your overall health insurance costs.
• HSA-compatible or not: Families can also choose to manage their healthcare by opening a high deductible health plan (HDHP) in conjunction with a health savings account (HSA), on their own or through an employer health insurance plan. HSA plans are like a savings account, where families can save money on a pre-tax basis for payments toward qualified medical expenses. Under tax law, HSA-compatible plans must have a minimum deductible and a maximum out-of-pocket cost set for both individuals and families. One thing to consider with HDHP plans is that the deductibles can be as high as maximum out-of-pocket costs.

To navigate all these maternity and family plan options, it’s helpful to talk with a family health insurance broker who will use your budget and your ideal healthcare coverage to present you with a selection of relevant health insurance plans. 

Top Health Insurance Providers for Arizona Families

In Arizona, those seeking maternity and family health coverage have lots of provider options. The following are some of the top family and maternity health insurers we recommend in Arizona. 

• Ambetter: In terms of popularity for ACA Marketplace plans, Ambetter has the most people enrolled. One major benefit to Ambetter is that this provider offers state-to-state reciprocity, which means if you need healthcare in a different state, you’ll be covered by doctors who are contracted with Ambetter in that state.
• UnitedHealthcare (UHC): For private family health insurance plans, UnitedHealthcare (UHC) is very popular, with their UHC Choice Plus PPO network being accepted at most Arizona facilities. UHC also offers individual dental and vision products for Arizona families.
• Blue Cross Blue Shield (BCBS): Blue Cross Blue Shield (BCBS) is another popular health insurance options for Arizona families. It’s the only health insurer in Arizona that provides plans for all 15 counties, with a statewide PPO network that’s contracted with all major hospital networks in Arizona, other than Mayo Clinic Care Network.
• Cigna: Cigna is also popular with Arizona families, with an extensive lab network and contracts with several Arizona healthcare providers. Because Cigna ACA Marketplace costs tend to be pricier compared to other carriers, it can be a good family choice if you have preferred doctors or prescriptions that are covered by Cigna.

We recommend to look at both the financial and healthcare value of a plan, as well as customer satisfaction ratings for family coverage. Each network has its own unique strengths, so it’s important to compare how they’ll benefit your family.

If you have doctors you’re particularly interested in seeing, that’s an important consideration, because you’ll want those providers covered to keep costs lower. Think about how frequently you anticipate doctors’ visits when factoring in expenses. 

Need a Family Health Insurance Plan in Arizona? Contact Us

AZ Health Insurance Brokers specializes in maternity and family health insurance plans in Arizona. We help people who are growing their families or who are planning on becoming pregnant to choose the right maternity healthcare coverage so they’re secure on this incredible journey. As your spouse and/or children’s healthcare needs change, we can help you find the right plan that fits your healthcare budget and your desired coverage.

The first step to getting the right healthcare plan starts with contacting our office. You can call us at 602.617.4107, email info@azhealthinsurancebrokers.com or contact us online. We’ll be in touch to answer any questions you have.

Maternity & Family Health Insurance FAQs