The One With Aflac Maternity

Received this question in regards to my health care answers:

Crystal, do you know a lot about Aflac and pregnancy? I've heard good things about maybe you'll know the backside of it as to advantages and disadvantages as far as pregnancy?

First let me just put a disclaimer on ALL my answers . . . . it's still up to you to check and make sure on things before you do anything. I'm telling you my experience, what I understand, and what the research I have done on the questions have shown me.  Gooooooodd SOOOO no one sue me if something doesn't happen a certain way - every insurance company and plan is different, most have the same underlying intricacies, but some can be different, so be sure to check. I'm just trying to offer the understandings that I have found that many people don't know.

So - AFLAC INSURANCE!

Aflac insurnace for maternity is great. It's one of the only plans that I can legitimately see the ability to use and abuse on and get more return back than your initial investment - good for you, bad for Aflac. First everyone may need to understand how Aflac works. You pay them monthly premiums which they turn around and invest, THAT is how they can pay you back more than you have ever paid in. There are both similarities to normal insurance and differences to normal insurance.

Aflac will pay out a certain percentage based on the medical code the doctor provides. For example, my parents have aflac dental insurance - Aflac will pay them around $50 for just a standard cleaning and check up. Keep in mind, that a standard cleaning and check up normally costs over $100 so while Aflac is helping you pay for a service, they NEVER will pay for all of it. Also there are normally caps, they will only pay on a specific code (procedure) a certain amount of times per year before they are done. For example they may pay for three cavity fillings per year, so if you have more you're left with that. Also, most plans require you to pay into it a certain amount of months before you can receive payments - for dental you can't get anything back until you've paid for three months and crowns won't pay out until after a year. Most of their other plans work the same way.

They are different than insurance companies because with insurance once you pay your deductible and out of pocket maximums, insurance pays for everything else (with the exception of co-pays and procedures that aren't covered) whereas Aflac will generally pay out a certain portion and at some point in time you cap out and they will no longer pay.

As far as Aflac Maternity goes . . . . I have heard amazing things. Unfortunately, all three kids have been surprises so I have never had it myself, but I have many friends that have, and I have talked to Aflac several times about it (we have Aflac plans availabl at work and I am the liason). Essentially you pay around $100/month for the plan. They require you to have the plan for 10 months before they will pay you anything. So make sure you have the plan in place at least a month before you get pregnant and make sure you don't have the baby premature - the payment back to you is not based on when the due date is, it's based on when the delivery is!!!!

Depending on the type of delivery - natural vs c-section - and how things are coded, they will pay you back $2500-$4000 (it may be slightly more or less, it's been awhile since I talked to Aflac about it). So if you have the plan for 10 months you paid them $1000 and in the end, if you have a c-section like me, you'll end up getting almost $4000 back, so you make $3000!!! Sounds like a winner to me! Like I said, the exact numbers are approximate, but the idea is the same. If you only have the plan for 10 or 12 months you are guaranteed to make SOME amount of money back beyond your initial investment.

Drawbacks - there really aren't a ton if you understand how it all works, and keep that in mind when you sign up. Aflac was created to be a supplemental insurance, it is not met to be your only insurance. If the choice comes down to having Aflac or regular insuranc for maternity, I would choose standard insurance every time. Aflac won't pay out on complications - they won't pay you if your baby lands in NICU, or if you end up with some kind of infection (at least not under maternity, but other plans they have will pay some money). If you end up on Aflac maternity longer than two years, chances are you are going to lose money. If you have a baby prematurely, you will lose money. Also keep in mind that it will never pay for everything. While "making" $3000 would have been awsome with any of my kids if I had an Aflac plan, $3000 was still less than our $5000 maternity deductible, so while it "supplements" your payments so in then end you are having to pay less, it is not guaranteed to pay for everything.

My thoughts - as long as it is strictly for supplemental insurance, I think talking to someone about Aflac maternity is a great idea!