Many women want to know their short-term disability insurance options when they are pregnant and getting ready for childbirth and maternity leave.

This article explains all of the short-term disability insurance options for pregnant women. We will also discuss how insurance companies view normal pregnancy, childbirth, and maternity leave.

We will also discuss other options that are available to you in detail. This article is a deep guide to short-term disability insurance and different options for pregnancy, childbirth, and maternity leave. We discuss the particulars transparently so that you can understand your options.

Here is what we will discuss:

• What You Need To Do First
• Basics of Short-Term Disability Insurance for Childbirth, Pregnancy, and Maternity Leave
• 2 Short-Term Disability Insurance Options for Childbirth, Pregnancy, and Maternity Leave
• Other Options Available for Expectant Moms and Parents
• FAQs about Short-Term Disability Insurance and Childbirth/Maternity Leave
• Final Thoughts about Short-Term Disability Insurance and Childbirth/Maternity Leave

This guide provides complete information about your paid maternity options and childbirth, including short-term disability insurance.

Before Anything, Here is What You Need to Do First

Many new parents—men and women—ignore this first, critical step when they find out they are expecting a new baby. In fact, this step is something you want to do well before getting pregnant.

Picking out a name?

No.

Setting up a baby shower registry?

No.

Figuring out how you will pay for the delivery?

No, but you are really close. You do need to know how you will pay (i.e., health insurance) for the baby’s delivery.

The first thing you want to do well before you are pregnant is to figure out how you will still receive an income during your maternity leave (assuming you are working and your income supports your household).

Are You Sure Your Employer Will “Take Care of It”?

Oh, John. My employer has already worked that out for me.

They do? Can you tell me your company’s maternity leave plan? Every company has one. Most have paternity leave (i.e., father’s leave) as well.

Well…I don’t know it…

Unfortunately, most women (and men with paternity/parental leave) don’t know until it is too late.

Hey, John. I am a self-employed hairstylist. I work for myself, so what happens to me?

Well, you don’t receive anything unless you live in a state that offers state-based disability insurance (more on that later) or you have other means.

But, I need income during my maternity leave! My family relies on my income!

Right. That is my point. You need to develop a plan for your income before you are pregnant. That is the first thing you need to do. I receive too many phone calls, emails, and requests from expecting mothers who are looking for ways to receive an income during their impending maternity leave. Unfortunately, for most of them, it is too late. The reason is that many short-term disability insurance plans – both individual and group/employer plans – and other options (discussed below) have waiting periods (more on that later) to qualify for benefits for childbirth, maternity leave, or pregnancy.

Before getting pregnant, you will want to:

• Contact your HR department (if you are an employee) and review your employer’s maternity leave plan
• Review your state’s disability insurance plan (if you live in a state that has one)
• Analyze individual short-term disability insurance options
• Review other options

We will discuss all of these options, but first, we will review the short-term disability insurance options for childbirth, pregnancy, and maternity leave.

Basics of Short-Term Disability Insurance for Childbirth, Maternity Leave, and Pregnancy

Before discussing short-term disability insurance options, you must know some basic disability facts. Many of these facts are similar to group/employer short-term disability insurance options.

First, your short-term disability benefits are based on your W-2/employee salary (if an employee) or your net income if you are self-employed. Your net income is found on your respective business tax return, depending on how you file (sole proprietor, LLC, S-corp, or C-corp).

Short-term disability insurance replaces a portion of your income. It does not pay your full income or salary. The reasons are that the benefits (on an individual plan) are income tax-free. Moreover, most plans pay up to 60% to 70% of your gross salary (if an employee) or net income (if self-employed).

Second, every policy has a waiting period (technically, called an elimination period). Contrary to what you may think, it is not the time period of when your policy starts. If you are approved for short-term disability insurance, you will have immediate coverage.

The waiting period starts with a claim. Upon a claim, you “wait” a certain number of days before you are eligible for benefits. Short-term disability insurance policies typically have the following waiting periods:

• 0/7 days
• 7/7 days
• 14/14 days
• 30 days

What does the “X/X” mean? The first number is the waiting period for a disability due to an accident. The second number is the waiting period for a disability due to an illness or sickness. So, 0/7 means no waiting period on a disability due to an accident and a 7-day waiting period due to an illness.

The benefit amount is the monthly (or weekly, depending on the insurance company) amount you’ll receive upon an approved claim and once you’ve completed the waiting period.

Disability Payments Don’t Last Forever

The benefit period is the maximum time period you’ll receive your benefit amount. For short-term disability coverage, the benefit period could be:

• 3 months
• 6 months
• 1 year
• 2 years

If you are still disabled after the benefit period ends, your disability benefit payments stop. In other words, you receive no more money unless you have continued coverage with a long-term disability insurance policy (more on that later).

Most policies have some variation of the own occupation definition. You will want a policy with this definition as the policy pays you a benefit if you can’t perform the duties of your own occupation, even if you can perform a different job.

For example, let’s say you are a dental hygienist and break your hand. A broken hand will make it hard for you to perform your duties as a dental hygienist. So, that is a disability. Even if you can still perform a different occupation, like voice transcribing or being a greeter at Walmart, the short-term disability plan pays a benefit.

Limited Disability Insurance Riders

Here’s a big contrast between a short-term disability policy and a long-term disability policy. Short-term policies are usually very basic in structure and don’t offer many riders. Riders allow you to customize your policy to meet your needs. Long-term disability policies typically offer many riders that allow you to customize your policy.

Short-term policies generally do not. They are “plain vanilla” as they are truly designed to provide benefits for a short time. In other words, short-term disability insurance pays benefits for only like 3 or 6 months. For a time period that short, you really don’t need any riders. If you are still disabled after that, then your long-term policy (assuming you have one, which I recommend you do) continues paying your disability benefits.

Moreover, many short-term disability insurance plans have a maximum benefit amount. For example, some plans may limit the benefit amount to $1,500 per week or $4,000 per month. Again, the purpose is to cover short-term disabilities, not necessarily long-term ones.

A Different Waiting Period for a Normal Pregnancy

So, I mentioned earlier that every policy has a waiting period before you are eligible for disability benefits. This is also called the elimination period. When the carrier approves your application, you are covered from illness or injury the next day (after you pay your first premium).

For example, you have a waiting period of 7 days and are sick. You are eligible for benefits starting on the 8th day.

However, the situation is different if you make a claim for childbirth.

In this case, you would have had to purchase the policy between 9 months and 12 months before the claim for a childbirth due to a normal pregnancy.

We will discuss this situation in detail next.

Childbirth, Pregnancy, and Maternity Leave Definitions on Short-Term Disability Insurance Plans

If you want short-term disability insurance to cover childbirth, pregnancy, or maternity leave, you’ll have to understand how carriers view these situations.

First, however, as a reminder, short-term disability insurance will cover any type of illness or injury that prevents you from doing your own occupation (see above). As long as the illness or injury is not a pre-existing condition and/or excluded from coverage, the disability insurance company pays the disability benefit.

However, disability insurance companies have different requirements for short-term disability claims related to childbirth, pregnancy, or maternity leave.

First, we use childbirth, pregnancy, and maternity leave interchangeably. We assume your pregnancy is normal, and you will file a claim upon childbirth, which generally starts your maternity leave.

If you have a normal pregnancy, most short-term disability plans (including some employer plans) pay these benefits:

• 6 weeks for a normal birth
• 8 weeks for a cesarean section

As I mentioned earlier, there is a nine-month to 12-month waiting period before the effective date for benefits on a normal pregnancy claim.

If you have pregnancy complications, they are treated as illnesses. In other words, the disability insurance company voids the 9-month/12-month waiting period. The policy pays benefits for the full benefit period or when you return to work, whichever happens first.

Moreover, many (if not all) disability insurance carriers will cover a disability from pregnancy complications.

Some examples will make this clear.

Examples of Short-Term Disability Insurance Claims and Benefits for a Normal Childbirth and With Complications

Joanne purchased a short-term disability insurance policy two years ago. It has a $3,000 monthly benefit (or $750 per week), a 3-month benefit period (13 weeks), and a 14/14 waiting period on accidents and illnesses. She recently found out she is currently pregnant with a normal 9-month due date. Let’s assume the carrier pays $750 every week.

First, since she purchased the policy 2 years ago, she has already satisfied the 9-month waiting period requirement for benefits for a disability claim due to a normal pregnancy/childbirth. She files a claim, which is approved. The waiting period of 14 days and the claim starts upon her delivery. She has a normal delivery and waits 14 days. On the 15th day, she is eligible for benefits and receives her first $750 on or around day 22 of maternity leave. Since this is a normal delivery, her benefit period is 6 weeks. She receives $750 for another 5 weeks and doesn’t receive additional payments for the rest of her maternity leave. In total, she received $4,500.

Compare this with a cesarean delivery. Everything is the same, but Joanne receives $750 for 8 weeks instead of 6 weeks.

Pregnancy Complications

If she has pregnancy complications and is disabled, then her complications are treated as an illness.  The carrier waives the 9-month waiting period. She has the standard 14-day waiting period. On the 15th day, she is eligible for benefits and receives a payment as long as she is disabled, up to 13 weeks. If she is still disabled after that, and has long-term disability insurance, then the long-term disability policy picks up when the short-term disability policy ends.

Let’s say she finds out she is pregnant and buys a policy. Unfortunately, her claim is likely denied because of the waiting period, unless she develops complications from pregnancy.

Do you see how that works? If you have any questions about these examples, please contact us. I am happy to explain further.

Two Short-Term Disability Insurance Plans That Cover a Normal Pregnancy, Childbirth, and Maternity Leave

We only work with two private individual short-term disability insurance plans covering a normal pregnancy, childbirth, and maternity leave.

Now, are there more? Yes, there are. Other options are likely available through associations or group/employers—more on that next.

Here are overviews of each of them:

Plan #1

• elimination period/waiting periods of 0/7, 7/7, 14, 30, 60, or 90
• benefit periods of 13 weeks, 26 weeks, 1 year, or 2 years
• benefit amount: up to $1,500 per week for an employee and $1,000 per week for a self-employed professional
• offers a lump sum $500 (max) benefit for childbirth

Plan #2

• elimination period/waiting periods of 0/7, 7/7, 14, 30, 60, or 90
• benefit periods of 3 months (13 weeks), 6 months, 1 year, or 2 years
• benefit amount up to $3,000 per month
• the benefit period ends when your doctor gives you the OK to go back to work or when the contracted benefit period ends, whichever comes first

Contact us if you would like more information or a quote.

Other Options Available For Expectant Mothers and Parents

We would be remiss if we did not discuss these other options for expectant mothers and parents. As I mentioned earlier in the article, it is a good idea to check out all available options. Plenty of other options may exist for you and your situation. These are in no particular order.

Federal Medical Leave Act (FMLA)

The Federal Medical Leave Act (FMLA) is a federal law that allows a person to take an unpaid leave of absence for a covered medical situation. The covered medical reasons include childbirth and maternity leave. Additionally, the law protects the person’s job. As a new mother, your employer can’t terminate your employment because you took maternity leave to care for a new child.

The law allows 12 weeks of unpaid leave every 12 months for a covered event.

Although it is unpaid leave, the job-protection / job security advantage underscores the importance of this law. Additionally, your employer can’t cancel your health insurance during this timeframe. This is a very important law.

Your Company’s PTO / Sick Leave

If you are an employee, you likely have accrued company sick time or paid time off. This is another option. Contact your human resources department to find out the sick days/vacation time you have available.

State-Based Short-Term Disability Insurance

Many states have, or will provide, state-based short-term disability insurance that covers childbirth, normal pregnancy, and maternity leave. These states include:

• New York
• Massachusetts
• New Jersey
• California
• Connecticut
• Washington State
• Colorado
• Oregon
• New Hampshire
• Hawaii
• Rhode Island
• District of Columbia (DC)

These states will establish their own state-based short-term disability plan within the next year or so:

• Minnesota
• Maine
• Vermont
• Delaware

These plans generally follow the FMLA and family leave. Often, they go above and beyond the FMLA requirements.

If you are an employee, you likely see your share of the cost on your pay stub. Many of these states offer a separate plan for self-employed professionals.

The good news is that these plans are guaranteed enrollment with no underwriting or medical exam required.

These plans differ based on the state where you live. If you live in one of these states, I urge you to contact them and review their childbirth/maternity leave rules. For example, Massachusetts’s plan allows 12 weeks of paid leave to care for a new baby. However, if you are sick or hurt and can’t work, then the plan allows up to 26 weeks of paid leave. See the difference?

Company Short-Term Disability Insurance

If you are an employee and your company provides short-term disability insurance, the plan likely covers normal childbirth/maternity leave.

Many of these plans are offered at the time of employment. Moreover, you then have to renew every year during your company’s open enrollment, where you re-enroll or disenroll in company-provided benefits.

Many group / employer short-term disability insurance plans that offer childbirth/maternity leave benefits have a waiting period. In other words, you can’t join the plan and then file a claim for maternity leave. Most group/employer plans have a 9-month or even 12-month waiting period BEFORE you can make a claim for childbirth benefits.

Many benefits exist for group/employer short-term disability insurance plans. For one, no medical exam or underwriting is required. You just apply during your enrollment period, and then you have disability insurance.

Some drawbacks exist, however. Most plans are “plain vanilla,” which is necessary to meet the company’s needs. Many also have benefit and definition limitations, which are outside the scope of the article.

If you are a business owner or an employee who works for a company without short-term disability insurance, feel free to contact us. We have a group/employer short-term disability insurance plan that offers coverage for childbirth / maternity. It is guaranteed issue, starting at 2 eligible employees. The plan is very flexible and affordable. Moreover, the business owner can set this up as a voluntary benefit, provided participation requirements are met.

Hospital Indemnity Plan

Many people don’t know this, but some hospital indemnity plans will cover a normal pregnancy / childbirth. What is a hospital indemnity insurance? It a supplement plan that tags on to your underlying health insurance plan. It pays additional cash benefits if a covered event happens.

For example, if you break your leg and need surgery to repair it, the insurance provider may pay a lump cash benefit for the surgery, the ER or urgent care cost, and any follow-up visits. Some hospital indemnity plans pay a lump sum benefit for a normal pregnancy or childbirth as long as the baby is delivered in the hospital.

Frequently Asked Questions About Short-Term Disability Insurance and Childbirth, Pregnancy, and Maternity Leave

We answer common questions about short-term disability insurance for pregnancy, childbirth, and maternity leave.

What is short-term disability insurance, and how does it apply to childbirth?

Short-term disability insurance provides income replacement for a limited period when you’re unable to work due to a covered medical condition, including pregnancy and childbirth. It typically covers a portion of your income during maternity leave for recovery after delivery.

How long does short-term disability insurance cover for childbirth?

Coverage usually lasts 6 weeks for a normal delivery or 8 weeks for a cesarean section, though this varies by policy. Some plans may extend coverage if medical complications arise. More on that later.

What percentage of income does short-term disability insurance typically replace during maternity leave and childbirth?

Most policies replace 60-70% of your pre-disability income, though some may offer up to 80% or 100%, depending on the plan.

Is there a waiting period before short-term disability benefits start after childbirth?

Yes, let’s talk about childbirth claims. If you intend to make a claim for childbirth or maternity leave, nearly all plans (including group/employer short-term disability insurance plans) have a waiting period. Most plans have a waiting period of 9 months to 12 months for a normal childbirth claim, depending on the plan. In other words, the plan needs to be in force 9 to 12 months BEFORE making a childbirth claim.

Now, once you meet this waiting period, you can make a claim for a normal pregnancy! However, another waiting period exists. This happens after you make a claim. It is called the elimination period (i.e., waiting period). Most short-term disability policies have a waiting period of 7-14 days before eligibility of benefits begin. Some plans may require you to use sick leave or PTO before the plan pays a benefit.

Can I purchase short-term disability insurance while already pregnant?

Likely not, unless the plan is guaranteed issue with no pre-existing condition clause. You see, a current pregnancy is often considered a pre-existing condition. You typically need to enroll before becoming pregnant for childbirth to be covered. As I mentioned, many short-term disability insurance plans have a waiting period of 9 to 12 months for childbirth. In other words, if you deliver the baby (a normal pregnancy) during this waiting period, the carrier denies the claim.

However, if you purchase the plan well before becoming pregnant, then the pregnancy is not a pre-existing condition, and the carrier approves the claim. Let’s look at an example.

Joanne purchases a short-term disability insurance plan with a 12-month waiting period for a normal pregnancy claim. She becomes pregnant a month later and delivers nine months later. Since she delivers during the waiting period (12 months), the carrier denies the claim.

Now, let’s change it to the fact that she purchased the plan a year ago. The carrier approves the claim, and there is no waiting period since she already purchased the plan one year before the claim.

It is important to note that this normal pregnancy waiting period doesn’t apply to any other illness or accident, including pregnancy complications. Let’s say you develop severe gestational diabetes and your doctor orders bed rest. Well, you can’t work, so that is a disability. It is a complication from pregnancy, so the carrier waives the 9-month to 12-month waiting period. The only waiting period now is the elimination period, which is usually 7 to 14 days.

Final Thoughts About Short-Term Disability Insurance for Childbirth, Pregnancy, and Maternity Leave

You should have a good understanding of short-term disability insurance options for childbirth, pregnancy, and maternity leave. We reviewed two different individual, short-term disability insurance options that cover childbirth and maternity leave.

Additional options include:

• FMLA
• PTO/Sick Time
• State-based Short-term Disability Insurance Plans
• Your Company’s Group Short-Term Disability Insurance Plan
• Hospital Indemnity Plan

Do you have any questions or would you like to get started? Feel free to contact us or use the form below.

I am happy to review your options and answer any questions you have.

Unlike other brokers or agencies, there is no risk to contacting us. We only work in your and your family’s best interests. If we can’t help you, we’ll point you in the right direction and part as friends (seriously). You can then reach out to us again if your needs change.