Pregnancy Health Insurance

The cost of healthcare is skyrocketing in the United States. The purpose of health insurance, also known as a health plan or health coverage, is to help you pay for your medical care. Obtaining adequate health insurance is important for everyone. This is especially true if you are or plan to become pregnant. Pregnancy health insurance covers many services for women during pregnancy. You should do a thorough review of all the available options to make sure you get a plan that is right for you. These can be tricky waters to navigate, so don’t be afraid to enlist the assistance of a health insurance professional.

What Services Will Health Insurance Cover For Pregnant Women?

According to the Affordable Care Act (ACA) health care law, all insurance plans on the Health Insurance Marketplace (Marketplace) must cover numerous services for pregnant women. As such, you can use the Marketplace to determine and compare the pregnancy insurance coverage in your state. Some of the services these insurance plans cover include:

Pregnancy Health Insurance
Pregnancy Health Insurance

Prenatal Care Visits With No Co-Pay

Prenatal care is the type of medical care you get while you are pregnant. Prenatal literally means “before birth”. Each visit where they check how you and/or the baby are doing during your pregnancy is prenatal care. A doctor visit normally has a co-pay but under this provision, you don’t even have to pay that.

Another nice feature is that you do not need a referral from your primary care provider (PCP) in order to see a specialist related to your pregnancy. Prenatal care providers can include an obstetrician/gynecologist (known as OB/GYN), a nurse practitioner, or even a nurse-midwife.

Breastfeeding Assistance With No Co-Pay

Insurance plans are required to cover support for breastfeeding. This includes a breast pump and other associated equipment. It even includes coverage for a lactating consultant to help guide you through the breastfeeding process. These services may be provided before or after birth as appropriate and last for the entire duration of breastfeeding.

Other Services Included In Insurance For Pregnant Women

  • Labor and birth services
  • Sick checkups
  • Regular checkups
  • Hospital care
  • Emergency services

Some of the additional services above, like emergency services, are covered for everyone, not just pregnant women. Also, the Health care law states that any health insurance plan cannot:

  • Charge you more merely because you are a woman
  • Charge you more or disqualify you if you have a pre-existing medical condition
  • Stop your health insurance if you get sick
  • Set an annual or lifetime limit on your health coverage. In other words, they can’t just cancel your policy because you reach a certain dollar limit
  • Make you pay unlimited out-of-pocket costs since every insurance coverage must limit your payments yearly. If you reach that limit, it is the insurance company's responsibility to pay for your covered medical expenses until the end of the year

How To Choose Maternity Insurance Plans

When choosing health insurance with maternity coverage, start by looking at the plan summary. The summary should include the expected pregnancy care costs. And since every plan will use the same summary form, you can easily compare the prices and services for the different programs.

Plan summaries can be found in the Health Insurance Marketplace, an online resource, to help you determine the maternity plans in your state. Your employer might also have health insurance coverage you can use. So check with your employer and assess your office health insurance for pregnant women and its benefits. As mentioned before, an insurance professional can be of great benefit at this stage of things, especially since these plans are different by state.

Pregnancy Health Insurance
Pregnancy Health Insurance

Can You Already Be Pregnant and Sign Up For a Health Plan?

Yes. Insurance for pregnancy allows you to sign up while you are already pregnant as a pre-existing condition, meaning you were pregnant before signing up for the health insurance. According to the ACA, no maternity insurance plans should deny you coverage or increase your health care costs because of a pre-existing prenatal condition.

I Need Help Paying For Health Insurance

Medicaid is a government health insurance plan that provides low-cost or free health insurance to low-income people. Medicaid is a state-run program, so coverage can vary by state although Medicaid must follow the same rules as plans from the Health Insurance Marketplace.

If you earn too much money for Medicaid coverage, some states will allow you to get insurance for pregnancy through the Children's Health Insurance Program (CHIP). CHIP Is an insurance coverage offered to pregnant women and some children from families that earn too much to get Medicaid but not enough to afford private insurance. You can apply for CHIP or Medicaid at any time. There are no open enrollment periods like other insurance in the Marketplace.

If you don’t qualify for Medicaid, you might qualify for tax credits that can help pay for your pregnancy health insurance through the insurance marketplace in your state. Make sure you indicate that you are pregnant when on the Marketplace so you receive the relevant information.

Still Have Questions?

We hope this articled has highlighted the importance of making sure you have adequate coverage if you are or plan to become pregnant. As mentioned in the opening paragraph, you should never be afraid to enlist the assistance of a health insurance professional. As is usually the case with most insurance, what is right for one person or family may not be right for someone else. Lehrman Group has been a trusted provider and broker agent for health insurance plans in Arizona since 1988. Our brokers can evaluate your specific needs and help you choose a plan that is appropriate for your situation.