If you’re a mother-to-be and you’re confused about health insurance, you’re not alone. With the introduction of the Affordable Care Act (ACA), there have been a lot of changes in the way insurance works — especially for pregnant women. Let’s take a look at some of the most common insurance questions that new and future moms often ask, and find out their answers.
Can I Get Health Insurance If I’m Already Pregnant?
Yes, absolutely. In the past, insurance companies considered pregnancy a pre-existing condition and could either deny coverage to pregnant women, or could offer coverage with a rider that excluded maternity-related care and expenses. However, under the ACA, health insurance companies can no longer deny or charge you more for coverage if you have a pre-existing condition.
Having a baby is considered a Qualifying Life Event, which means you can get health insurance outside of Open Enrollment. Start comparing plans while you’re pregnant so you’ll be ready to select coverage once your little one arrives.
Where Do I Get Health Insurance?
Does your employer or your spouse’s employer offer health care coverage? If so, you’ll likely get the most value for your health care dollar by taking advantage of a plan where your employer covers at least some of the cost of the premium.
If your employer or your spouse’s employer offers group benefits, you may want to enroll in that coverage. However, if you’re unemployed or don’t have access to group health insurance, you can still get coverage. Buying individual health insurance through the Marketplace is also an option for many soon-to-be moms — and you may even qualify to receive a government tax subsidy to help lower the cost of your insurance. Consider working with a licensed insurance agent to help explore which m=Marketplace plans are available to you and determine which one best meets your needs.
What Kinds of Things Will My Health Insurance Cover?
Most health insurance plans cover basic prenatal care, including doctor visits and things like testing for gestational diabetes and Rh incompatibility. Additionally, many plans also cover costs associated with labor and delivery, plus care immediately after giving birth. However, every plan is different, so it’s extremely important that you learn about the specifics of your plan so you know what to expect.
While choosing a plan, look to see what maternity-related costs are covered and which aren’t — especially if you’re considering an alternative birthing environment, like a water birth, or are planning on using the services of a midwife, services that are not covered by many plans.
How Do I Choose the Right Plan?
Picking the right health insurance plan ultimately comes down to finding a plan that meets your health care needs and fits into your budget. If you’ve been working with a particular doctor or prefer to stay in a specific hospital network, make sure that they accept the health insurance you’re considering purchasing. Otherwise, you may incur higher out-of-network costs. Don’t forget to ensure that your preferred pediatrician’s office will also be in-network to help keep your costs under control. Do your research about which doctors accept which insurance prior to making a decision so you won’t be faced with any unwelcome surprises.
A Policy That’s Right for You and Your Baby
The health insurance landscape has changed quite a bit in the past five years, making it easier for pregnant women to get coverage. Moms-to-be can get health insurance through an employer, a state- or federally-funded program, or through the Marketplace. However, different policies cover different things — and not every doctor accepts every plan. Take a close look at any policy you’re considering to ensure you’re getting the one that’s right for you and your baby.
