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What Does Health Insurance Cover After Pregnancy?

New Mother Holding Newborn Baby

Your health insurance covers some of the medical costs during and after having your baby. Expectant mothers rely on their health insurance to cover outpatient services for prenatal visits with their doctor, screenings, medications, and inpatient care before and during the birth process. Health insurance policies vary in the options they provide, and you may need to find a doctor you like in the insurance network, for prenatal care, birth, and postnatal care.

Your New Baby and Your Health Insurance

Under the ACA (Affordable Care Act), your health insurance is required to cover maternity and newborn care, without added out-of-pocket costs. Well-baby checkups and lactation support, along with providing you with a breast pump must be provided to the insured person. Once you return to work (if you are planning to), your employer must allow you enough time to pump breast milk for up to one year and provide a private area where you can pump. Take note that some short-term health plans are not required to cover maternity care, so if you are pregnant, a short-term healthcare plan may be the wrong choice.

Pregnancy and Well Baby Checkups: What Health Insurance is Right for Me?

To ensure you are covered throughout your pregnancy and after the birth of your baby, your health insurance policy must be ACA-compliant. You have about six weeks to enroll in a health insurance plan. The 2022 deadline to enroll falls on January 15. During that period, you can enroll in a health plan, or change your plan.

All ACA-compliant health plans cover maternity. Before the ACA was enacted, only 12 percent of the health insurance plans covered pregnancy, as it was considered a “pre-existing condition.” Some healthcare plans that were put in place before the passage of the ACA, are called “grandfathered,” and rarely, if ever, cover pre and postnatal care for mother and child. You can change plans during the open enrollment period if you are participating in a grandfathered health insurance plan.

The Act has changed the landscape of healthcare for women, and if you are planning to become pregnant, or are already expecting, ensuring you have the best possible health insurance in place is essential. You can get help from a local insurance agent to help you choose the plan that suits your budget.

New Baby and Your Health Insurance

It is of great importance that you have health insurance after giving birth to your baby. Your child is covered for 30 days after birth, after which the baby must be added to your health insurance policy. The medical services you are eligible to receive through your health insurance include:

  • Well-baby checkups
  • Comprehensive lactation support
  • Counseling
  • Breastfeeding equipment

The Birth of a Baby: A “Qualifying Event.”

Enrollment in health insurance must take place during the open enrollment period – except when it comes to “qualifying life events.” The birth of a baby, under the Act, is a qualifying life event. These life events allow you to enroll during a Special Enrollment Period. Talk to one of our friendly, local health insurance agents to find out how you can get your new baby covered, change your health insurance, or find a better or more affordable plan.

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