Health Insurance and Pregnancy: The Basics

Health Insurance and Pregnancy: The Basics

Having a baby is life changing. While babies are a blessing, they also cost money – even before they're born. That’s why it’s important to have health insurance before and after you become pregnant.

With health insurance maternity benefits, you’ll save a lot of money. It also helps ensure you get the proper check-ups and care you and your baby need. Pre-natal care is a vital part of a healthy pregnancy. Moms-to-be who don't have proper insurance may be more likely to skip necessary care in order to save money. Doing so can put the mother and baby’s life at risk.

There’s a common misconception that pregnancy is treated as a pre-existing condition that health plans don’t have to cover. Under current health care law, that's no longer the case.

Now, thanks to the Affordable Care Act, every qualified health plan offered outside and inside the Health Insurance Marketplace must offer coverage for maternity care and childbirth services. There may be some exceptions for grandfathered plans, so call the number on the back of your member ID card if you’re unsure whether maternity care is covered under your plan.

If you plan to become pregnant or are pregnant now, consider your options carefully when it comes to maternity and childbirth coverage. When selecting a health insurance plan, ask the following questions:

  • What diagnostic tests are covered during pregnancy?
  • How much will copayments cost for my office visits and admission to the hospital for childbirth?
  • How much will my monthly premium be?
  • How much is my deductible?
  • How many prenatal visits am I allowed?
  • Do I qualify for any tax credits that make this plan more affordable?
  • Does the plan cover midwife and doula services?

Do you have more questions about how health insurance works? Ask us in the comments.

Originally published 8/4/2015; Revised 2023

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