Pregnant woman sitting in a chair and using a laptop

What You Need to Know About Maternity Coverage

In good news for many women in North Carolina thinking about having children, it’s now mandatory for all health insurance providers to provide maternity care coverage. In 2014, the Affordable Care Act became law, requiring pregnancy, labor, delivery, and newborn care coverage.

HealthPlans of NC

Health Plans of NC, Kelly Quinn

How Has Maternity Coverage Changed?

In good news for many women in North Carolina thinking about having children, it’s now mandatory for all health insurance providers to provide maternity care coverage. In 2014, the Affordable Care Act became law, requiring pregnancy, labor, delivery, and newborn care coverage.

How Has Maternity Coverage Changed?

You may not realize, but maternity coverage wasn’t always a required benefit. Before 2014, only 12% of all individual insurance plans offered maternity coverage, and pregnancy was often considered a pre-existing condition. As a result, if you weren’t already enrolled in an insurance program when falling pregnant you may not have had maternity leave coverage.

If maternity coverage was offered, the cost of the insurance premium was likely to be high, making affordable maternity insurance challenging to find. Thankfully, this is no longer the case. For women in North Carolina and across America, maternity coverage is now guaranteed.

What Is Covered with Maternity Coverage?

During your pregnancy, there are several things covered under your insurance plan, along with care for when your baby arrives. 

  • Outpatient services: including prenatal and postnatal visits and necessary screenings, such as gestational diabetes screenings, lab tests, and medications.

  • Inpatient services: including hospitalization, physician fees, and other inpatient services.

  • After the birth: newborn baby care, lactation counseling, and breast pump rental.

When Should You Enroll in A Health Plan For Maternity Coverage?

You can enroll in a health plan or make changes to a different health plan during the annual Open Enrollment Period, which starts on November 1st each year. Coverage begins the following year.

Pregnancy itself isn’t an exception to the Open Enrollment Period, but a newborn baby does qualify as an exception to the Open Enrollment Period date. When the baby is born, a 60 Day Special Enrollment Period is triggered. This means you, your spouse, and your children can enroll or change health care plans.

How to Get Affordable Maternity Coverage

Maternity coverage is now a mandatory benefit in all North Carolina family health insurance plans. So you can select an insurance plan that best fits your and your family’s needs. When making your selection, check if a government program is available to subsidize your insurance. 

You can compare plans, select the right health insurance plan for your needs, and complete the enrollment process online. If you need help, our team of knowledgeable and local health insurance agents can help you get the best private health insurance North Carolina, including Open Enrollment tips. Get in touch with us today.

Ready to get started?

See plans and pricing today.