Questions About Maternity Coverage? 

A Quick Overview

It is mandatory for all health insurance providers to provide maternity care coverage. In 2014, the Affordable Care Act became law, requiring coverage for pregnancy, labor, delivery, and newborn care.

How Has Maternity Coverage Changed?

You may not realize that maternity coverage was not always a required benefit. Prior to 2014, only 12% of all individual insurance plans offered maternity coverage.

Pregnancy was often considered a pre-existing condition. This meant that maternity care might not be offered if the individual was not already enrolled in the insurance program.

If maternity coverage was offered, the cost of the insurance premium might be higher if coverage was offered. That is no longer the case. Now, maternity coverage is guaranteed for pregnant Americans.

What Is Covered by Health Plans During Pregnancy and for Newborns?

  • Outpatient services. This includes prenatal and postnatal visits, and necessary screenings, such as gestational diabetes screenings, lab tests, and medications.
  • Hospitalization, physician fees, and other inpatient services.
  • Newborn baby care.
  • Lactation counseling and breast pump rental.

When Should You Enroll in A Health Plan to Have Maternity Coverage?

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

Pregnancy is not an exception to the Open Enrollment Period. However, 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 enables you, your spouse, and any of your children, including the newborn, to enroll or change health care plans.

How to Get Affordable Maternity Coverage

Maternity coverage is a mandatory benefit in health insurance plans, so you can select the plan that best fits your needs. You can check if a government program is available to subsidize your insurance, select your health insurance plan, and complete the enrollment process, all conveniently online.

Reach out to the Health Plans of North Carolina Agent on this website to learn more or enroll.

SEE ALSO: What You Need To Know About Maternity Coverage, What You Need To Know About Health Insurance If You Are Trying For A Baby

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