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Health Care Reform:

Health Insurance & Affordable Care Act

Insurance When You're Pregnant: FAQ

The new health insurance law, known as the Affordable Care Act, is expanding health care. It's also giving people more protection from unfair insurance hikes. Pregnant women will benefit. They'll have more choices to get health insurance. And they may get more benefits, too.

Can a health plan refuse to let me enroll because I'm pregnant?

In the past, many insurance companies could turn you down if you applied while you were pregnant. Those plans considered pregnancy a pre-existing condition.

Starting in 2014, health plans cannot deny you coverage if you are pregnant. That's true whether you get insurance through your employer or buy it on your own.

What's more, health plans cannot charge you more to have a policy because you are pregnant. That means they can't adjust your premium, which is the amount you pay each month to have insurance, based on your gender or health condition.

How can I get health insurance while I'm pregnant?

First, see if your employer -- or your spouse's -- offers health insurance. Enrolling in one of those health plans is likely your most cost-effective option for the most comprehensive care.  Most employers help share the cost of the premiums.

If you don't have that choice, you can go to your state's health insurance Marketplace, which is also called an Exchange.

On your state's Marketplace, you can see if you are eligible for Medicaid. You can compare health plans' costs and benefits. And you can see if you are eligible to get financial help from the government to pay your premiums.

Will I get the same coverage no matter which state I live in or which plan I choose?

Not necessarily. Every state and every plan is not the same. Each state chooses which health plans it will sell on its Marketplace and what the basic benefits each one must have. Each health plan can expand that basic package in a number of ways.

So look at the summary of benefits closely, especially for prenatal and maternity services.

What prenatal care can I expect to be covered by my health plan during my pregnancy?

As of 2014, health plans sold on each state's Marketplace must cover preventive care without charging you for it. Health plans offered from large employers do not have to cover all these services, but many of them do.

  • Testing for sexually transmitted diseases
  • Rh blood typing and antibody testing
  • Folic acid supplements, which help protect your baby from certain birth defects
  • A wide range of prenatal tests, including anemia screening, UTI screening, and screening and help to quit tobacco use
  • Testing for gestational diabetes
  • Breastfeeding counseling and equipment
  • Birth control after you've had your baby

What's covered for maternity can vary from health plan to health plan. That's true if you get insurance through your work or buy it yourself. So for any health plan you are considering, look at the details in its summary of benefits.

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