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Insurance When You're Pregnant: FAQ

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

Some of these services have been available at no cost since 2012. They're listed roughly in the order you would need them, over the course of your pregnancy.

  • Certain prenatal care
  • Testing for sexually transmitted diseases
  • Testing for a blood condition known as Rh incompatibility
  • Folic acid supplements, which help protect your baby from certain birth defects  (with a prescription)
  • A wide range of prenatal tests, including anemia screening, and screening for urinary tract infections
  • Testing for gestational diabetes
  • Screening and help to quit tobacco use
  • Breastfeeding counseling and equipment
  • Birth control after you've had your baby

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

What delivery costs and after-delivery costs will be covered by health insurance?

Most health plans will cover the costs of delivery and aftercare, but, as with any other stay in a hospital or other health care facility, you may need to pay part of the bill. Your costs may include having to meet your health plan’s deductible as well as copays or coinsurance, or in some cases both copays and coinsurance.

Your deductible is the money you have to spend before your insurance helps pay for your care.

Copays are a flat fee you pay when you see a doctor, such as $20 per visit.

With coinsurance, you pay a percentage of the cost of your medical care.

You can find out what services are covered by your plan and what your costs are likely to be by looking at your health plan's summary of benefits or by calling your insurance company.

Here are some things you might want to look for:

  • Labor and delivery services in the setting you choose, such as a birthing center, home, or hospital
  • Alternative birthing options, like water birth
  • Midwife services
  • Enhanced coverage for high-risk pregnancy or pregnancy complications
  • Delivery/C-section costs after infertility treatment
  • Medically prescribed C-section including recovery
  • Neonatal care

Am I eligible for Medicaid while I'm pregnant?

All states offer Medicaid coverage to pregnant women whose income makes them eligible. The amount of money you can earn and still qualify varies by state.

States have the option to extend Medicaid coverage to pregnant women with incomes up to or over 185% of the federal poverty level, and most states have done so. In 2014, that’s roughly $21,256.50 for an individual. Coverage continues through pregnancy, labor, delivery, and the first 60 days after birth.

Some states may cover your maternity care under the Children's Health Insurance Program.

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