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Health Care Reform:

Health Insurance & Affordable Care Act

Insurance When You're Pregnant: FAQ

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

Most health plans will cover much of 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 2015, that’s roughly $21,590 for an individual. Coverage continues through pregnancy, labor, delivery, and the first 60 days after birth. If you qualify for Medicaid because of  pregnancy, you may still be eligible to buy extra coverage through your state’s Marketplace. In some states, women who qualify for Medicaid because of pregnancy only get the pregnancy benefits. So you may not be covered for other types of health care.

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

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