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Health Care Reform:

Health Insurance & Affordable Care Act

Care for New Moms: What's Covered by Health Reform

As a new mom, you'll want to focus on enjoying your newborn. Easy access to health care should help. Several changes made by the Affordable Care Act will help make sure you and your baby get good care.

After Delivery: Postpartum Care

Under the Affordable Care Act, health plans must make several types of care available. For instance:

Well-woman visits. You get one free doctor's visit every year. It can help you get the recommended preventive care you need and other services to stay healthy.

Depression screening and treatment. Free screening for depression, including postpartum depression, is available.  If you have postpartum depression, you can get treatment. Health plans must cover behavioral health and substance abuse treatment just as they would cover treatment for other medical conditions.

Quitting smoking. Smoking is bad for you. And secondhand smoke can harm your baby. You can get free help to quit under health care reform.

Diabetes screening. Some women develop diabetes during pregnancy. This is called gestational diabetes. As part of your prenatal care, you can get screened for gestational diabetes, at no cost to you at the time of your visit.

Domestic violence screening and counseling. One in four women is a victim of domestic violence.  Under the law, screening and counseling for domestic violence is covered at no cost for all women of childbearing age.

All new health plans will have these benefits. So does Medicaid. But if your health plan was in place before the Affordable Care Act became law and has made very few changes to its benefits, it is considered a "grandfathered" plan. These plans can require you to pay a copay, coinsurance, or deductible at the time of the service. Some plans offered by workplaces are grandfathered. But most big companies expect that their plans will lose this grandfathered status within the next few years. You must confirm whether your plan provides preventive services at no cost.

Breastfeeding Support

Breastfeeding is one of the best ways for you to protect your health and the health of your newborn. Because of that, one goal of health reform is to make breastfeeding easier. It does that by getting rid of things that have kept many women from breastfeeding.

Support, supplies, and counseling. Under the Affordable Care Act, health plans must provide free breastfeeding help from trained counselors. You can also get a breast pump free of charge through your plan. But you do not get to choose what kind of pump, electric or manual. That's up to your insurance company. It can also choose whether you get to keep the pump or use a rental.

Breastfeeding in the workplace. By law, you now must get a reasonable break time during your workday to express breast milk. Your employer also has to provide a private place where you can pump your breast milk without interruption from others. A bathroom is not considered an appropriate space. You have this benefit for up to one year after your baby is born.

Selecting the Right Plan

If you are pregnant or are a new mom, you’ll want to closely examine the specific services and medications covered in each essential health benefits category when you're comparing health plans in your state's insurance Marketplace. Here are some things to consider:

  • Does the plan limit the number of prenatal visits?
  • What diagnostic tests are covered?
  • Can I use a doula or a midwife under my plan?
  • Will the plan cover a home birth?
  • How high is my monthly premium?
  • What are the copays and deductibles?

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