Health Insurance When You're Pregnant
It's not as much fun as planning your nursery, but understanding your health insurance is important for every mom-to-be.
Knowing what your plan covers -- and what it doesn't -- can help you avoid surprises down the road.
When you're pregnant, you'll need a series of doctor visits and tests to check your health and your baby's health. Which services your insurance covers, and how much you'll have to pay, depends on your plan.
The health reform law requires that new health plans cover certain preventive medical services, including some when you're pregnant. You won't have to use your own money for these services as long as the doctor is on the insurance company's "in-network" list.
For example, if you have a plan that started on or after Aug. 1, 2012, your insurance company must cover services such as:
Testing for conditions. This includes conditions that could be harmful to you or your baby, such as:
- Hepatitis B
- Gestational diabetes
- Bacteriuria, a type of bacterial infection
- Rh incompatibility, an immune condition that can develop in pregnancy
Plans may differ in how they approach prenatal testing, such as ultrasounds. "Some plans may cover just one ultrasound during pregnancy, while others will cover as many as the physician orders," says Cynthia Pellegrini. She is senior vice president of public policy and government affairs for the March of Dimes.
Also, most plans will only cover amniocentesis for women who are considered at high risk of having a baby with certain birth defects, Pellegrini says. This includes women ages 35 or older or those with a family history of an inherited disease.
When it comes time for giving birth, plans have different policies. "In general, most employer-provided health plans cover prenatal care and routine labor and delivery costs for the first one or two days in the hospital," Pelligrini says. "However, if the mother or baby have complications during delivery and require a longer stay, there may be significant differences in what's covered."