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.
You generally have to use a provider in your plan’s network in order to receive these services.
After Delivery: Postpartum Care
Under the Affordable Care Act, health plans must make several types of preventive care available at no cost. 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.
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.
Contraception. Under the Affordable Care Act, plans must cover all FDA-approved contraception methods without cost-sharing, although this is under threat by a legal challenge. Talk to your obstetrician about what method might be right for you.
If your health plan was in place before the Affordable Care Act became law and has made very few changes to its benefits, it may be considered a "grandfathered" plan. These plans can require you to pay a copay, coinsurance, or deductible at the time of the service. You must confirm whether your plan provides preventive services at no cost.
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, if you are an hourly paid worker, you 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 as well as each plan's provider network 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?
- Are my obstetrician and pediatrician in the plan’s network?
Giving birth or adopting a child entitles you to a special open enrollment period to shop for and purchase coverage on your state’s insurance Marketplace. This means if you missed the annual open enrollment period you can still sign up for a new health plan or change your existing plan after giving birth or adopting a child. You have 60 days after the birth or adoption of your child to make changes to your health plan. So, if after you have your child, you discover your preferred pediatrician is not in your plan’s network, you can make a change.