Can You Get Private Health Insurance While Pregnant

Environmental And Recreational Risks

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Pregnant women should remember to discuss their travel plans, including any planned or potential recreational activities, with a health care provider, as some may not be recommended or may require additional precautions.

  • It is recommended that pregnant women avoid altitudes above 3,658 metres . For high-risk pregnancies and women in the late stages of pregnancy, altitudes should be limited to 2,500 metres .
  • Women with pregnancy-related complications should avoid unnecessary high-altitude exposure.
  • Keep in mind that most high-altitude destinations are far from medical care services. Remember to discuss all planned activities with your health care provider.

How To Get Health Insurance Coverage Through A Spouse

Getting health insurance through a spouse is another great option if youâre pregnant, or youâre planning to become pregnant, and they have an employer-sponsored plan thatâll cover you.

The questions you should answer before getting health coverage through a spouse, though, include:

  • How much will you have to pay per month to be added to your spouseâs plan?
  • Will it provide all the coverage youâll need during your pregnancy?
  • What about copays and co-insurance? How much could they cost you throughout your pregnancy?
  • How will this plan cover your newborn? And how much might that cost you and your spouse?

If youâre happy with the answers you receive to those questions, go ahead and join your spouseâs health insurance plan. If youâre not happy with those answers, though, weigh your options. A plan bought through your stateâs ACA or Obamacare marketplace may be a better bet. Or you might find that buying a plan directly from an insurance company provides the best coverage for the best price.

And, again, donât forget about Medicaid. Should you qualify for it, it could provide you with the best coverage for the best price of all the options discussed here.

To learn more about this topic, check out our article about picking the right plan when both spouses have employer-sponsored health insurance.

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Is Pregnancy Considered A Pre

Yes, pregnancy is considered a pre-existing condition for health insurance with maternity cover but not for regular health insurance. Therefore, it is advisable to buy health insurance with maternity cover as early as you think it is suitable for example, you can consider buying maternity health insurance right after your marriage.

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When Should I Take Out A Health Insurance Policy

Most private health insurance policies have a 12-month waiting period. During this time, you cant claim any pregnancy-related health expenses.

If you want private obstetric care during your pregnancy and birth, you will need to do one of the following:

  • take out private health insurance with relevant cover, 12 months before you are pregnant
  • upgrade your existing policy 12 months before you are pregnant
  • pay for your care yourself

What Is Supplemental Insurance For Pregnancy

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Health insurance for pregnant women can also include supplemental insurance, and there are two main types short-term disability insurance and hospital indemnity insurance. Heres how these supplemental plans work:

  • Short-term disability insurance: Many employers offer short-term disability insurance, which provides income replacement during maternity leave and if the mother is placed on bed rest before birth. You can also purchase private disability insurance if you are unemployed or if your company doesnt offer it.
  • Hospital indemnity insurance: Hospital indemnity insurance pays for the cost of delivery, including hospital admission, medications, and emergency surgery. It may also pay for newborn care if the baby is born prematurely or needs to spend time in the intensive care unit. Hospital indemnity insurance can be a good option if you cant purchase a full health insurance policy before giving birth.

Although supplemental maternity insurance plans can be beneficial, there are some downsides. Notably, you have to purchase both short-term disability and hospital indemnity insurance before you get pregnant to use the coverage. And if you suffer from pre-existing conditions, hospital indemnity plans may not cover treatment related to your condition.

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If You Have Concerns About Being Able To Pay For Insurance Options For Insurance During Pregnancy Include Medicaid And The Childrens Health Insurance Program

Health insurance helps you pay for medical care. Health insurance is really important for you, especially if youre pregnant.

What health care services are covered for a pregnant woman?

After the Affordable Care Act passed, health care law requires all insurance plans on the Health Insurance Marketplace or Medicaid to cover many services for pregnant women. The Marketplace is an online resource that helps you find and compare health plans in your state. These insurance plans cover services for pregnant women including:

  • All prenatal care visits with no co-pay. Prenatal care is medical care you get during pregnancy. No co-pay means you dont have to pay your health care provider each time you go for a prenatal checkup. You can see your prenatal care provider without a referral from a primary care provider . So you dont have to see your primary care provider first to get an OK to see a prenatal care provider, like an obstetrician/gynecologist , nurse-midwife or nurse practitioner.
  • Labor and birth services
  • Breastfeeding help with no co-pay. This includes visits with a lactation consultant, breastfeeding equipment and breast pumps. A lactation consultant is someone with special training in helping women breastfeed.

Insurance plans in the Marketplace and Medicaid have to cover these services for everyone, including pregnant women:

  • Regular health checkups
  • Checkups when youre sick

Health care law says that a plan cant:

Is it OK to be pregnant when you sign up for a health plan?

Can You Enroll Or Switch Health Insurance Plans While Pregnant

Are you pregnant and curious if you can switch health coverage while pregnant? You can enroll in health insurance during the open enrollment period, which usually runs from November 1st through December 15th in most states. However, this years open enrollment was extended in many states due to COVID-19. In New Jersey, the deadline to enroll in a new plan is December 31, 2021.

You cannot enroll or change health insurance plans outside of the open enrollment period unless you experience a qualifying life event. A qualifying life event will trigger a special enrollment period, which typically lasts 60-days. During these 60 days, you may enroll or switch health insurance coverage.

Giving birth is considered a qualifying life event however, becoming pregnant is not a qualifying life event. This means that after you give birth, you will qualify for a special enrollment period. During these 60 days, you can enroll in a new health insurance plan, switch plans, or keep your current plan and add your child to your coverage.

What pregnancy benefits should you consider when looking at plans?

If you are pregnant or plan to become pregnant, some critical things to consider about your current or any potential health insurance plan are:

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What Prenatal Care Can I Expect To Be Covered By My Health Plan During My Pregnancy

All health plans* must cover certain preventive care with no out-of-pocket cost to you at the time of the visit.

These services are listed roughly in the order you would need them over the course of your pregnancy.

  • Testing and counseling for sexually transmitted diseases, including HIV
  • Testing for a blood condition known as Rh incompatibility
  • Folic acid supplements, which help protect your baby from certain birth defects
  • 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
  • Labor and delivery costs, including your hospital stay
  • 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, review the details of the planâs summary of benefits or call the insurance company for more information.

Does Health Insurance Cover Prenatal Care And Other Pregnancy Services

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Yes. Routine prenatal, childbirth, and newborn care services are essential benefits. And all qualified health insurance plans must cover them, even if you were pregnant before your health coverage started. Talk with your doctor or contact your health insurance company for more information about the services your plan covers.

If you dont have health insurance and youre pregnant, plan to get pregnant, or you just gave birth, you may be able to get coverage for yourself and your baby through Medicaid or the Health Insurance Marketplace. Read more on

Your state may also have programs that provide free or low-cost medical care and as well as additional services to help you have a healthy pregnancy. For more information, call 1-800-311-BABY .

Some Planned Parenthood health centers may offer free or low-cost pregnancy services, or offer resources for affordable care where you live. Contact your local Planned Parenthood for more information.

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Find Cheap Health Insurance Quotes In Your Area

Maternity coverage has greatly improved in recent years, as the Affordable Care Act requires health care plans to cover pregnancy services. The best health insurance will provide coverage for all pregnancy costs, including prenatal testing, blood work, ultrasounds, monthly or weekly doctor visits, and the labor and delivery of the baby. These medical bills can add up quickly, with the average cost of pregnancy ranging from $9,000 to $200,000 without insurance. More affordable plans are also available, such as hospital indemnity policies, but they donât include as many benefits as other maternity coverage.

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Early And Periodic Screening Diagnostic And Treatment

The Early and Periodic Screening, Diagnostic and Treatment benefit provides comprehensive and preventive health care services. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services.

All Health First Colorado coverable, medically necessary services must be provided even if the service is not available under the state plan to other people who qualify for Health First Colorado. Benefits not listed are not considered to be a state plan benefit and are therefore outside of EPSDT coverage and exceptions. No arbitrary limitations on services are allowed, e.g., one pair of eyeglasses or 10 physical therapy visits per year.

Who Qualifies?

Children and Youth ages 20 and younger who are enrolled in Health First Colorado.

Top Benefits:

  • Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
  • Arrange for corrective treatment as determined by child health screenings

Co-pay Costs:

Children under the age of 19 do not have co-pays. Co-pay costs for youth ages 19 and 20 vary, see program information page.

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What If I’m Pregnant With No Insurance

If you have no insurance and are unable to sign up for coverage now , you may have some other options:

  • Medicaid covers pregnancy and childbirth, and you may qualify now that you’re pregnant, even if you didn’t qualify before. You can enroll in Medicaid year-round.
  • CHIP, the Children’s Health Insurance Program, covers prenatal care, childbirth, and baby care during pregnancy and for 60 days after delivery. You may qualify for CHIP, even if you don’t qualify for Medicaid. You can also enroll in CHIP year-round.
  • Community-based health centers provide health care services to those in need. These receive federal funding and often offer a sliding scale, depending on the ability to pay for services.
  • Some Planned Parenthood centers offer free or low-cost prenatal services. Even if they don’t, they may be able to point you to other resources in your area.
  • Hill-Burton facilities are public and nonprofit facilities that received financial assistance under the Hill-Burton Act . These facilities are required to offer free or reduced-cost health care to those with incomes below the Federal poverty guidelines.
  • Talk with your local Health Department. They may be able to provide you with information on maternity resources in your area.

Read more about financial help for pregnant women and families.

Is It Harder To Conceive At 32

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According to the American Society for Reproductive Medicine, as a woman reaches her mid- to late 30s, shes less likely to become pregnant and more like to have miscarriages because the quality and quantity of her eggs are dwindling. Women at this age might feel tremendous anxiety when it comes to having children.

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Does Health Insurance Cover Breastfeeding Services

Yes. Most health insurance plans must cover breastfeeding counseling, support, and equipment during pregnancy and after birth, for as long as youre nursing.

Health insurance must cover the cost of a breast pump. But plans may have guidelines on the type of pump they will cover and whether you get it before or after the baby’s birth, among other rules. Your covered pump might be a rental or a new one youll get to keep.

You and your doctor will decide what breastfeeding services are right for you. Health insurance plans often follow your doctors breastfeeding recommendations. Some plans may require your doctor to pre-authorize services before your insurance will cover them. Talk with your doctor and contact your health insurance provider for more information about breastfeeding coverage and benefits.

Will My Insurance Plan Cover My Pregnancy

The Affordable Care Act requires all plans on the Health Insurance Marketplace or Medicaid to cover prenatal care, childbirth, and newborn care, even if you were pregnant before your coverage started. These are considered essential health benefits. So whether you receive health insurance through an employer or directly on the Marketplace , you should have coverage.

There are exceptions. Small employers don’t have to provide healthcare coverage, but if they do, they must include maternity care. And group plans aren’t required to provide complete maternity coverage for dependent children, even though adult children can remain on their parent’s healthcare plans through age 26.

Some older plans, known as grandfathered health plans, aren’t required to cover pregnancy, childbirth, or preventive care. A grandfathered plan is a health plan that existed on March 23, 2010, before the Affordable Care Act went into effect, and has not been significantly changed since then. If you have one, you may not receive some of the protections offered by qualified plans. For example, a grandfathered plan isn’t required to provide free preventive care or pregnancy and childbirth coverage.

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Special Enrollment Periods And Qualifying Life Events

But if you find yourself uninsured and pregnant after open enrollment has ended but many months ahead of the start of the next year’s enrollment period, certain circumstances could provide you with another chance to enroll.

Although some pregnant people might be eligible for special enrollment periods due to qualifying events, pregnancy itselfis generally not a qualifying event. But for individual/family coverage, there’s an exception in New York, Connecticut, DC, New Jersey, Maryland, and Maine.

In every state, the birth of a baby is a qualifying life event that will allow you to enroll in coverage through an available employer-sponsored plan or the individual/family market. Pregnancy, on the other hand, is generally not a qualifying event. But DC, Connecticut, Maine, Maryland, New Jersey, and New York have implemented rules that allow a person to enroll in coverage through the state-run health insurance exchange, with the confirmation of the pregnancy serving as the qualifying life event.

The birth of the baby is always a qualifying event, and allows both the baby and parent to enroll in a health plan. However, that doesn’t help with prenatal care or the cost of the delivery itself.

If you’re not eligible for insurance through the ACA or your job, or if you need prenatal care before the next open enrollment period, you do have some options.

Health Insurance For Pregnant Women

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Elizabeth Rivelli is a freelance writer who covers various insurance topics. Her areas of expertise are life insurance, car insurance, property insurance and health insurance. Elizabeths byline has appeared in dozens of online publications, including Investopedia, CNET and Bankrate. She has also written for several insurance carriers.

Les, a former managing editor, insurance, at QuinStreet, has more than 20 years of experience in journalism. In his career, he has covered everything from health insurance to presidential politics.Read full bio > >

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Pregnant women cant be denied health insurance coverage for being pregnant.Since the passage of the Affordable Care Act over a decade ago, its become much easier for pregnant women to get health insurance. Before the ACA, pregnant women were subject to higher insurance rates and could even be denied coverage.

If youre wondering whether health insurance covers pregnancy, the answer is yes.

Doctors must closely monitor expecting mothers, so having health insurance is extremely important. Pregnancy insurance also covers labor and delivery in a hospital or birthing center, including procedures like cesarean sections.

If youre currently pregnant or are planning for a baby, its important to know what types of pregnancy insurance are best, and how to get health insurance during pregnancy.

Key Takeaways

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Is It Worth It To Get Maternity Insurance

Having maternity insurance in place when giving birth protects your newborn should it be born with any congenital disease. If any complications do arise, maternity plans usually cover a newborn for up to 30 days after delivery. After that, you’ll need to make sure your baby is covered with newborn insurance coverage.

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