Pregnancy Health Insurance: Compare Coverage and Costs

If you have an employer plan, compare its maternity benefits with any other coverage available to you; if you’re shopping individually, look at Affordable Care Act Marketplace plans, which cover maternity and newborn care as essential health benefits. If your income may qualify you for Medicaid, apply or check your state’s rules, since pregnancy-related eligibility can differ from standard adult eligibility.

For each plan, add up the premium, deductible, copays or coinsurance, and out-of-pocket maximum, then look at how those amounts apply to prenatal care, hospital delivery, and specialist visits. A lower-premium plan may cost you more overall if you expect substantial hospital charges, while a higher-premium plan may be worth considering if its network and cost-sharing better fit your care.

Ask whether your OB-GYN or midwife, delivery hospital, and any anticipated maternal-fetal medicine specialists are in network for the specific plan you’re considering. Also review the plan’s rules for ultrasounds, lab work, anesthesia, and newborn care, because a hospital being in network does not mean every clinician involved will be in network.

Check the listed dimensions for confirm your care team and hospital against the available vehicle space before use.

Check enrollment deadlines early: pregnancy alone generally does not create a federal Marketplace special enrollment period, though state rules and other qualifying events may provide options. Birth typically creates a special enrollment opportunity, so keep your plan’s newborn enrollment instructions handy and act promptly after delivery; our baby health insurance and newborn enrollment checklist and Baby Health Insurance Made Simple printable PDF eBook can help you organize that next step.