Maternity Care
Starting or growing your family is an exciting journey. Our maternity coverage ensures you receive quality prenatal, delivery, and postnatal care without the financial stress, so you can focus on your new arrival.
Starting or growing your family is an exciting journey. Our maternity coverage ensures you receive quality prenatal, delivery, and postnatal care without the financial stress, so you can focus on your new arrival.
Having a baby is one of life's most joyful events, but it's also one of the most expensive. The average cost of pregnancy and childbirth in the United States exceeds $18,000 for a vaginal delivery and $28,000 for a cesarean section. Without insurance, these costs can create significant financial hardship during what should be a happy time for your family.
Under the Affordable Care Act, maternity care is recognized as one of the ten essential health benefits that all comprehensive health plans must cover. This ensures that pregnancy-related care, including prenatal visits, labor and delivery, and postpartum care, is available to all women with health insurance. However, understanding what's covered and how to maximize your benefits helps ensure you receive the best care possible.
Our health insurance plans provide comprehensive maternity coverage from the moment you discover you're pregnant through delivery and beyond. We cover prenatal care, hospital delivery, newborn care, and postpartum services so you can focus on your growing family instead of worrying about medical bills.
Complete prenatal coverage including monthly and weekly checkups, ultrasounds (including anatomy scans), blood tests, genetic screening, and continuous monitoring throughout all three trimesters of your pregnancy.
Full coverage for labor and delivery including hospital stay, delivery room, physician fees, anesthesia, nursing care, and all services needed during childbirth whether vaginal delivery or cesarean section.
Coverage for your baby begins at birth, including initial examinations, newborn screenings, hearing tests, vaccinations, and any necessary medical care during the hospital stay. Baby is covered under your plan for 30 days.
Follow-up care for mother and baby after delivery, including the six-week postpartum checkup, pelvic floor assessment, mental health screening, and ongoing support during the recovery period.
Full coverage for pregnancy complications including cesarean sections, preterm labor, gestational diabetes, preeclampsia, high-risk pregnancies, NICU care for baby, and extended hospital stays when medically necessary.
Breastfeeding support services including lactation consultant visits, breast pump coverage (one per pregnancy at no cost), nursing supplies, and counseling to help establish successful breastfeeding.
Initial pregnancy confirmation, early prenatal visits, blood work including blood type and Rh factor, initial ultrasound to confirm viability and due date, genetic screening options (NIPT, nuchal translucency), and discussion of birth preferences with your provider.
Monthly prenatal visits, anatomy ultrasound around 20 weeks to assess fetal development, glucose screening for gestational diabetes, continued monitoring of maternal and fetal health, and preparation for the third trimester.
Bi-weekly and then weekly prenatal visits, Group B strep testing, fetal monitoring, birth planning discussions, and preparation for delivery. Additional monitoring for high-risk pregnancies or complications.
Hospital admission for labor and delivery, all delivery-related services, hospital stay (typically 2 nights for vaginal, 4 for cesarean), newborn care, and postpartum recovery support including the six-week follow-up visit.
Planning for your baby includes understanding how your insurance will cover pregnancy and delivery:
Many OB-GYNs use global billing, which means prenatal care, delivery, and postpartum care are billed as one package. You may be asked to pay your estimated out-of-pocket costs during pregnancy, with adjustments made after delivery based on actual services.
Hospital charges for delivery are separate from your OB-GYN's fees. These include room and board, nursing care, delivery room, and supplies. Your baby's care is also billed separately. Understanding these separate charges helps you anticipate total costs.
Your newborn is automatically covered under your plan for the first 30 days after birth. You must add baby to your plan within 30-60 days (depending on your plan) to continue coverage. This is a qualifying life event that allows enrollment outside open enrollment.
Maternity care costs count toward your annual deductible and out-of-pocket maximum. If you reach your out-of-pocket maximum, remaining covered services for the year are paid at 100%. Strategic timing can help maximize your benefits.
Ideally, have health insurance in place before you conceive. Pregnancy alone doesn't qualify as a special enrollment event, so if you become pregnant without insurance, you may have to wait until open enrollment. If you're planning pregnancy, enroll during open enrollment or through a qualifying life event.
Your costs depend on your plan's deductible, coinsurance, and out-of-pocket maximum. Most women pay between $2,000 and $5,000 out-of-pocket for uncomplicated deliveries with insurance. Cesarean sections or complications may cost more but are capped at your out-of-pocket maximum.
Many insurance plans cover certified nurse-midwives and accredited birthing centers as alternatives to hospital delivery. Coverage varies by plan, so check your specific benefits. Midwife-attended births and birthing center deliveries often have lower costs than hospital deliveries.
High-risk pregnancies requiring additional monitoring, specialist care, or extended hospitalization are covered. You may need care from a maternal-fetal medicine specialist, more frequent ultrasounds, and additional testing. These medically necessary services are covered under your maternity benefits.
Yes, under the ACA, insurance plans must cover a breast pump at no cost to you. Plans typically cover one manual or electric pump per pregnancy. Some plans offer specific pump brands through designated suppliers, while others reimburse you for a pump of your choice. Check with your insurance for details.
From the first prenatal visit to bringing your baby home, comprehensive maternity coverage ensures you receive quality care throughout your pregnancy journey. Speak with a licensed agent today to find a plan that gives your growing family the protection you deserve.