Is Your Baby Covered By Your Health Insurance?

Doctor comforting baby
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When I was a brand new mother, I had just graduated college.

And I mean that very literally — I graduated from college one week and delivered my daughter the next, which meant that I wasn't exactly job hunting right out of the gate.

Although I had insurance coverage, I had no idea how the coverage worked for my baby. In fact, I wept tears of gratitude when I finally got it all straightened out and realized that my baby was covered under my insurance as well.

To start out life together without the burden of medical bills felt like the biggest gift ever.

So, I definitely know firsthand how confusing figuring out insurance rules, especially when it comes to maternity coverage and baby care, can be.

The Washington Post recently pointed out that for many types of insurance under the Affordable Care Act, labor and delivery coverage may not necessarily be part of the insurance plan.

For instance, even though the law changed and now allows adult children to stay on their parents' insurance up to age 26, there was some confusion with what those plans won't cover if that "child" happens to get pregnant and have a baby. And insurance plans that were "grandfathered in" may not cover anything at all for pregnant women and their babies.

While some people believe that insurance coverage that covers pregnancy and delivery care shouldn't be mandated (I have an uncle like this--"Why would I pay for maternity coverage?" he scoffs.

"I'll never have a baby!"), while others see exempting maternity and baby care as a form of discrimination, since (obviously), maternity and baby health care are directly tied to women. It's not like, I, as a woman who can have a baby, get to choose if I don't contribute to Medicare for the elderly, so why am I singled out because I have a uterus, right?

Anyways, back to the point at hand, if you are pregnant or hope to become pregnant and are planning on using a health insurance option under the Health Insurance Marketplace, you may want to be sure you have all the information you need to make the best choice for coverage. has some helpful tips on the topic including:

  • Maternity and childbirth care are "essential" health benefits, meaning by law, they have to covered by any plan in the Marketplace
  • You can get coverage even after you are pregnant. You can't be denied coverage for "pre-existing conditions, including pregnancy anymore.
  • Although all plans must cover maternity and birth care, you will still need to understand exactly what the insurance will pay out and what you will be responsible for. The Marketplace recommends reading this sample guide to familiarize yourself with the language of what insurance covers and what it doesn't.
  • Any plan outside of the Marketplace (for example, private insurance or those through your employer) may not guarantee maternity, birth, and baby care, so call your specific insurance company to double-check.
  • Low-income women and their babies are still eligible for state insurance coverage through Medicaid or CHIP.
  • Having a baby qualifies as a "Special Enrollment Period" meaning that you eligible to switch to a new plan and if approved, the new plan will kick in from the day of the baby's birth.

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