Does Health Insurance Cover Pregnancy?

In Category: Health Insurance

Does Health Insurance Cover Pregnancy? Image
  • Posted On: January 03, 2022
  • Article By: Rolando Yera

Under the Affordable Care Act, pregnancy is one of the ten essential benefits and must be covered by health insurance plans offered to individuals and families. Health insurance for pregnancy, labor, delivery and newborn care became mandatory in 2014 under the Affordable Care Act (ACA).

Having a baby qualifies you for the Healthcare Marketplace Special Enrollment Period.

If you don't have health insurance at the moment and you are pregnant, this doesn't qualify you immediately for coverage. However, according to, you'll be eligible to apply within 60 days of your child's birth. In most cases, you cannot get healthcare coverage without a qualifying life event and wait for open enrollment.

Before recent legislation, you could have been denied coverage as being pregnant is a preexisting condition. However, that is no longer the case, and all marketplace, employer-provided, and Medicaid plans must cover maternity and newborn care.

Before the Affordable Care Act, roughly 12% of health care plans on the market covered pregnancy. Since then, 100% of listed health care plans have provided coverage.

What Services Are Covered

Covered services may vary depending on the plan you have. Typically outpatient and inpatient services such as doctor visits, lab studies, hospitalization, and medications are covered. Health plans on the marketplace are required to provide a summary of benefits and coverage documents. Be sure to look through the documents carefully to decide which plan is best for you and your child.

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