Pregnancy is a time of joy and excitement, but also of uncertainty and anxiety. One of the most important decisions you will have to make is how to pay for the medical care that you and your baby will need.
Choosing the best health insurance for pregnancy can help you reduce your out-of-pocket costs and access quality care.
In this article, we will explore the different health insurance options for pregnant women, the factors to consider when choosing a plan, and the best health insurance providers for pregnancy.
Health Insurance Options for Pregnant Women
Depending on your income, employment status, and eligibility, you may have several health insurance options to choose from when you are pregnant or planning to get pregnant. Here are some of the most common ones:
- Medicaid or the Children’s Health Insurance Program (CHIP): These are federal and state programs that provide free or low-cost health coverage to low-income individuals and families, including pregnant women and children. If you qualify for Medicaid or CHIP, you will be covered for prenatal care, delivery, postpartum care, and other essential health benefits. You can apply for Medicaid or CHIP at any time during the year through your state’s agency or website.
- Marketplace Insurance: This is health insurance that you can buy through the Health Insurance Marketplace, a platform created by the Affordable Care Act (ACA). Marketplace plans cover pregnancy and childbirth as essential health benefits, as well as preventive services like screenings and vaccines. You can also get financial assistance to lower your premiums and deductibles if you meet certain income requirements. You can enroll in a Marketplace plan during the open enrollment period, which usually runs from November to December each year, or during a special enrollment period if you have a qualifying life event, such as getting married, losing other coverage, or having a baby.
- Employer-Sponsored Health Insurance: This is health insurance that you get through your employer or your spouse’s employer. Employer-sponsored plans also cover pregnancy and childbirth as essential health benefits, but they may vary in terms of costs and benefits depending on the plan type and level. You can enroll in an employer-sponsored plan during the open enrollment period set by your employer, or during a special enrollment period if you have a qualifying life event.
- Supplemental Insurance: This is health insurance that you can buy separately from your primary health insurance to cover specific expenses or situations that your primary plan does not cover. For example, you can buy supplemental insurance for maternity care, hospitalization, critical illness, or disability. Supplemental insurance can help you pay for extra costs that may arise during pregnancy, such as copays, coinsurance, or deductibles.
- Virtual care options: These are online platforms or apps that provide telehealth services, such as consultations, prescriptions, referrals, or monitoring. Virtual care options can be convenient and affordable alternatives to in-person visits, especially during the COVID-19 pandemic. Some virtual care options are covered by your primary health insurance, while others may charge a fee or require a subscription.
Factors to Consider When Choosing Health Insurance for Pregnancy
When choosing health insurance for pregnancy, there are several factors that you should consider to find the best plan for your needs and budget. Here are some of the most important ones:
Coverage for Prenatal Care, Delivery, and Postpartum care
Prenatal care is the regular medical check-ups and tests that you get during pregnancy to monitor your health and your baby’s development. Delivery is the process of giving birth to your baby, either vaginally or by cesarean section. Postpartum care is the medical care that you get after delivery to help you recover and care for your baby. These services are essential for a healthy pregnancy and childbirth, and they can be expensive without adequate coverage. You should look for a plan that covers these services in full or with minimal cost-sharing.
Costs and Deductibles
Costs are the amount of money that you have to pay for your health insurance and your health care services. Deductibles are the amount of money that you have to pay out of pocket before your health insurance starts to pay its share. You should look for a plan that has affordable premiums (the monthly fee that you pay for your insurance), copays (the fixed amount that you pay for each service), coinsurance (the percentage of the cost that you pay for each service), and deductibles. You should also check if you qualify for any subsidies or discounts that can lower your costs.
Maternity Benefits and Coverage
Maternity benefits are the additional services or features that your health insurance offers to support you during pregnancy and childbirth. For example, some plans may offer maternity programs that provide education, counseling, coaching, or other resources to help you prepare for parenthood. Some plans may also offer coverage for extra services that may not be considered essential health benefits, such as infertility treatments, home births, doulas, or lactation consultants. You should look for a plan that has generous maternity benefits and coverage that suits your preferences and needs.
Best Health Insurance Providers for Pregnant Women
There are many health insurance providers that offer plans for pregnant women, but some of them stand out for their quality, affordability, and customer service. Here are some of the best health insurance providers for pregnant women:
1. Kaiser Permanente
Kaiser Permanente is a health care system that operates in eight states and Washington, D.C. It offers integrated care, meaning that it provides both health insurance and healthcare services through its own network of doctors, hospitals, and clinics. Kaiser Permanente has the best customer service among health insurance providers, according to the J.D. Power 2021 U.S. Commercial Member Health Plan Study. It also has high ratings for quality and satisfaction from the National Committee for Quality Assurance (NCQA). Kaiser Permanente offers comprehensive coverage for pregnancy and childbirth, as well as maternity programs, virtual care options, and wellness resources.
2. Blue Cross Blue Shield
Blue Cross Blue Shield is a federation of 36 independent health insurance companies that operate in all 50 states and Puerto Rico. It has the largest network of doctors and hospitals in the country, which gives you more choices and flexibility when seeking care. Blue Cross Blue Shield also has high ratings for quality and satisfaction from the NCQA. Blue Cross Blue Shield offers coverage for pregnancy and childbirth as essential health benefits, as well as maternity programs that provide personalized support and guidance to expectant mothers.
Aetna is a health insurance company that operates in all 50 states and Washington, D.C. It has a large network of doctors and hospitals, as well as virtual care options and wellness resources. Aetna has the cheapest plans among health insurance providers, according to ValuePenguin’s analysis of the average costs of a Silver plan for a 30-year-old. Aetna offers coverage for pregnancy and childbirth as essential health benefits, as well as maternity programs that provide education, tools, and incentives to help you have a healthy pregnancy.
Choosing the best health insurance for pregnancy can be challenging, but it can also make a big difference in your health and your finances. You should compare the different health insurance options available to you, consider the factors that matter most to you, and look for the best health insurance providers for pregnant women. By doing so, you can ensure that you and your baby get the best possible care at the best possible price.