Pregnancy And Your Individual Health Insurance Plan: What You Need To Know
The news that you are expecting a baby can be a great source of joy for you and your family, but you may wonder how it will work with your current individual health insurance plan. Here are a few things you should know about your pregnancy and your health insurance plan.
Pregnancy Is No Longer A Pre-Existing Condition
In some cases, you may find out you are pregnant before your individual health insurance plan takes effect. While insurance companies used to be able to consider pregnancy a pre-existing condition, they can no longer do so. This means that no matter what, your pregnancy qualifies for the same prenatal care benefits as anyone whose coverage was already in effect at the time of conception. Your insurer will not be able to discriminate against you because of your pregnancy.
Not All Plans Cover Maternity Care
All insurance plans that are part of the insurance marketplace are required to provide coverage for prenatal care and childbirth. This is also true for Medicaid and CHIPs (Children's Health Insurance Programs). There are, however, some exclusions to the mandate for maternity coverage. Some private plans that are not part of the marketplace were grandfathered in with the Affordable Care Act, which means they don't have to follow all the rules that govern the marketplace. If you have a private policy that was grandfathered in, check with your insurer to see what type of coverage you have. You may be able to apply for a Special Enrollment Period (SEP), which allows you to switch your coverage outside of the open enrollment period for the ACA.
New Prenatal Care Service Coverage
The Affordable Care Act provides certain guarantees for women's health during pregnancy. As a result, there are several different services covered by insurance plans both inside and outside of the insurance marketplace. If you are pregnant, you can take advantage of some of the following services without having to pay the full amount out of pocket:
- BRCA genetic counseling for high-risk pregnancies
- Routine screenings for STDs, anemia and infections
- Breastfeeding consultations
- Gestational diabetes screening and care
- Folic acid supplements for pregnant and nursing women
Your individual health insurance plan will likely cover other services, such as regular prenatal exams, prenatal testing and some of the costs associated with childbirth. Remember to talk with your insurance provider to see what your expected out-of-pocket costs will be so you can budget throughout your pregnancy.
Talk to your insurance carrier and your healthcare provider to coordinate your prenatal care so you get the best possible treatment and care throughout your pregnancy.
To learn more, contact a company like Canopy.