Health Insurance and Pregnancy: What You Need to Know

This article originally appeared on the American Fidelity blog.

From buying diapers to creating a birth plan, there’s a lot to prepare for when you’re expecting a child. While you probably won’t be gifted health insurance at a baby shower, it’s still a vital part of your pregnancy experience.

Understanding your coverage can help you better prepare for the claims process before and after childbirth. Here are some tips to help ensure you’re in-the-know.

Review Your Maternity Coverage

Did you know maternity coverage is one of the 10 essential health benefits? That means all health insurance plans must cover maternity services, including:

Postnatal doctor visits
Gestational diabetes screenings
Lab screenings
Hospitalization
Physician fees
Newborn baby care
Lactation counseling

While these are covered services, it doesn’t mean your insurance will pay the entire cost. Chances are, you’ll still be billed for a portion of the costs, especially if you have a higher deductible. Make sure to review your deductible, out-of-pocket costs, and coverage so you’re better prepared for the costs ahead.

Check Your Network

To avoid excess costs, it’s important to stay in your insurance’s network for medical procedures and services. If you’re planning to expand your family, make sure your desired physician is in your insurance network before you schedule an appointment.

If you’re pregnant and plan to give birth in a hospital, confirm that the hospital is in your network as well. Sometimes, your doctor may be in network, but the hospital is not.

It’s also important to know that some services you receive during childbirth may end up being out of your network. For example, if you receive an epidural, the anesthesiologist may not be in your insurance network.

A quick call to your hospital of choice can answer some of these questions and help you better prepare for future expenses.

Consider Disability Insurance

If you’re thinking about having a baby, it’s a good time to consider purchasing disability insurance. Disability insurance pays a portion of your salary when you’re unable to work due to a covered illness or injury—like childbirth. With disability insurance, you could still receive a paycheck when you’re out of work on maternity leave.

It’s important to purchase disability insurance before you become pregnant, as pregnancy will be considered a pre-existing condition and may not be covered.

Already have disability insurance? Review your policy to understand your coverage, elimination period, and other important factors.

Save Your Receipts

If you have a reimbursement account—like a Healthcare Flexible Spending Account (HCFSA), Health Savings Account (HSA), or Health Reimbursement Arrangement (HRA)—you can submit some pregnancy-related expenses for reimbursement.
For example, the following medical expenses are eligible for reimbursement:

Obstetrical expenses
Prenatal expenses
Prenatal vitamins
Lamaze class
Breast pumps and lactation supplies (excluding breastfeeding bras)
Feminine hygiene products
Pain relievers
Deductibles

Reviewing and understanding your health insurance is a great step in preparing for the road ahead. Be sure to speak with your HR representative for more information about your specific health coverage.

This blog is up to date as of April 2021 and has not been updated for changes in the law, administration or current events.