The truth about pregnancy is that you can’t always plan for it. Unexpected pregnancies happen. For some, you may be left wondering what to do about health insurance. Thankfully, health insurance for pregnant women is now more readily available, with plans now covering pregnancy and childcare. In this article, we will explore three prominent companies renowned for offering health insurance options for pregnant women.
Best health insurance for pregnant women: shortlist
Selecting the best insurance plan for pregnancy is paramount when ensuring comprehensive healthcare coverage during pregnancy. Whether you prioritize overall quality, affordability, or exceptional customer satisfaction, there is a health insurance option among these providers that may suit you best. Let's delve into the specifics of each company and the benefits they offer for expectant mothers:
- Kaiser Permanente - Best overall for pregnant women
- Blue Cross Blue Shield - Top cheap insurance for pregnant women
- Aetna - Best customer satisfaction
In selecting the following health insurance providers as our top choices for pregnant women, we evaluated several criteria, such as the size of each network, plan options, and reputation. These factors ensure that expectant mothers receive comprehensive and reliable healthcare coverage throughout their pregnancy.
Please note, the relevance of the content in this article depends on its publication and/or the date of the last update as laws and regulations are evolving.
Top health insurance providers for pregnant women
Considering these providers' networks, plan features, and quality, we have identified the following providers as exceptional options for pregnant women seeking reliable health insurance coverage.
1. Kaiser Permanente — best insurance plan for pregnancy
Kaiser Permanente is widely regarded as the best option for pregnant women due to its comprehensive approach to healthcare. They prioritize preventive care, personalized treatment, and patient satisfaction. With an extensive network of healthcare providers, expectant mothers have convenient access to quality care. Kaiser Permanente's health insurance plans for pregnant women typically include comprehensive prenatal care, childbirth services, and postpartum support.
2. Blue Cross Blue Shield — affordable insurance for pregnant women
- Available in 50 states and Puerto Rico, with variations based on plan types
- Offers dental, vision, hearing, and transportation coverage
- Rated 4.17 out of 5 by CMS
Blue Cross Blue Shield is recognized as a top choice for affordable health insurance options for pregnant women. They offer a vast network of healthcare providers nationwide, ensuring ample opportunities for maternity care. Their health insurance plans for pregnant women often come at competitive prices without compromising essential coverage for prenatal care, labor and delivery, and postpartum services.
3. Aetna — great customer satisfaction
- Available in 50 states and Washington, DC, with variations based on plan types
- Along dental, vision, and hearing coverage, it also offers lifestyle benefits
- Rated 3.87 out of 5 by CMS
Aetna is known for its commitment to customer satisfaction, making it an excellent choice for pregnant women. Their extensive network of healthcare providers allows expectant mothers to choose from a wide range of doctors, hospitals, and specialists. Aetna's health insurance plans for pregnant women typically include comprehensive prenatal care, childbirth services, and postpartum support while prioritizing patient-centered, individualized care.
Comparing the best health insurance companies for pregnant women
Now that we have explored each health insurance provider's strengths, features, and considerations, let's take a closer look at a side-by-side comparison of Kaiser Permanente, Blue Cross Blue Shield, and Aetna.
| Provider | Network size | Plan features | Customer service rankings |
| Kaiser Permanente | Large | Comprehensive prenatal care, childbirth services, postpartum support | High |
| Blue Cross Blue Shield | Large | Affordable pricing for prenatal care, labor and delivery, postpartum services | High |
| Aetna | Large | Comprehensive prenatal care, childbirth services, postpartum support | High |
How we ranked the best health insurance companies for pregnant women
In ranking the best health insurance for pregnancy, we considered multiple factors to assess their suitability for pregnant women. The following criteria were taken into account to determine the rankings:
Overall Value. We evaluated the overall value provided by each insurance provider regarding the combination of plan features, network size, customer service, and affordability.
Availability in States. Providers with broader availability were ranked higher as they offered more comprehensive access to their services.
Network Size. A larger network size ensures more choices for pregnant women to access quality care, including doctors, hospitals, specialists, and other healthcare professionals.
Plan Features and Coverage. This includes prenatal care, childbirth services, postpartum support, and other essential healthcare services. Additional benefits like dental coverage, different plan types (HMO, PPO), and varying metal levels (e.g., Bronze, Silver, and Gold) were also considered.
Costs. This includes premiums, deductibles, out-of-pocket expenses, copayments, and coinsurance. Providers offering competitive pricing and reasonable cost-sharing structures were given favorable consideration.
Customer Satisfaction. Providers with a track record of high customer satisfaction, positive customer experiences, and responsive customer service were given added weight in the rankings.
Health insurance during pregnancy – what you should know
Prior to the Affordable Care Act (ACA), pregnancy was considered a pre-existing condition. Many insurance companies offered very little coverage. Some did not cover maternity care at all. Now, thanks to the Affordable Care Act, health insurance companies can no longer deny you coverage if you are already pregnant at the time you apply for insurance. If you’re looking for health insurance that covers pregnancy, you have several options to choose from.
Most insurance plans have a window for enrollment. Typically, this occurs toward the end of the year from October through December. This enrollment is for the following calendar year, with plans starting on January 1st. However, you can still enroll after the enrollment period if you qualify for a Special Enrollment Period. You can contact your insurance company or the marketplace call center to enroll whenever you wish to add or change your plan.
In addition to marketplace health plans, you can find insurance coverage through private health insurance companies. These plans work in the same way, with monthly premiums and coverage. However, these plans are typically more expensive and may not work within your budget.
What health insurance covers pregnancy?
Due to the ACA law, health insurance companies are required to cover pregnancy and childbirth as part of their plans. You can find this covered in all individual and family plans, as well as employer plans. Because the nature of getting pregnant isn’t something you can necessarily plan for, there are measures in place for women in need of additional coverage. Under the Special Enrollment Period, you can enroll in a health plan outside of the normal enrollment period. It’s important to know that being pregnant does not mean you qualify, but giving birth does.
Employer sponsored
Many employers offer health insurance plans to their employees and their families. Since your employer is covering a portion of your plan, this is often the most cost-effective option. Some companies may not necessarily fall under the ACA guidelines, so maternity care may not be covered. Be sure to check your summary of benefits and coverage policy to check if you’ll be covered.
Marketplace
The Health Insurance Marketplace is a great source to find health coverage. Essentially, it’s a resource where individuals, families, and small businesses can find, compare, and enroll in a health insurance plan that meets their needs. All plans within the Marketplace cover maternity and newborn care ― this includes services needed both before and after your child is born.
Medicaid
Medicaid plans provide low-cost or free health coverage to low-income families and pregnant women. Eligibility to enroll depends on your income, household size, and citizenship status. Keep in mind that policies vary by state, so you’ll need to contact your local Medicaid branch for further details. If you are eligible, Medicaid will cover you for 60 days after you give birth, whereas your child will be covered by Medicaid for up to a year. With this health insurance, there’s no waiting period.
What is covered in insurance for pregnant women?
With the ACA law in place, insurance plans have expanded coverage for expectant mothers. Coverage can vary, depending on the company and specific plan. When researching and comparing different insurance plans, the best health insurance plan for pregnancy will offer basic benefits, plus any additional prenatal and postpartum care, some of which may include:
- Prenatal care doctor's visits
- Tests and screenings
- Childbirth and delivery cost
- Breastfeeding equipment, including breast pumps
- Newborn screenings
What if I am pregnant without health insurance?
Being pregnant without health insurance can be a stressful situation. In an analysis conducted by the Kaiser Family Foundation, they found that the average cost of pregnancy (including childbirth and postpartum care) was $18,865. Women enrolled in large group plans paid an average of $2,854 in out-of-pocket expenses. There are variables that may affect your costs ― cesarean births, for example ― but regardless, without any insurance, you may find the financial burden overwhelming.
If you don’t have insurance, you can check your local walk-in clinics and community health centers for non-emergency care. The out-of-pocket cost is usually lower; some may even charge you based on your income. You can also apply to receive Medicaid health insurance. As a government-sponsored health program, many low-income individuals qualify while still being able to receive quality care and benefits.
Why is it important to have health insurance when pregnant?
Having health insurance during pregnancy is crucial for several reasons. It provides access to prenatal care, ensuring regular check-ups to monitor the health of both the mother and the baby.
Health insurance covers essential services like prenatal tests, ultrasounds, and screenings, contributing to the early detection and management of potential complications. Financially, it protects expectant mothers from the significant costs associated with prenatal care, hospital stays, and childbirth expenses.
Health insurance also allows for a choice of healthcare providers and specialized hospitals experienced in maternity care. Insurance coverage ensures access to immediate and necessary medical attention in emergencies or unexpected situations.
Furthermore, postpartum care is covered, supporting the recovery process and addressing postpartum complications. Overall, having health insurance provides peace of mind, reduces financial stress, and ensures comprehensive care throughout the pregnancy journey, benefiting the health and well-being of both the mother and the baby.
Can you get free health insurance if you are pregnant?
Pregnancy is a critical time to have proper healthcare coverage. While health insurance typically involves costs, there are options available that can provide free or low-cost coverage for pregnant women. Here are a few avenues to explore:
- Medicaid. Medicaid is a federal and state program that offers free or low-cost health insurance to individuals with limited income, including pregnant women. Eligibility criteria vary by state, but Medicaid generally provides comprehensive coverage for prenatal care, labor and delivery, and postpartum services.
- Children's Health Insurance Program (CHIP). CHIP is a program that provides free or low-cost health insurance for children and pregnant women in families who earn too much to qualify for Medicaid but cannot afford private insurance. Each state has its own CHIP program with varying eligibility guidelines.
- Affordable Care Act (ACA) Marketplace. The ACA provides options for subsidized health insurance plans through the Health Insurance Marketplace. Depending on income and family size, pregnant women may qualify for premium tax credits that significantly reduce the cost of health insurance coverage.
- Local Assistance Programs. Some local or community-based organizations offer assistance programs specifically designed to provide healthcare coverage for pregnant women in need. These programs may offer free or low-cost health insurance options or connect pregnant women with resources for accessing affordable care.
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FAQ
Why should you have insurance when pregnant?
Health insurance for pregnant women can provide peace of mind. It may also help save money in the long run. It can provide coverage for additional and unexpected medical needs throughout pregnancy, such as screenings, checkups, and necessary lab work.
Is it worth getting private health insurance during pregnancy?
If you are pregnant and are not already enrolled in an insurance plan, private health insurance coverage is another option to consider. Although it’s typically more expensive than Medicaid, it will still provide the necessary coverage you’ll need throughout your pregnancy.
Do pregnant women qualify for Medicaid coverage?
Yes, women who are pregnant at the time of enrollment may qualify for Medicaid coverage. Unlike marketplace plans, you do not need to wait for the enrollment period to apply for Medicaid. You can enroll at any time during the year.
Is pregnancy a pre-existing condition?
Pregnancy is not considered a pre-existing condition under current health insurance regulations. The Affordable Care Act (ACA) prohibits insurers from denying coverage or charging higher premiums based on pregnancy or other pre-existing conditions. Pregnant women cannot be denied coverage or charged more due to their pregnancy.
- Healthcare. Health Insurance Marketplace.
- Healthcare. Special enrollment opportunities.
- Kaiser Family Foundation. Health Costs Associated with Pregnancy, Childbirth, and Postpartum Care.
- WebMD. Insurance When You're Pregnant: FAQ.
- BCBS. BCBS companies support new and expectant mothers.
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