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 plans for pregnancy in 2024
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 as good health insurance for pregnancy. 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.
Best insurance plans for pregnancy: provider reviews
Considering these providers' networks, plan features, and quality, we have identified the following providers as the best insurance for pregnancy.
1. Kaiser Permanente — best insurance plan for pregnancy
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Available in 8 states and Washington, DC, with variations based on plan types
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Members can access a broad range of health and wellness resources
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Emergency and urgent care covered anywhere in the world
Kaiser Permanente is widely regarded as being among the best health insurance options for pregnant women due to its comprehensive and affordable approach to healthcare. Their business model is built on prioritizing preventive care, personalized treatment, and patient satisfaction. Kaiser Permanente's extensive network of healthcare providers gives expectant mothers a cost-effective and convenient means of accessing quality medical care. Their 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
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Available in 50 states and Puerto Rico, with variations based on plan types
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Offers dental, vision, hearing, and transportation coverage
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Rated 4.17 out of 5 by CMS
Blue Cross Blue Shield is another company that 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 getting maternity care at affordable rates. Blue Cross Blue Shield's 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
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Available in 49 states and Washington, DC, with variations based on plan types
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Enjoy plan benefits like $0 preventive care, access to walk-in clinic visits
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Get care on your schedule with 24/7 virtual care plus
Aetna is an insurance company that is known for its commitment to customer satisfaction, which, aside from the policies it offers, is one of the reasons why it is 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 (premium estimates based on costs for a 25-year-old woman who earns $40,000 per year living in Atlanta, Georgia).
Provider | Number of states plans are available in | Plan features | Additional benefits | Plan types available | Customer service rankings | Estimated monthly premium |
Kaiser Permanente | 8 | Comprehensive prenatal care, childbirth services, postpartum support | Mental health, dental, and vision | HMO and PPO | High | $313.03 |
Blue Cross Blue Shield | 50 | Affordable pricing for prenatal care, labor and delivery, postpartum services | Prescription medications, emergency services, and preventive care | HMO and PPO | High | $372.24 |
Aetna | 50 | Comprehensive prenatal care, childbirth services, postpartum support | Online resources and programs promoting wellness | HMO, PPO, and POS | High | $342.72 |
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 plan features, network size, customer service, and affordability.
- Availability in states. Providers with increased availability ranked higher as they offered more comprehensive access to services.
- Network size. A larger network size ensures more choices for pregnant women to access quality care.
- Plan features and coverage. Includes prenatal care, childbirth services, and postpartum support.
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Costs. Premiums, deductibles, out-of-pocket expenses, copayments, and coinsurance.
Health insurance during pregnancy – what you should know
Prior to the Affordable Care Act (ACA), pregnancy was considered a pre-existing condition. Today, health insurance companies can no longer deny you coverage if you are already pregnant when you apply for insurance.
Most insurance plans have an enrollment window that lasts from October to December, with coverage generally starting on January 1st of the following year. However, you can still enroll after this period if you qualify for a Special Enrollment Period. Contact your insurance company or the marketplace call center to enroll whenever you wish to add or change your plan.
You can enroll in a private health insurance plan as an alternative to marketplace coverage, but these plans are typically more expensive than marketplace plans.
What health insurance covers pregnancy?
Health insurance companies are legally required to cover pregnancy and childbirth in all individual and family plans, as well as employer plans. Under the Special Enrollment Period, you can enroll in a health plan outside of the normal enrollment period, since giving birth qualifies as a special circumstance (however, pregnancy in itself won't qualify you for the Special Enrollment Period).
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 see 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 depends on your income, household size, and citizenship status. Policies vary by state, so you’ll need to contact your local Medicaid branch for further details. If you're eligible, Medicaid will cover you for 60 days after giving birth. Your child will be covered by Medicaid for up to a year. Medicaid has no waiting period.
Supplemental pregnancy insurance: what is available?
Pregnant women have supplemental insurance options that can cover health services that are typically lacking from most health insurance policies, as well as replacing lost income resulting from an illness, injury, or disability.
Critical illness insurance
With many types of insurance related to health insurance, the insurance company covers a fraction of covered expenses and leaves the policyholder to pay the remainder out-of-pocket. With critical illness insurance, the policyholder is given a lump sum after being diagnosed with a serious illness that is covered under the policy.
Dental insurance
Dental insurance is commonly absent from health insurance policies. With this type of insurance policy, you can get coverage for dental treatments aimed at preventing dental problems such as tooth decay and gum disease, and procedures for maintaining dental health.
Short-term disability insurance
Short-term disability insurance usually covers you for six months or less after you sustain an injury or illness that prevents you from being able to work. This type of coverage pays you a portion of the income you earned while working as an employee.
Long-term disability insurance
This functions like short-term disability insurance, with the difference being the length of coverage. This coverage lasts longer than six months. If you have short-term disability in addition to this, your long-term disability coverage will begin once your short-term disability coverage ends.
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.
Can you get free health insurance if you are pregnant?
There are options that provide free or low-cost coverage, such as:
- Medicaid. Medicaid is a federal and state program that offers discounted health insurance to lower income individuals. Eligibility varies by state, and Medicaid generally provides comprehensive coverage for prenatal care, labor and delivery, and postpartum services.
- Children's Health Insurance Program (CHIP). CHIP provides 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 offers subsidized health plans through the Health Insurance Marketplace. Depending on income and family size, pregnant women may qualify for premium tax credits that significantly reduce costs.
- Local Assistance Programs. Some community-based organizations offer assistance programs that provide free or low-cost health insurance for pregnant women in need, and connect them with resources for affordable care.
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FAQ
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 quality 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.
9 resources
- HealthCare. Special enrollment opportunities.
- KFF. Health Costs Associated with Pregnancy, Childbirth, and Postpartum Care.
- WebMD. Insurance When You're Pregnant: FAQ.
- BCBS. BCBS companies support new and expectant mothers.
- Aetna. Pregnancy care.
- HealthCare. Health coverage if you're pregnant, plan to get pregnant, or recently gave birth.
- Health Insurance. What is supplemental insurance?
- BCBS. Medical Plan Details.
- Kaiser Permanente. KP GA Signature Bronze Virtual Complete 5500/1500 RxDed.
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