Affordable Care Act

Maternity Insurance Coverage under ObamaCare

Published on October 08, 2014


Maternity insurance coverage for pregnancy, labor, delivery, and newborn baby care became mandatory in 2014 under the Affordable Care Act (ACA or “Obamacare.”) In fact, maternity insurance coverage is one of the 10 essential health benefits that must be covered by all health insurance plans offered to individuals, families, and small groups.

Changes in maternity insurance coverage

Before 2014, maternity coverage wasn’t a guaranteed benefit, and only about 12% of plans sold in the individual market included this coverage, according to Maternity coverage was offered only by some health insurance plans or had to be added as a special rider to a plan. Pregnancy was considered a pre-existing condition, meaning maternity insurance coverage was either unavailable to women who were already pregnant when they enrolled, or would cost more.
With Obamacare, women have guaranteed access to maternity coverage for the first time in U.S. This is a clear advantage for women who are or may become pregnant.

Coverage for expecting mothers and babies

Maternity insurance coverage under Obamacare includes the following:

  • Outpatient services, such as prenatal and postnatal doctor visits, gestational diabetes screenings, lab studies, medications, etc.
  • Inpatient services, such as hospitalization, physician fees, etc.
  • Newborn baby care
  • Lactation counseling and breast-pump rental

When to sign up for maternity insurance coverage

You can always enroll in health plan that includes maternity insurance coverage during the Open Enrollment Period (OEP), which this year runs from November 15, 2014 to February 15, 2015.
Be aware that becoming pregnant is not a qualifying life event that makes you eligible to enroll in or change your health plan at any other time of year. However, the birth of your baby is a qualifying life event: the birth triggers a 60-day Special Enrollment Period (SEP) during which you, your spouse, and your children can enroll in and/or change health plans.

Cost of maternity insurance coverage

Take a look at the average monthly premiums and annual deductibles for Obamacare-compliant health plans that include maternity insurance coverage.

Metallic Level
Average Premium Average Deductible
Catastrophic $176 $6,342
Bronze $223 $5,401
Silver $273 $2,958
Gold $321 $1,254
Platinum $380 $509
TOTAL $285 $3,612

To see what maternity plans are available in your state, get a free personalized quote by visiting our maternity coverage page.

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