Does health insurance cover pregnancy?
Yes — pregnancy, maternity, and newborn care is one of the ACA's ten essential health benefits, and plans must cover it even if you're already pregnant when coverage starts, subject to your deductible and cost-sharing.
What flips the answer
- Covered when
You have an ACA marketplace or employer plan — maternity care is a required essential health benefit, even mid-pregnancy.
- Covered when
You qualify for Medicaid or CHIP, which cover pregnancy-related care based on income.
- Not covered when
You have a short-term limited-duration or grandfathered plan that can exclude maternity coverage.
- Not covered when
You use out-of-network providers on a plan with no out-of-network benefit for the non-preventive portions of care.
Pregnancy, maternity, and newborn care is a required essential health benefit on ACA marketplace plans and most employer plans. That covers prenatal care, labor and delivery, and newborn care. Because pregnancy can't be treated as a pre-existing condition, coverage applies even if you're already pregnant when the plan starts.
Many prenatal services are covered as preventive care with no cost-sharing in-network — for example, standard prenatal visits and certain screenings — while delivery and other services apply to your deductible, copays, and coinsurance up to your out-of-pocket maximum.
Being pregnant can also affect enrollment. In most states the birth of a child is a qualifying life event that opens a special enrollment period, and Medicaid and CHIP cover pregnancy-related care for those who qualify by income.
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