Maternity Coverage under the Affordable Care Act (ACA)
Are Maternity Coverage Only Plans Still Available Under the ACA?
Unlike before the Affordable Care Act (ACA), maternity coverage is no longer available as a standalone insurance option. Under the ACA, health insurance plans must provide comprehensive coverage, including maternity care as an essential health benefit. This means that all ACA-compliant plans include coverage for pregnancy, prenatal care, labor and delivery, and postpartum care.
Key Points to Note:
Maternity coverage is included in all ACA-compliant health insurance plans.
Maternity care is not subject to a separate deductible or copay; it’s covered under the plan’s overall benefits.
The ACA prohibits discrimination based on pregnancy, so health insurance premiums cannot be higher for women who intend to or are already pregnant.
Open Enrollment and Qualifying Events for Maternity Coverage:
You can enroll in an ACA plan during the annual open enrollment period, which typically runs from November 1 to January 15.
If you become pregnant outside of the open enrollment period, you may qualify for a special enrollment period (SEP). Examples of SEPs include:
Marriage
Divorce
Loss of health insurance
Gaining dependent (such as a newborn)
Choosing the Right ACA Plan for Maternity Coverage:
When selecting an ACA plan, consider the following factors:
Monthly premium: The amount you pay each month for coverage.
Deductible: The amount you pay out-of-pocket for medical expenses before insurance coverage begins.
Coinsurance: The percentage of covered services you pay after meeting your deductible.
Network: The group of healthcare providers and facilities covered by the plan.
Additional Resources:
[Healthcare.gov](https://www.healthcare.gov/)
[National Women’s Law Center](https://nwlc.org/)
[Center on Budget and Policy Priorities](https://www.cbpp.org/)
By understanding these key points, you can make informed decisions about your health insurance coverage and ensure you have the necessary protection for you and your future family.
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