Jeffrey Wade
Pregnancy is an expensive time, with the Peterson-KFF Health System Tracker putting the average cost of pregnancy, childbirth, and postpartum care in the US at nearly $19,000—and that’s for people with insurance. Luckily, insurance covers most of that cost, but finding the right insurance plan is key to ensuring you get the care you want. In this regard, there are multiple options for health insurance coverage for pregnant women, including through an employer, the Affordable Care Act marketplace at HealthCare.gov, directly from a health insurance company, or through Medicaid or the Children’s Health Insurance Program (CHIP) if eligible.
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What You'll Learn
Best insurance companies for pregnancy
Pregnancy is an important stage of life that requires adequate medical care. In the United States, health insurance for pregnancy can be complex, and there are various options to consider. Firstly, it is important to note that under the Affordable Care Act (ACA), women cannot be denied health insurance due to pregnancy. All Marketplace and Medicaid plans are required to cover pregnancy and childbirth, including prenatal and postnatal care. This means that maternity care is now an essential health benefit, and insurance companies cannot deny coverage for pregnancy-related healthcare services such as doctor visits, prenatal tests, ultrasounds, delivery, postpartum care, and newborn care.
When considering the best insurance companies for pregnancy, there are several factors to keep in mind. Firstly, look for a plan with a broad network of healthcare providers and reasonable pricing. Evaluate the deductibles, copays, and coinsurance to understand the potential expenses. Additionally, consider the specific benefits offered, such as childbirth education or postpartum mental health services. Prescription drug coverage is also crucial, so ensure that any essential medications during pregnancy are covered.
- Kaiser Permanente: According to Forbes, Kaiser Permanente is the best health insurance company for pregnant women. They offer cheap rates and excellent customer service. Kaiser Permanente's plans are integrated with their medical offices, making the payment process more seamless and contributing to high customer satisfaction. However, their plans are only available in eight states and Washington, D.C.
- Ambetter: Ambetter is a highly-rated insurance provider for pregnancy, with a MoneyGeek score of 93 out of 100 for a 26-year-old pregnant woman buying a silver plan. Ambetter offers health insurance in 29 states, but it is important to confirm that your preferred doctors and hospitals accept their insurance.
- Aetna, Oscar, and Blue Cross Blue Shield: These companies offer strong options for pregnancy coverage if you purchase their plans on the Affordable Care Act (ACA) health insurance marketplace.
- Medicaid: Medicaid is a good option for low-income individuals and families, including pregnant women. It offers free or low-cost coverage for pregnancy and childbirth. Eligibility requirements vary by state, so check with your state's Medicaid office or Healthcare.gov to determine if you qualify.
- Employer-provided coverage: If you or your spouse has health insurance through your employer that includes pregnancy coverage, this can be the simplest and most cost-effective option. Typically, your employer will contribute to your monthly premium, keeping rates low.
Remember, the best insurance for pregnancy will depend on your specific circumstances, such as your income, location, and individual healthcare needs during pregnancy. It is important to carefully review the coverage details, deductibles, and copays of any insurance plan before making a decision.
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Preparing for pregnancy costs
Understanding Insurance Coverage
Firstly, it is crucial to understand your insurance coverage options. The Affordable Care Act (ACA) requires all insurance plans on the Health Insurance Marketplace or Medicaid to cover various services for pregnant women. These services include prenatal care visits with no co-pay, meaning you don't have to pay each time you visit your healthcare provider during pregnancy. You can also choose your prenatal care provider without a referral from a primary care provider. However, it is important to remember that pregnancy may not be considered a "qualifying life event" to start a special enrollment period, so you may need to plan your insurance coverage before becoming pregnant.
Comparing Costs and Services
When choosing a health plan, look at the plan summary, which includes the expected costs of pregnancy care. The SBC (Summary of Benefits and Coverage) document will outline your benefits and expected costs for different services, including pregnancy. By comparing these summaries, you can easily compare costs and services across different plans. Additionally, consider the specific providers, hospitals, and physicians you prefer, as using out-of-network providers can significantly increase your costs.
Considering Additional Expenses
In addition to insurance coverage, there may be additional expenses to consider. For example, if you require fertility treatments, many insurance plans do not cover fertility care like IVF, which can be costly. Additionally, if you choose to use a birthing centre, doula, midwife, or have an at-home birth, insurance may not cover these costs. Vaginal births generally cost less than C-sections, but sometimes a C-section may be required. Postpartum care, including lactation support, may also be necessary, and not all insurance plans cover these services.
Exploring Financial Assistance
If you are concerned about the cost of pregnancy and childbirth, there are financial assistance options available. Many states offer Medicaid coverage for pregnant women, providing free or low-cost health insurance for those with low incomes. In some states, if you earn too much for Medicaid, you may qualify for the Children's Health Insurance Program (CHIP), which offers coverage for pregnant women who cannot afford private insurance. Additionally, you may be able to receive tax credits to help pay for insurance through your state's Marketplace.
Planning for Out-of-Pocket Costs
Even with insurance, there will likely be out-of-pocket costs associated with pregnancy and childbirth. The average out-of-pocket cost for patients in the US is around $3,000. To help with these expenses, consider opening or contributing to a health savings account (HSA) or a medical flexible savings account (FSA). These accounts allow you to set aside pre-tax dollars to cover costs related to pregnancy and childbirth.
By carefully considering your insurance options, comparing costs and services, planning for additional expenses, exploring financial assistance, and saving for out-of-pocket costs, you can effectively prepare for the financial aspects of pregnancy.
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Pregnancy as a pre-existing condition
In the past, insurance companies could deny coverage if you were pregnant when you applied. Many health plans considered pregnancy a pre-existing condition. However, under the Affordable Care Act (ACA), women cannot be denied health insurance due to pregnancy. Health plans cannot charge more for coverage because of pregnancy.
Pregnancy alone doesn't qualify someone for a Special Enrollment Period. However, the birth of a child does. This means that after giving birth, you can enrol in a Marketplace plan even if it's outside the Open Enrollment Period.
If you're pregnant and don't have insurance, you can't buy coverage through the marketplace unless you have another qualifying life event. However, there are other ways to get insurance during pregnancy. If you or your partner have access to employer-sponsored health insurance, check if the plan covers pregnancy and maternity care. Usually, this is the cheapest way to get a policy, as your employer will pay part of your monthly health insurance premium.
If you're found eligible during your pregnancy, you'll be covered for at least 60 days after you give birth, depending on your state. Some states offer coverage for a full 12 months after you give birth. If you have Medicaid when you give birth, your newborn is automatically enrolled in Medicaid coverage and will remain eligible for at least a year.
Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans, including some low-income people, families, children, and pregnant women. Eligibility depends on household size, income, and citizenship or immigration status. Specific rules and benefits vary by state.
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Medicaid and CHIP coverage
Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans, including low-income people, families, children, pregnant women, the elderly, and people with disabilities. Eligibility for these programs depends on household size, income, and citizenship or immigration status.
Medicaid offers coverage for low-income individuals and families, including pregnant women. Thanks to Medicaid expansion under the ACA, adults with incomes up to 138% of the Federal Poverty Level ($21,597 in 2025) may qualify for coverage during pregnancy. Eligibility requirements vary by state, so check your state's Medicaid office or visit Healthcare.gov to see if you qualify.
The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) included a new option for states to provide Medicaid and CHIP coverage to children and pregnant individuals who are lawfully residing in the United States, including those within their first five years of having certain legal status. Previously, federal law required a 5-year waiting period before many legal immigrants were permitted to enrol in Medicaid and CHIP.
Pregnant women might be able to get free health coverage during their pregnancy through Medicaid for Pregnant Women or the CHIP Perinatal program. Medicaid provides health coverage to low-income pregnant women during pregnancy and up to 12 months after giving birth. CHIP Perinatal provides limited coverage during pregnancy and two postpartum visits within 60 days of the end of the pregnancy for women who cannot get Medicaid and don't have health insurance.
If you are found eligible for Medicaid or CHIP during your pregnancy, you’ll be covered for at least 60 days after you give birth, depending on your state. Some states offer coverage for a full 12 months after giving birth. When your state’s coverage period ends, you may no longer qualify. Your state will notify you if your coverage is ending. If your coverage ends, you can apply and enrol in a Marketplace plan. If you have Medicaid when you give birth, your newborn is automatically enrolled in Medicaid coverage and will remain eligible for at least a year.
When looking for the best health insurance during pregnancy, choose a plan with a broad network of healthcare providers and reasonable pricing. Under the Affordable Care Act (ACA), women cannot be denied health insurance due to pregnancy. However, securing coverage for prenatal and postnatal care is important since pregnancy doesn’t qualify for a Special Enrollment Period.
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Additional insurance considerations
When considering the best medical insurance for pregnancy, it is important to evaluate your specific circumstances, as the best option for you may differ from someone else. For example, you might need more or different prenatal care than other mothers, which means your health insurance plan might need to be different.
If you are a minor and you're pregnant, your parent's insurance plan is required to cover your pregnancy care. Your delivery might be covered, but this depends on your parent's policy.
If you are married or in a domestic partnership, check if your spouse, partner, or eligible boyfriend/girlfriend has health insurance that covers pregnancy. You may be eligible to be added as a dependent on their plan.
If you or your partner have access to employer-sponsored health insurance, check if the plan covers pregnancy and maternity care. This is usually the cheapest way to get a policy as your employer will pay part of your monthly health insurance premium, keeping rates low.
If you don't have coverage through your employer, you can consider Medicaid, which offers free or low-cost health coverage to millions of Americans, including some low-income individuals, families, and pregnant women. Eligibility depends on your household size, income, and citizenship or immigration status, and specific rules and benefits vary by state.
If you are not eligible for Medicaid, you can apply for CHIP (Children's Health Insurance Program) at any time during the year. If you are found eligible for Medicaid or CHIP, your information will be sent to the state agency, and you won't be able to keep your Marketplace plan.
If you are planning your pregnancy, you will have more time to research and get quotes for health insurance. If your pregnancy is unplanned, you might find yourself in a rush to get coverage. If you have a high-risk pregnancy, you may need additional medical care or costly tests, which may impact your insurance coverage.
Supplemental maternity insurance pays you directly instead of paying a healthcare provider, but these policies usually need to be purchased before you get pregnant. There are two main types of extra insurance that you can buy for pregnancy: short-term disability and hospital indemnity. Short-term disability insurance is designed to replace a mother's income during maternity leave and if her doctor orders bed rest. Hospital indemnity insurance provides a fixed benefit that is paid based on how long you are in the hospital, and you can use the money for any reason, such as paying for a health insurance deductible, medication, childcare, or groceries. However, it is important to note that this is not a substitute for standard health insurance.
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Frequently asked questions
Some of the best insurance companies for pregnancy are Kaiser Permanente, Aetna, Oscar, and Blue Cross Blue Shield.
You can purchase health insurance through your employer, the Affordable Care Act (ACA) marketplace at HealthCare.gov, directly from a health insurance company, or through Medicaid or the Children's Health Insurance Program (CHIP) if you qualify.
It is important to consider whether your preferred providers and hospitals are in-network, as seeing an out-of-network provider may significantly increase your costs. Additionally, review the plan summary to understand the expected costs of pregnancy care and utilize the SBC document to compare different plans.
