What is Prenatal Insurance?

Autumn Rivers

Prenatal insurance covers most of the medical costs associated with pregnancy and delivery. It can be obtained through an employer, or purchased as in individual plan by those who are self-employed or do not get health benefits through their job. Some general health insurance plans require that a separate maternity rider be purchased before pregnancy in order for prenatal services to be covered. There are often certain regulations to abide by when prenatal insurance is covering a pregnancy, but following the rules is often cheaper than paying for all services out of pocket. For this reason, most women choose to get prenatal health insurance when possible, or try to qualify for government insurance when they cannot afford to make monthly payments.

Prenatal insurance typically covers all doctor appointments.
Prenatal insurance typically covers all doctor appointments.

Those who normally get by without health insurance may be surprised to find that this is difficult to do during pregnancy. Pregnant women without insurance often have to pay out of pocket for doctor appointments, ultrasounds, testing for mother and baby, labor and delivery, and the postpartum stage. Labor and delivery costs alone are usually enough to put many people in debt unless they have budgeted or made payment plans, and this expense does not include nine months of prenatal care. Thus, prenatal insurance is often desirable by those in any income bracket.

Prenatal insurance usually covers pelvic exams and Pap smears.
Prenatal insurance usually covers pelvic exams and Pap smears.

Most women get their prenatal insurance through either their job, or their spouse's employer. They may just get maternity coverage only when planning a pregnancy, or they may add a maternity rider onto their current plan. Women without access to an employer-provided plan may purchase individual prenatal insurance so that they are covered for the entire nine months. Those who cannot afford the monthly payments, deductibles, and copays that most plans often require can apply for government insurance. This type of prenatal insurance is usually available to nearly anyone under a certain income limit who can provide proof of their pregnancy.

While prenatal insurance can be a financial lifesaver for most pregnant women, there are often strict rules to abide by. For example, most insurance companies pay for any procedure that is medically necessary, including monthly doctor appointments for the first two trimesters, and then biweekly or weekly appointments toward the end of the pregnancy. Any emergency visits to the doctor or hospital are usually covered, along with required or recommended exams, such as a Pap smear, gestational diabetes testing, and screening for group B streptococcus. Additionally, one or two ultrasounds are usually covered, as well as a typical vaginal delivery or medically necessary cesarean section. Most procedures that are not considered medically necessary, including extra ultrasounds, screening for certain chromosomal abnormalities, and elective cesarean sections are not usually covered by prenatal insurance.

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