Maternity Coverage: All About Pregnancy and Health Insurance

When you’re expecting, you need your health insurance provider to cover your maternity health care needs. If you’re pregnant or plan to become pregnant, it pays to compare your options, and planning ahead before you conceive may provide more choices. The best option will provide affordable maternity insurance plans that cover all the essential health benefits you need, both before and after your baby is born. You have numerous choices of health insurance companies that cover pregnancy.

Keep reading to learn more about the best maternity insurance companies, what the companies have to offer, and which aspects are most important to compare.

• Mandated maternity coverage: Maternity care coverage is mandated on plans that conform to ACA standards. If you select an employer group health plan or a plan through the Health Insurance Marketplace, you’ll have maternity coverage. Plans purchased through the marketplace must include coverage for birth control and breastfeeding.
• Medicaid: Pregnant women with low income can qualify for Medicaid, which provides free or low-cost health coverage to those who qualify.
• Children’s Health Insurance Plan (CHIP): If you don’t qualify for Medicaid, you might qualify for the CHIP.

• Financial strength: The financial strength rating is based on the insurance company’s A.M. Best financial strength rating. A.M. Best is a credit rating agency specializing in the insurance industry, which rates an insurer’s ability to meet ongoing obligations.
• Customer satisfaction: The customer satisfaction rating takes into account Kaiser Permanente’s Better Business Bureau (BBB), National Committee for Quality Assurance (NCQA), and Consumer Affairs ratings. These ratings are calculated using customer complaints and satisfaction ratings.
• Value: The value rating calculates an insurer’s overall value based on monthly premium, annual deductible, office visit cost, emergency room (ER) visit cost, and annual maximum out-of-pocket cost.
• Coverage: The coverage rating considers the insurer’s availability of coverages, plan types, and network size.

There are numerous ways you can get health insurance that covers pregnancy. Common options for affordable maternity insurance plans include:

• Employer plans: Group health plans may be a benefit you receive at work and your employer may pay some or all of your monthly premium. Eligibility for employer-sponsored insurance varies by company. Maternity coverage is mandated under ACA-compliant group health plans, but coverage levels vary.
• Health Insurance Marketplace plans: The Health Insurance Marketplace lets you shop around individual health insurance plans. All marketplace plans are ACA-compliant and must provide maternity care coverage for you and your baby before and after the child is born. You may qualify for subsidies to reduce your monthly premium. Plans purchased through the marketplace must include coverage for birth control and breastfeeding.
• Medicare: Many people on Medicare are aged 65 or older, so pregnancy coverage isn’t typically needed. However, this government-sponsored health insurance coverage is also available to younger people with qualifying disabilities. Medicare covers pregnancy, childbirth, and postnatal care, but it won’t cover your baby once it’s born.
• Medicaid: This federal/state government health insurance program provides free or low-cost health coverage to pregnant women who qualify based on income. You can enroll any time and your coverage begins immediately. Your baby is automatically covered under Medicaid after birth. You can apply for Medicaid directly through your state Medicaid agency or the Health Insurance Marketplace.
• CHIP: The CHIP offers anytime enrollment with immediate coverage. Most states only cover children in families with low incomes who don’t qualify for Medicaid, but six states enroll pregnant women in the CHIP program. You can apply for CHIP through the Health Insurance Marketplace or directly through your state agency. This program is income-based, so not everyone will qualify.

Founded in 1853, Aetna is one of the nation’s leading diversified health care insurance providers. It offers insurance products in all 50 states and provides individual and family medical plans. Aetna doesn’t currently offer individual plans. In some states, health insurance plans may contain limitations and exclusions. Explore state-specific information before choosing Aetna as your health insurance provider.

Is Aetna a Good Health Insurance Provider?

What Do Aetna Health Insurance Plans Cover?

Aetna offers several health insurance options, including:

• Dental
• Family health insurance
• Individual health insurance
• Medicare
• Medicaid
• Pharmacy
• Vision

How is Aetna Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Aetna.

Anthem was formed in 2004 through a merger between WellPoint Health Networks and Anthem and became one of the nation’s leading and largest health benefits companies. It serves 25 states through its various affiliates and offers a broad portfolio of integrated health care plans and related services, including individual and family that cover maternity health care needs. However, products offered by its subsidiaries vary.

Is Anthem a Good Health Insurance Provider?

What Do Anthem Health Insurance Plans Cover?

Anthem offers several health insurance options, including:

• CHIP
• Dental
• Group insurance plans
• Individual health insurance
• Medicaid
• Medicare Advantage Plans
• Vision

How is Anthem Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Anthem.

Blue Cross Blue Shield (BCBS) has provided health insurance since 1929 and is one of the most recognized names in the health insurance industry. BCBS offers nationwide health care coverage in all 50 states, Washington, D.C., and Puerto Rico. It offers individual, family, and Medicare plans, and most health care providers accept BCBS. But regional affiliates function separately, and not all plans are available in every state.

Is Blue Cross Blue Shield a Good Health Insurance Provider?

What Do Blue Cross Blue Shield Health Insurance Plans Cover?

Blue Cross Blue Shield offers several health insurance options, including:

• Corporate health insurance
• Dental insurance
• Group insurance plans
• Health savings accounts (HSA)
• High-deductible health insurance
• Individual health insurance
• Medicaid
• Medicare
• Small-business health insurance

How is Blue Cross Blue Shield Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Blue Cross Blue Shield.

Established in 1981, Cigna is a global health service company. It partners with more than 1.5 million health care providers and facilities offering quality, cost-effective care. Cigna only offers individual and family plans in Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia, so it may not be available in your area.

Is Cigna a Good Health Insurance Provider?

What Do Kaiser Permanente Health Insurance Plans Cover?

Kaiser Permanente offers several health insurance options, including:

• Employer plans
• Family health insurance
• Individual health insurance
• Medicaid/Medi-Cal
• Medicare

How is Kaiser Permanente Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Kaiser Permanente.

Highmark was established in 1996 through a consolidation of Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield. As an independent licensee of the BCBS Association, Highmark is the largest health insurer in Pennsylvania and one of the largest BCBS affiliates in the nation. Highmark is a diversified health and wellness system based in Pittsburgh, but its plans are only available in Pennsylvania, Delaware, West Virginia, and 21 counties in northeastern and western New York.

Is Highmark a Good Health Insurance Provider?

What Do Highmark Health Insurance Plans Cover?

Highmark offers several health insurance options, including:

• CHIP
• Dental
• Individual and family plans
• Medicare Advantage and Medigap plans
• Travel
• Vision

How is Highmark Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Highmark.

Established in 1961, Humana offers an array of HMO, PPO, and PFFS plans in all 50 states, Washington, DC, and Puerto Rico. It’s one of the most popular employer health plans, but it no longer offers individual or family medical insurance plans. To cover a pregnancy, you’re limited to employer-based health insurance or Medicaid or Medicare plans if you qualify.

Is Humana a Good Health Insurance Provider?

How is Humana Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Humana.

Kaiser Permanente has led the way with innovative approaches to health care since 1945. Headquartered in Oakland, California, it’s one of the nation’s largest managed care organizations and not-for-profit health plans in the nation. Members receive exclusive access to its 22,000+ medical group physicians and hospitals. Kaiser provides a wide array of health care coverage, including maternity insurance plans, but plans are only available in select states.

Is Kaiser Permanente a Good Health Insurance Provider?

What Do Kaiser Permanente Health Insurance Plans Cover?

Kaiser Permanente offers several health insurance options, including:

• Employer plans
• Family health insurance
• Individual health insurance
• Medicaid/Medi-Cal
• Medicare

How is Kaiser Permanente Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Kaiser Permanente.

Founded in 1980, Molina Healthcare offers comprehensive individual and family plans and plans for those who qualify for managed health care services under Medicare, Medicaid, and the Children’s Health Insurance Program through the Health Insurance Marketplace. It boasts a large network of independent doctors in hospitals and clinics, but only in some states. Currently, you can also get Molina plans in 13 states. Its marketplace plans are also limited to certain states it services.

Is Molina Healthcare a Good Health Insurance Provider?

What Do Molina Healthcare Health Insurance Plans Cover?

Molina Healthcare offers several health insurance options, including:

• Family health insurance
• Individual health insurance
• Medicaid and CHIP
• Medicare

How is Molina Healthcare Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Molina Healthcare.

UnitedHealthcare (UHC) was formed in 1977 and offers health benefit programs to all ages and lifestyles, including nearly any type of health insurance plan. You’ll find maternity insurance plans in every state except New York, which is the only state UnitedHealthcare doesn’t service. While UHC’s health insurance offerings are extensive, some plan types aren’t available in every state, so learn what’s available in your area before choosing UnitedHealthcare.

Is UnitedHealthcare a Good Health Insurance Provider?

What Do UnitedHealthcare Health Insurance Plans Cover?

UnitedHealthcare offers numerous health insurance options:

• Dental
• Employer plans
• Family health insurance
• Individual health insurance
• Marketplace plans
• Medicaid
• Medicare
• Self-employed plans
• Short-term/TriTerm insurance
• Student plans
• Supplemental
• Vision

How is UnitedHealthcare Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated UnitedHealthcare.

WellCare was founded in 1985 by a small group of local doctors in Tampa, Florida. It’s one of the largest managed care organizations in the nation and offers health care plans in all 50 states through subsidiaries. In 2020, Centene bought out WellCare to create one of the largest providers of government-sponsored insurance.

Is WellCare a Good Health Insurance Provider?

What Do WellCare Health Insurance Plans Cover?

WellCare offers several health insurance options, including:

• Family health insurance
• Individual health insurance
• Medicaid
• Medicare

How is WellCare Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated WellCare.

• Find plans available in your area: Most insurance provider websites have a searchable tool that lets you input your ZIP code and other details, such as a current or future pregnancy, and the system pulls up the plans available in your area.
• Research the network: Health insurance networks include the health care providers and facilities contracted with the insurance company to provide services. If you want to see a specific doctor, research the network to see who’s listed.
• Research prescription drug coverage: Health insurance plans usually cover part of the cost of prescription drugs. Approved drugs are less expensive, so research prescription drug lists to see whether drugs, such as specific prenatal vitamins, are covered.
• Compare monthly premiums. Premiums are the amount you pay each month to keep your insurance plan active. Monthly premiums vary, so compare costs to find the most affordable maternity insurance plans that provide the coverage you need.
• Compare deductibles: Deductibles are the amount you must pay before your insurance plan kicks in and starts paying part of your health care costs. You may get a lower deductible with a higher premium, so keep this in mind when comparing plans. Deductibles are annual, so if your pregnancy and delivery aren’t in the same calendar year, you might hit your deductible twice.
• Compare copays: Copays are the portion you pay after your insurance plan kicks in once you’ve met your deductible. Copayment amounts vary for different services within the same plan, so compare all the different copays involved.
• Research dental coverage: A comprehensive health plan may include dental coverage for basic or preventive services, but you may need to purchase stand-alone dental coverage. Oral health is important during pregnancy, so research plans to see what’s included.
• Check insurer ratings: Ratings let you compare how a health insurance provider compares to its competitors in performance and product offerings, which is valuable information to have when comparing affordable maternity insurance plans.

• Centers for Disease Control and Prevention | Pregnancy and Oral Health | Last accessed September 2024
• Centers for Medicare & Medicaid Services | Medicare Benefit Policy Manual | Last accessed September 2024
• HealthCare.gov | Health coverage if you’re pregnant, plan to get pregnant, or recently gave birth | Last accessed September 2024
• HealthCare.gov | Health Insurance Marketplace | Last accessed September 2024
• HealthCare.gov | Medicaid & CHIP coverage | Last accessed September 2024
• HealthCare.gov | The Children’s Health Insurance Program | Last accessed September 2024
• Medicaid and CHIP Payment and Access Commission | CHIP eligibility | Last accessed September 2024
• U.S. Department of Labor | Health Plans and Benefits | Last accessed September 2024