Services for Pregnant Women or Women Who may Become Pregnant
- Breastfeeding support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women.
- Breast feeding support, counseling and equipment for the duration of breast feeding
- Coverage for pumps and equipment must be covered under Marketplace plans
- Birth control: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.
- Folic acid supplements for women who may become pregnant
- Gestational diabetes screening for women 24 weeks pregnant (or later) and those at high risk of developing gestational diabetes
- Gonorrhea screening for all women at higher risk
- Hepatitis B screening for pregnant women at their first prenatal visit
- Maternal depression screening for mothers at well-baby visits (PDF, 1.5 MB)
- Preeclampsia prevention and screening for pregnant women with high blood pressure
- Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
- Syphilis screening
- Expanded tobacco intervention and counseling for pregnant tobacco users
- Urinary tract or other infection screening
- Covered contraceptive methods
FDA-approved contraceptive methods prescribed by a woman’s doctor are covered, including:
- Barrier methods, like diaphragms and sponges
- Hormonal methods, like birth control pills and vaginal rings
- Implanted devices, like intrauterine devices (IUDs)
- Emergency contraception, like Plan B® and ella®
- Sterilization procedures
- Patient education and counseling
Plans aren’t required to cover drugs to induce abortions and services for male reproductive capacity, like vasectomies.
Pregnancy and Special Enrollment Periods
- If you’re outside of an enrollment period, becoming pregnant does not give you a special election period (SEP). The birth of a child does open a special election period. Depending on your employer or individual coverage, you will typically have 30-60 days after the birth to add the baby.
- Medicaid and CHIP can begin anytime if found eligible
- If found ineligible for Medicaid or CHIP, this create a special enrollment period and you can sign up for coverage through the marketplace.
Adding a Baby to your Coverage
Once you give birth, you will need to update your coverage and add your child to the plan. Depending on your employer or individual coverage, you will typically have 30-60 days after the birth to add the baby. The policy will be back dated to the day of the birth.
No Existing Coverage at the Time of Birth
Having a baby gives you a special enrollment period. Your coverage will begin the day your baby is born. If applying after the birth, your plan will back date to the day of the birth.
Medicaid and CHIP
If found eligible for Medicaid or CHIP you will be covered for the birth and the baby will be covered. If the Medicaid or CHIP coverage ends you are eligible to enroll in a Marketplace plan.