Health Insurance for your pregnancy

Health insurance will help cover prenatal care, birth and pediatric care and immunizations for your baby. With the Affordable Care Act, most people are required to have health insurance. If your employer does not provide insurance, you can buy your own individual health plan during open enrollment or outside of open enrollment if you experience a qualifying event. You are able to purchase an individual health plan through:

• Washington Healthplanfinder is the online marketplace where you can compare health plans, find free or low-cost plans, or get help paying for your plan, depending on your income.
• Or directly from a health insurance company.

Washington Apple Health for Pregnant Women (also known as Pregnancy Medicaid) is available for pregnant women who live in Washington and meet the income requirements. Apple Health provides free prenatal medical, emergency dental, limited vision coverage and mental health benefits. Learn more about Washington Apple Health for your pregnancy and see if you qualify.

Shopping for health insurance can be confusing but WithinReach is here to help. Our friendly, local, and knowledgeable staff can help you understand and apply for health insurance based on your needs and budget. Call the Help Me Grow Washington Hotline at 1-800-322-2588 today to get started.

What does health insurance cover?

New changes in health reform law require all health plans to cover the same set of essential health benefits.  This is great news for pregnant women as you can be assured that the following services will be covered:

• Maternity and newborn care (care before and after your baby is born)
• Breastfeeding support, supplies and counseling
• Screening for gestational diabetes
• Contraceptive methods and counseling
• And more

Beyond the required health benefits, each plan will vary in their benefits. It is important to understand your specific health insurance plan so that you can receive the best care possible, and avoid surprise medical bills. Call your health insurance provider to learn about your benefits for prenatal, labor and postpartum care.

Some Questions to Ask Your Health Care Provider:

• What are my maternity benefits? Do I have medical, dental and vision benefits?
• Does my health care provider and birth facility accept my health plan?
• What are my deductible and co-payment amounts for maternity care?
• Does my plan cover things related to pregnancy such as breast pumps, childbirth classes or doula care?
• Can I add my baby to my health care plan after they are born?
• Do I have coverage if my baby needs to stay in the hospital?

If you have health insurance, but do not have a provider for your prenatal care, contact your plan right away. It is important to start prenatal care as soon as possible.

Your health care plan should be able to give you a list of providers that are in your plans “network” (providers that accept your insurance). If you receive care from a provider that is not part of your plan’s network, you may not have coverage.