What services do plans have to cover for pregnant women?

Federal law requires most employer and all ACA-compliant individual insurance plans, including those available through the Marketplaces, to cover maternity services including child birth and newborn care. 

These plans also must cover prenatal visits and screenings, folic acid supplements, tobacco cessation counseling and interventions, and breastfeeding services without any co-pay because they are considered preventive services. 

What services do plans have to cover for pregnant women?

All state Medicaid programs cover maternity care without cost-sharing to low-income women who qualify for coverage.

Breastfeeding services

The ACA requires that all new ACA-compliant plans, including those in the employer market, individual market, and health insurance Marketplaces, cover lactation counseling and breast pump rental without any charge.

 Check your plan details to find out the specific number of counseling sessions and types of breast pump that are covered, or if your plan covers purchase of a breast pump. If you are nursing and work for a large employer (50 or more employees), your employer must provide access to a private room (that is not a bathroom) and break time for you to express milk.

Short-term health insurance policies do not have to provide benefits required by the ACA, including breastfeeding services. Health care sharing ministries, which are membership groups usually affiliated with a religion that help members pay for health care (not insurance), are also not subject to ACA benefit requirements, including breastfeeding services.

Source KFF

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