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California health insurance  -  Understand health insurance in California  -  Health plans and pregnancy

Pregnancy Care and your California health insurance plan

California family health insuranceThe question of whether to cover pregnancy used to pose many questions for prospective mothers as some of the plans on the market (the better priced ones) did not cover maternity. That is no longer the case as of July 1st, 2012.

All ACA compliant California health insurance plans on the individual family market now cover maternity.

Group health insurance plans already covered maternity so that remains the same.

Another big factor affecting pregnancy care is that preventative benefits including well-baby and well-child checkups are now covered at 100% on all newer plans (assumes in-network provider). Now there is no reason to avoid classes on childbirth, breastfeeding, and nutrition during pregnancy.

Does pregnancy qualify for a Special Enrollment outside of Open Enrollment?

Pregnancy is not a Special Enrollment trigger but there may be other triggers accompanying the pregnancy which will allow us to enroll.  If you are interested in exploring these options, please call 800-320-6269.

The first question is to find an Obstetrician and Hospital for both pregnancy and delivery.

Pregnancy and your Doctor Choice

Make sure to find an obstetrician in your California health plan's network to keep your costs down. You can typically see an obstetrician without a referral but double check with your plan's benefits. Make sure you know which hospital the doctor is contracted with. There are legal protections which allows you to stay with your doctor if they leave the health plan after your 6th month of pregnancy. Legally, California health plans much cover a minimum of 2 days in the hospital after vaginal delivery and 4 days after C-section.

After delivery or adoption of a baby, make sure to add your child to your health plan right away.

 There's a 30 day window to this but it's best to do it right away. Children are now guaranteed issue on the individual family market but they can increase the rates based on the health of the child.



Other important articles:
Preventative health care for women in California

How the new Covered California plans differ


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