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Navigating the different types of health care coverage available to pregnant women can be difficult. Fortunately, with the advent of the ACA, pregnant women have increased health care coverage options. Low-income women who are uninsured upon becoming pregnant may enroll in Medicaid and receive comprehensive health care services during and immediately after pregnancy. Women who already have health insurance at the time they become pregnant can typically keep that coverage or, if they qualify, transition to Medicaid.
So, for example, if a woman is pregnant with triplets, she counts as a household of four. States may decide whether to count the pregnant woman as one or two people for determining the eligibility of others in the household.
So if a woman is pregnant with triplets, in determining the eligibility of other household members, she would only count as one or two people. Household income cannot exceed the limit set by the state cash assistance program AFDC that was in effect on May 1, States must accept self-attestation of pregnancy unless the state has information that is not reasonably compatible with such attestation. See pp. Pregnancy-related Medicaid that meets Minimum Essential Coverage MEC requirements is comprehensive coverage because it covers all medically necessary services.
In addition to some pregnancy-related Medicaid, the following types of Medicaid coverage are not considered MEC: family planning expansion under a state plan amendment; optional coverage of tuberculosis-related services; and coverage of medical emergency services only.
For more information about which preventive services related to pregnancy are covered without cost-sharing, see Preventive Service Tracker, Kaiser Family Found. However, it is not clear whether a woman will have to switch to the pregnancy-related category if she comes up for redetermination while enrolled in the new Medicaid category for low-income adults.
Women who are already enrolled in expansion Medicaid at the time that they become pregnant may either retain their current coverage until their next renewal or transition to pregnancy-related coverage. Oversight Dec. If a woman continues to be eligible for Medicaid, e. Contraceptive Equity is a policy framework under which contraceptive care is easily accessible and covered…. The National Health Law Program is dedicated to ensuring appropriate implementation and monitoring for states that have adopted Contraceptive….
September 5, By: Amy Chen. Download Publication. Introduction Access to affordable and high-quality comprehensive health care services during pregnancy has long depended on what type of health insurance one is eligible for and enrolled in. Can an uninsured woman enroll in a public health insurance plan upon becoming pregnant? Can uninsured women enroll in Marketplace coverage upon becoming pregnant? What is the cost-sharing obligation under a Marketplace plan? Can an uninsured woman enroll in Marketplace coverage upon giving birth?
What changes when a woman already enrolled in Medicaid becomes pregnant? Will Medicaid also cover a newborn? What is the cost-sharing obligation under Medicaid? Do full-scope and expansion Medicaid provide pregnant women with comprehensive health insurance? Do Marketplace health plans provide women with comprehensive coverage, including maternity care?
Can a woman who transitioned from Marketplace insurance to Medicaid or CHIP re-enroll in a Marketplace plan, if otherwise eligible, upon giving birth?
Will a Marketplace health plan also cover a newborn? Is abortion covered by Marketplace plans? Do employer-sponsored or other non-Marketplace private insurance plans provide women with comprehensive coverage, including maternity care? Can a woman remain on private insurance while using Medicaid benefits? Does private insurance also cover a newborn? Does private insurance cover abortion? Case: Medicaid. Related Content. Currently, 39 states and Washington, DC provide coverage beyond emergency dental services and all states offer dental services for pregnancy-related Medicaid coverage.
This map and chart highlight dental benefits for general adults and pregnant populations enrolled in Medicaid. Chart information sources include state Medicaid agency websites and documents and direct communication with state officials. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the US government. Washington, DC Office: 20th St.
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