Having a baby gives birth to a bundle of financial and health insuranceconcerns, but the load is getting lighter for many expectant and new moms, thanks to a provision of the federal Patient Protection and Affordable Care Act.
Under the law, new health insurance plans must cover preventive care 100 percent. That means you pay zero out-of-pocket expenses for prevention — no deductible, coinsurance or co-pay — if you’re covered by one of these plans.
Federal officials have outlined dozens of preventive care services for men, women and children, which new plans must fully cover this year. Recently the U.S. Department of Health and Human Services issued another set of women’s preventive care services that new plans must fully cover starting Aug. 1 of next year.
“This is a tremendous opportunity to improve health care for all women in our country,” says Dr. Richard Smith, an obstetrician and gynecologist with Women’s Health Services at Henry Ford Hospital in Detroit. “Prevention works.”
Smith, who has delivered more than 7,000 babies and is a past president of the Michigan State Medical Society, says he has seen countless examples of good prenatal care and routine screenings preventing serious problems.
Here are six health insurance freebies expectant and new moms should know about.
1. Screening for conditions that could hurt you and the baby
New plans this year must cover screening for a variety of conditions, which are easily treated, but can cause problems for you and the baby if they go undetected. Fully covered screenings include tests for iron deficiency, hepatitis B, Rh incompatibility between your blood and the baby’s blood, and bacterial urinary or other infections.
Starting in August 2012, new health insurance plans must also fully cover screening for gestational diabetes. Women who develop diabetes during pregnancy have a higher risk of developing type 2 diabetes later in life, and their babies are at higher risk of being overweight and insulin-resistant through childhood. The screening is conducted between the 24th and 28th week of pregnancy or at the first prenatal visit for women at high risk for developing gestational diabetes.
2. Counseling to quit smoking or drinking
Smoking and drinking during pregnancy aren’t good for you, and they’re terrible for your baby. Smoking during pregnancy increases the chance of stillbirth and miscarriage, and can also lead to low birth weight and premature birth, says the March of Dimes, a nonprofit organization that works to improve the health of mothers and babies. Drinking alcohol during pregnancy can lead to a wide range of physical and mental birth defects. New health plans this year must fully cover counseling by a physician to help you quit smoking or drinking during pregnancy.
3. Breastfeeding support and supplies
“Breastfeeding is one of the best things mothers can do for their children,” Smith says.
Breast milk is easier to digest than formula, provides the perfect nutrition for the baby and includes cells, hormones and antibodies to protect babies from illness.
Breastfeeding is also good for moms. It’s linked to lower risks in women for type 2 diabetes, breast cancer, ovarian cancer and postpartum depression, according to the U.S. Department of Health and Human Services Office on Women’s Health.
But cost can be a barrier. A good breast pump can run upwards of $250 and rental can cost $2 a day, says Marsha Walker, a board member of the U.S. Lactation Consultant Association. Although breastfeeding is a natural process, she says, sometimes a new mom and baby need expert help, especially if either has a complex medical condition.
“Many mothers have lacked access to the care they needed because health insurance companies wouldn’t pay for it,” she says.
Starting in August 2012, new health plans must fully cover breastfeeding support and supplies.
4. Routine vaccines
Under new health plans this year, you don’t pay anything out of pocket for your baby’s immunizations. Fully covered vaccines include hepatitis A and B; tetanus, diphtheria and pertussis; measles, mumps and rubella; varicella (chicken pox); and other standard recommended shots. Routine vaccines for older children and adults are also fully covered.
5. Well-baby visits
Well-child visits to the doctor are now fully covered under new health plans. For babies, these visits take place every few months to chart their growth, assess development and screen for health conditions. They also give you a chance to discuss concerns with the baby’s doctor.
6. Well-woman visit
Don’t skimp on your health after the birth. Starting August 2012, new plans must fully cover annual well-woman visits to the doctor. During this visit you can get access to other recommended preventive care, such as cervical and breast cancer screening, screening for high blood pressure, weight-loss education if you’re obese, and more. Also, new health plans must also cover birth control 100 percent.
Beware that plans created and sold before March 23, 2010, do not have to fully cover preventive care services. Check with your health insurance plan to learn about coverage for preventive care, and take advantage of free services to help you stay healthy and save money long term.
If you’re uninsured and thinking about having a baby, get health insurance quotes now. It will be impossible to find insurance on the individual private market to cover prenatal care and labor and delivery after you’re already pregnant. Read more about how pregnancy complicates health insurance options.