Women’s Health

What services do plans have to cover for pregnancy?

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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 cost-sharing because they are considered preventive services. All state Medicaid programs cover maternity care without cost-sharing to low-income women who qualify for coverage.

Short-term health insurance policies do not have to provide benefits required by the ACA, such as preventive services and maternity care, and most short-term plans exclude maternity 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 maternity.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.