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You’ve Got Healthcare: Here’s How to Gain It & Use It

By By Elizabeth T. Jordan, DNSC, RNC, FAAN

You’ve Got Healthcare: Here’s How to Gain It & Use It

With the implementation of the Affordable Care Act in January, the more than 6.5 million women who get pregnant each year-and the 4 million who will carry a baby to birth-now have guaranteed access to healthcare, including maternity care and a full range of services, including family health.

Under the new healthcare law, you can’t be charged more for insurance because you’re a woman, and you can’t be denied healthcare for pre-existing conditions, like cancer or pregnancy. The good news for childbearing women is that health plans are required to cover maternity services as a part of “essential health benefits,” and insurers can’t charge you higher rates or refuse to cover your childbirth costs if you’re pregnant.

That’s particularly great news because without health insurance, a typical pregnancy, labor and birth without any complications can cost between $7,000 and $12,000. Those charges can exceed $20,000 if complications emerge or if cesarean is required, experts estimate.

In fact, all new health plans must cover services for pregnant women at no additional cost. If you’re considering pregnancy, you should take folic acid supplements to prevent the most common neural tube birth defects, and if you’re pregnant already, you should be able to receive these supplements at no additional cost. Same for smoking cessation and counseling at no additional cost for pregnant women. Routine services provided should include but aren’t limited to:
– Prenatal visits-which are proven to help provide the healthiest outcomes if you get regular prenatal care
– Ultrasound, X-rays or lab charges
– Hospital or birthing center labor and birth charges (including use of delivery room, hospital bed and board, physician care, and anesthesia if needed)
– Routine newborn circumcision, if desired


If you return or go to work, your employer is required to provide time and a place for you to pump breastmilk.

The Affordable Care Act will also cover home visits from nurses post-birth. And contraceptives, if you’re taking care to not get pregnant soon after birth-experts recommend that pregnancies be spaced at least 18 months apart to allow your body adequate recovery before you place it under the stressors of pregnancy again.


If you didn’t purchase healthcare during the open enrollment period in early 2014, you’ll have to wait for the next open enrollment for the Healthcare Marketplace (http://www.healthcare.gov). There are waivers for special circumstances so check to see if you qualify to get healthcare now. November 15 kicks off the next and last open enrollment period in 2014, and for 2015, open enrollment starts on February 15th, 2015.


All plans in the Healthcare Marketplace and most plans cover support from a lactation consultant, a breast pump and basic breastfeeding supplies before or after your baby is born. There are some exceptions for plans that remained unchanged under the new healthcare law. For example, if you have an employer-provided health plan, check with your plan’s benefits administrator or call the number on the back of your insurance card to learn about your specific breastfeeding benefits.

For plans providing breastfeeding support, buying or renting a breastfeeding pump is covered. Your plan may have specific policies around the types of pumps recommended or provided but the law specifies that the type of pump needed is between your healthcare provider and you. You’ll likely need your healthcare provider’s recommendation or an authorization, depending on your plan’s policies, to get your pump covered.

Many breast pump manufacturers and distributors who sell medical devices are launching apps and websites specifically designed to help you use your benefits toward a pump and nursing supplies. Start by exploring your options at manufacturers’ websites, which are designed to help you match your benefits to the pumps they have available to you under your plan and where to purchase or acquire one.

Elizabeth T. Jordan, DNSC, RNC, FAAN is an associate professor of Nursing at the University of South Florida, College of Nursing, and an expert advisor to Healthy Mom&Baby

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