Trying to get pregnant? Make sure you know the bottom line on baby-making—what you don't understand can affect your bub-to-be's health.
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“A women was denied coverage because she had a baby with a medically mandated Cesarean section,” said U.S. Sen. Barbara Mikulski, D-Md., after federal health reform legislation passed in late March. “When she tried to get insurance coverage with another company, she was told she had to be sterilized in order to get [it]. That will never, ever happen again.” Here are other ways in which the new law benefits pregnant women, new moms and babies, in order of implementation:
1. Coverage for birth centers
Medicaid, a state- and federally funded program for low-income families, will pay for deliveries at freestanding birth centers. “This is a big deal because private insurers often follow the precedent set by Medicaid,” says Kate Bauer, executive director of the American Association of Birth Centers.
Effective date: now
2. Pumping breaks at work
Companies with more than 50 employees will be required to allow a nursing woman “reasonable time” to express breast milk during work hours until her child is 1 year old. These employers must also provide a private place—not a bathroom—where women can pump. Effective date: now
3. Certified-midwife coverage
“Licensed birth attendants,” aka certified midwives, serving women at birth centers will be eligible for Medicaid reimbursement (certified nurse-midwives are already eligible).
Effective date: on or after January 2011
4. Postpartum depression support
Money will be allocated to research causes and treatments for postpartum depression and psychosis, increase awareness and improve the screening of women after childbirth.
Effective date: fall 2010
5. Free preventive care for women and children
All new health plans are required to provide well-baby checkups, immunizations for women and children and other preventive services with no co-pays.
Effective date: Jan. 1, 2011
6. Home visits
Medicaid will provide prenatal and postpartum nurse home-visit programs.
Effective date: varies by state
7. Mandatory maternity coverage
All health plans will be required to cover prenatal, maternity and newborn care, as well as mental health and pediatric services, including dental and vision, as part of an essential health benefits package.
Effective date: 2014
8. No more denials due to previous C-section
In fact, exclusions due to any pre-existing health condition, including pregnancy, will be banned.
Effective date: 2014 (Children with pre-existing conditions cannot be denied coverage starting this year.)
9. No more “gender rating”
Individual and small-group insurance plans will be barred from charging women higher premiums than men. In the past, women have paid as much as 84 percent more than men for the same individual policy that excluded maternity coverage, according to the National Women’s Law Center.
Effective date: 2014