Navigating the Health Insurance Landscape by Robert Adziashvili - HTML preview

Navigating the Health Insurance Landscape

4. Example One: How ACA handles Maternity , Labor/Delivery

The Affo rdabl e Care Ac t ( ACA) , al so k n o wn as O bamac are, made c han ges t o i mpro v e ac c ess t o heal t hc are serv i c es, espec i al l y fo r mat ern i t y c are. Let 's l o o k at an exampl e o f ho w t he ACA han dl es t he expen ses rel at ed t o mat ern i t y fo r a pregn an t wo man wi t h an ACA-c o mpl i an t heal t h i n suran c e pl an .

D uri n g pregn an c y, t he ACA requi res i n suran c e pl an s t o c o v er pren at al c are, whi c h i n c l udes regul ar c hec k-ups, sc reen i n gs, an d t est s. The pregn an t wo man c an v i si t her heal t hc are pro v i der fo r t hese i mpo rt an t serv i c es wi t ho ut hav i n g t o pay fo r t hem o ut o f her o wn po c k et .

When i t 's t i me fo r l abo r an d del i v ery, t he pregn an t wo man wi l l rec ei v e c are fro m an O B/GYN. If she has an ACA-c o mpl i an t i n suran c e pl an , i t sho ul d c o v er t he c o st s o f t he O B/GYN serv i c es. Ho wev er, t he spec i fi c c o v erage det ai l s an d an y c o paymen t s o r deduc t i bl es wi l l depen d o n her i n di v i dual i n suran c e pl an .

The ACA al so man dat es t hat i n suran c e pl an s c o v er t he c o st s o f ho spi t al i z at i o n fo r c hi l dbi rt h, i n c l udi n g l abo r an d del i v ery. Thi s mean s t hat t he pregn an t wo man wo n 't hav e t o di rec t l y pay fo r ho spi t al expen ses rel at ed t o c hi l dbi rt h, suc h as t he del i v ery ro o m an d n ec essary medi c al equi pmen t . Addi t i o n al l y, an est hesi a duri n g del i v ery an d n ec essary medi c at i o n s sho ul d al so be c o v ered by ACA-c o mpl i an t i n suran c e pl an s.