Does the Affordable Care Act cover teen pregnancy? Maybe not

0 Comment(s) | Posted | by Elizabeth |

An article in yesterday’s Washington Post revealed an interesting loophole in how the Affordable Care Act may refuse care for pregnant teens and young adults. 

Here’s the scoop:

Employer-based health plans are required to cover maternity services (labor and deliver, etc.) under the Pregnancy Discrimination Act of 1978 BUT they are not required to provide the same coverage for dependent children covered by a parent’s insurance plan. That’s old info. However, while the Affordable Care Act extends parents’ ability to keep coverage for their children up to age 26, it doesn’t change this provision. So, a young person on a parent’s health insurance will not have the most major maternity expenses covered. (Disclaimer: Always check with your insurer about what’s covered and what’s not.)

The Affordable Care Act does include some pregnancy-related services under the Preventative Services for Women provision: prescription prenatal vitamins, gestational diabetes screening, STD tests (state-mandated during pregnancy and very expensive, as I have learned), and breastfeeding supplies and support. This is the same provision that provides contraceptives with no co-pay and it could kick in at any point between August 1st of this year and 2014 depending on the insurance plan. To be clear, these changes will mean great things for teens: fewer pregnancies and healthier pregnancies for girls who are covered.

The very complicated bottom line: If a teen or young adult is up to age 26 and still on a parent’s insurance and gets pregnant and qualifies for the Women’s Preventative Services provision, then many parts of prenatal care are covered but not the most expensive part – actually having the baby.


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