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Mercado Oficial de Seguros de Salud

El mercado de seguros de salud del estado de California desde 2013

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Pregnancy & Maternity Coverage in California

Planning a baby or already pregnant? All Covered California plans must cover maternity care as an Essential Health Benefit. Learn what's covered and how to choose the best plan for your pregnancy.

What's Covered

All Covered California plans cover:

  • Prenatal care: Regular checkups, ultrasounds, lab work
  • Labor and delivery: Hospital or birth center
  • Newborn care: Baby's first 30 days in hospital
  • Postpartum care: Follow-up visits after birth
  • Breastfeeding support: Lactation counseling, breast pumps
Good News: Preventive prenatal care is covered at 100% with no copay.

Pregnancy Costs by Plan

Your out-of-pocket costs depend on your plan's deductible and hospital costs. These are Covered California's standard 2027 plans:

Plan (2027) Deductible Prenatal Care Hospital Stay Out-of-Pocket Max
Bronze 60 $5,800 no charge 40% $11,650
Silver 70 $4,700 no charge 30% $11,650
Silver 73 $4,700 no charge 30% $9,600
Silver 87 $1,100 no charge 20% $4,000
Silver 94 $200 no charge 10% $3,000
Gold 80 $0 no charge $375 per day up to 5 days or 30% $9,600
Platinum 90 $0 no charge $325 per day up to 5 days or 10% $5,500

Labor and delivery count as a hospital stay. C-sections and complications cost more, up to the plan's out-of-pocket maximum. The quote form shows each plan's costs for you.

Best Plans for Pregnancy

If you're planning a pregnancy, consider upgrading to a Gold or Platinum plan during Open Enrollment.

Pro Tip: Compare total costs (premiums + expected out-of-pocket) rather than just monthly premium. Higher-tier plans often save money when you have a baby.

When to Enroll

  • Already pregnant: Pregnancy alone doesn't qualify for SEP, so enroll during Open Enrollment or with another qualifying life event. You can apply for Medi-Cal any time of year, and the Medi-Cal Access Program covers pregnancy at higher incomes
  • Planning pregnancy: Enroll during Open Enrollment for best plan choice
  • After birth: Baby qualifies for SEP to be added to your plan

Planning Your Coverage?

Our agents can help you calculate costs and choose the best plan for your pregnancy.

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