Is prenatal care covered by insurance?
Doctor visits, tests, and screenings during pregnancy. Here’s how each kind of plan usually handles it.
- Employer or MarketplaceUsually covered
Yes, maternity care is covered, and routine prenatal visits are often $0.
More details
ACA-compliant plans cover pregnancy, even if you were pregnant before enrolling. Many plans bill routine prenatal visits as part of a global maternity fee; specialized tests may have cost sharing.
Cost: Routine prenatal visits are often $0; ultrasounds and specialist care may have cost sharing.
- Original MedicareCovered with conditions
Covered for people with Medicare, under the usual Part A and Part B rules.
More details
Pregnancy-related care is covered when medically necessary for people on Medicare due to disability.
Cost: Generally 20% of the Medicare-approved amount after the Part B deductible.
- Medicare AdvantageCovered with conditions
Yes, Medicare Advantage plans must cover prenatal care, but your plan sets the copay.
More details
Pregnancy-related care is covered when medically necessary for people on Medicare due to disability. plans must cover this too, but set their own copays and often require providers and prior authorization.
Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.
- MedicaidUsually covered
Yes, Medicaid covers pregnancy care at no cost to you.
More details
Medicaid covers about 4 in 10 U.S. births, and many pregnant people qualify at higher incomes than other adults. Nearly every state now keeps you covered for 12 months after the birth, even if your income changes.
Cost: $0: Medicaid can’t charge copays for pregnancy-related care.
What usually has to be true
- Use in-network OB, midwife, and lab providers.
- Tell your plan you’re pregnant: many offer extra support programs.
Good to know
- Every state’s Medicaid program covers pregnant people, often at higher incomes than other adults.
- Grandfathered and short-term plans may exclude maternity care.
Related
- Childbirth & delivery · Hospital or birth-center delivery, including C-sections.
- Ultrasound · Sonogram imaging, including pregnancy ultrasounds.
- Breast pump · Breast pumps and lactation support.
Sources
Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.
- 1Pregnancy and health coverage
HealthCare.gov
Marketplace and other ACA-compliant plans cover pregnancy and childbirth, including care before and after the baby is born, even when the pregnancy began before coverage started.
- 2Preventive care benefits for women
HealthCare.gov
Covered services for women include mammograms, cervical cancer screening, BRCA genetic counseling and testing for those at higher risk, bone density screening, contraception, well-woman visits, and breastfeeding support and supplies.
- 3Doctor and other provider services
Medicare.gov
Part B covers medically necessary doctor services, including outpatient and some inpatient services; you generally pay 20% of the approved amount after the deductible.
- 4Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
- 5Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.
General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.