QUESTION

I’m covered as a dependent under my parent’s plan and I’m pregnant. Will my parent’s plan cover my prenatal care and delivery? Will my parent’s plan cover my baby after he’s born?

Individuals with coverage | Issues For Young Adults: Student Health Plans and Coverage on Parent’s Health Plans
ANSWER

Your parent’s plan is probably required to cover some of your prenatal maternity care. If your parent’s plan is an individual or small group market policy, it is subject to the essential health benefits requirement and must cover maternity care for you, as a dependent. If your parent’s plan is an employer plan, offered through their work, it may cover some, but not all maternity care, such as delivery charges for you, as a dependent child. If your parent’s plan is a grandfathered or transitional plan, or an alternative form of coverage, including short-term limited duration insurance, an association health plan, or a health care sharing ministry, it may not cover maternity services at all. For more information, visit the ACA Consumer Protections for Private Coverage under Other Resources.

If the plan does cover your maternity costs, the plan is not required to cover your child as a dependent. You will be responsible for obtaining coverage for your baby. Depending on your income, you may be eligible for coverage for your pregnancy and your child may be eligible for coverage under the Medicaid/CHIP program in your state. Or, you can buy a child-only policy through the marketplace and, depending on your income, you may be eligible for a premium tax credit to reduce your cost of that coverage. (45 C.F.R. § 147.120; 45 C.F.R. § 146.130; 26 U.S.C. § 36B).

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