Medicare typically does cover pregnancy at all stages throughout the pregnancy, from diagnosis, through childbirth and through some postnatal care.
The Part of Original Medicare (Part A or Part B) that covers your pregnancy care will depend on the type of facility in which you undergo delivery and other childbirth-related services.
Medicare Advantage (Part C) plans may also cover pregnancy care that would be covered by Original Medicare. They also include an annual out-of-pocket spending limit, which Original Medicare doesn’t offer.
Medicare offers coverage to qualified Americans age 65 and older, but some people may also be eligible for Medicare under 65 due to a qualifying disability or condition.
If someone is eligible for Medicare under 65, their pregnancy and childbirth care could potentially be covered by Medicare.
Medicare may provide coverage at all stages of pregnancy, including:
Depending on where you undergo your delivery and general care, Medicare Part A or Part B may cover some of your costs:
Medicare typically also covers certain screening services for pregnant beneficiaries if they are ordered by a doctor:
Medicare may not cover all pregnancy related expenses such as:
Once your baby is born, they are treated as a separate individual, and their health care is not covered by Medicare based on your Medicare eligibility.
Even if Medicare covers your pregnancy, there are some out-of-pocket costs you should expect to pay, which may include:
The Part A deductible is not annual. You could experience more than one benefit period in a given calendar year.
There is no annual limit on how much you could pay for the Part B coinsurance in a given year.
We recommend speaking with your doctor directly for specific cost and coverage information.
Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare.
Every Medicare Advantage plan must cover everything that Part A and Part B covers. If your pregnancy is covered by Original Medicare, it will also be covered by a Medicare Advantage plan.
Some Medicare Advantage plans also offer additional benefits, such as:
A licensed insurance agent can help you learn more about the Medicare Advantage plans that are available where you live.
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