Category: Uncategorized

A lot of people talk about how expensive it is to raise a child, but what about the expenses related to birth? Recent estimates show that hospital expenses for a birth can range from $8,000 to over $26,000. That’s a key reason why having health insurance is so crucial for pregnant women.  

Finding the right health insurance during pregnancy will protect both you and your baby and make sure you receive the healthcare you need. In Tennessee, pregnant women have several coverage options, from Medicaid programs to Marketplace health plans. Understanding these choices can help you access critical care, such as prenatal checkups, delivery services, and postpartum support, without incurring overwhelming financial stress.

Understanding Health Insurance Needs During Pregnancy

Your health insurance needs start early in your pregnancy.

Why Prenatal Coverage Is So Important

Prenatal care is more than just taking prenatal pills. This step is one of the most important aspects of a healthy pregnancy. Regular doctor visits help detect and prevent complications, monitor fetal development, and ensure that both mother and baby stay healthy. Without adequate insurance, many women delay care, increasing risks during pregnancy and childbirth.

Common Health Costs During Pregnancy

Expectant mothers can face a wide range of expenses, including:

• Routine OB/GYN visits
• Lab tests and ultrasounds
• Prenatal vitamins
• Delivery (hospital or birthing center costs)
• Postpartum checkups
• Breastfeeding support

Medicaid Options for Pregnant Women in Tennessee

Over 40% of pregnant women get at least some financial support from Medicaid. TennCare is Tennessee’s Medicaid program, offering comprehensive health coverage to qualifying pregnant women.

TennCare for Pregnant Women

TennCare offers a pregnancy-specific pathway to Medicaid eligibility, even if you wouldn’t typically qualify based on income alone.

How to Apply While Pregnant and Who Qualifies

Pregnant women can apply for TennCare online through TennCare Connect or by calling the TennCare phone number. You may qualify based on your income and household size—even if you’ve previously been denied Medicaid. In many cases, coverage begins retroactively to help cover the costs of recent medical visits.

Coverage Provided Under TennCare for Expectant Mothers

TennCare covers:

• All prenatal and postpartum care
• Labor and delivery
• Hospital stays
• Free breast pumps through TennCare
• Dental benefits
• Mental health support
• Access to WIC and other government assistance for pregnant mothers

You may also be eligible for free baby items through Medicaid programs or partner services, including diapers, car seats, or formula support.

Marketplace Health Insurance Plans for Pregnant Women

If you don’t qualify for Medicaid, the Health Insurance Marketplace offers another option for coverage.

Using the Health Insurance Marketplace in Tennessee

Visit HealthCare.gov to explore your options. You could be eligible for subsidies, which can lower your monthly premium based on your income. 

Special Enrollment Periods and Pregnancy

While pregnancy alone doesn’t trigger a Special Enrollment Period (SEP), giving birth does. However, if you’ve lost coverage recently or experienced another life change, you may qualify for an SEP. Otherwise, open enrollment typically happens in the fall.

Comparing Plans for Prenatal and Delivery Coverage

Not all Marketplace plans offer the same out-of-pocket costs or provider networks. When comparing, look for:

• In-network OB/GYNs and hospitals
• Deductibles and co-pays for maternity services
• Prescription coverage for prenatal vitamins
• Support services like lactation consultations

Additional Resources for Uninsured or Low-Income Pregnant Women

If you are pregnant and do not have insurance, you still have options to ensure you and your baby get healthcare services during pregnancy and beyond.

Help from Family & Children’s Services

If you’re uninsured or struggling financially, Tennessee offers programs beyond insurance. Family & Children’s Services helps connect pregnant women to food assistance, transportation to medical appointments, financial assistance, and support groups. These services can help reduce stress and improve outcomes for you and your baby. Contact us to learn more.

 

Featured Image: elenavolf / Shutterstock

 

On March 23, 2010, then-President Barack Obama signed the Affordable Care Act (ACA) into law. More than 50 million Americans, including families with small children, lacked health insurance and could not access needed healthcare. The goal of the ACA was to bring affordable health insurance to these people. Other provisions in the ACA ensured people with preexisting conditions could get insurance at a reasonable cost and provide coverage for specific medications, such as birth control. In addition, the Affordable Care Act (ACA) prohibits insurance companies from setting annual dollar limits on how much they spend on essential health benefits for a person’s care while they are enrolled in a plan.

The ACA created Health Insurance Marketplaces where people can purchase coverage and receive financial assistance to reduce premiums and deductibles. This can help people who may have been uninsured due to limited finances or preexisting conditions. Over the years, many people, including those in Tennessee, have gained health insurance through the ACA. The rollout experienced chaos and legal challenges, but the ACA has functioned as a safety net for many Americans. Tennesseans have used the ACA Marketplace, but the process can be confusing. GetCoveredTenn is your partner for a smoother process.

How the ACA Has Impacted Tennessee Residents

In 20234, more than 555,103 Tennesseans chose health plans on the ACA Marketplace. This means that more than six percent of the people of Tennessee benefited and found affordable and comprehensive health insurance to protect themselves and their families. The ACA Marketplace allows individuals at certain income levels to buy individual policies where the federal government offsets the cost of the policies. This helps lower or eliminate the monthly premiums and makes the policies more affordable to people who make less money.

As of 2024, Tennessee has not taken advantage of the option to expand Medicaid through the ACA to provide healthcare for the people in the gray area who make too much to qualify for Medicaid and too little to benefit from the ACA. Based on the Center on Budget and Policy Priorities report, in Tennessee, some 95,000 uninsured adults in the coverage gap will become eligible for TennCare if the state expends Medicaid.

Although the Medicaid coverage gap still impacts many uninsured Tennessean, the ACA has opened a pathway for many uninsured Tennesseans to gain access to health care.

Available Resources for Tennesseans to Access ACA Coverage

Navigating the ACA Marketplace and securing coverage can seem daunting. You can access the Marketplace online at HealthCare.gov. Once you reach the website, you will have to set up an account and provide a wealth of personal information, including your income. It can become confusing, and you may struggle to determine which policy is best for you and your family.

Non-profits, such as GetCoveredTenn, provide the helping hand you need to navigate the ACA Marketplace. You will find assistance in creating an account and more information on the types of health insurance policies that benefit you and your family. Our team of experts are available to answer any questions you may have. In-person or phone appointments are available.

GetCoveredTenn: Your Partner in Securing Affordable Health Insurance Under the ACA

At GetCoveredTenn, we understand the nuances of securing a policy that fits your budget and meets your coverage needs under the ACA. We are a non-profit with the goal of ensuring that all Tennesseans who need health insurance can gain access to a policy. Contact us now.