Keeping Track of Healthcare Benefits

 

James McNeill Whistler (American, 1834 – 1903 ), The Doctor, 1895, lithograph, Rosenwald Collection

As we all know, the current state of health care is probably in flux, but I think it is important to outline benefits that parents of newborns and breastfeeding mothers are entitled to under the current law, the Affordable Care Act, passed under the Obama administration. It is often called Obamacare.

First, here are basic rights your family has under the Health Insurance Portability and Accountability Act (HIPAA) as detailed on the Department of Labor website:

If your plan provides maternity benefits, you should be entitled to a minimum hospital stay of 48 hours following a vaginal delivery and 96 hours following a cesarean delivery.

You cannot be required to get a preauthorization from your plan in order for the minimum hospital stay to be covered.

Your plan must provide you with a notice regarding your rights relating to a hospital stay following childbirth.

Contact your health plan or your spouse’s health plan as soon as possible to find out how to enroll your new baby in group health plan coverage.

As long as you enroll your newborn within 30 days of birth, coverage should be effective as of your baby’s birth date, and your baby cannot be subject to a preexisting condition exclusion. This 30-day deadline also applies to the enrollment of adopted children.

In terms of breastfeeding, one of the most important changes with the ACA is the provision that every new mother is entitled to a breast pump from her insurance company. What kind of pump differs from company to company, but my experience in working at a hospital is most insurance companies were offering good quality double electric pumps.

ObamacareFacts is a good website if you have questions about the ACA.

And here is a good rundown of the preventive care benefits for pregnant and post-partum mothers,  as well as infants.

It’s important to note that lactation services are included in this list. You may never need the services of a lactation consultant after you leave the hospital, but if you’d like some help it’s good to know you can get coverage. Check with your insurance company to find out the details of what it will cover.

It’s very possible that some of these provisions will change under the Trump  administration so I will keep this updated.

For those of you who want a more in-depth view of healthcare news, the Washington Post has a daily update called The Health 202.