How pregnant workers can navigate open enrollment

If you expect to welcome a new baby to the family in 2019, cast a critical eye to your health benefits this fall.

It’s open enrollment season, a time when many Americans sign up for a health plan for the coming year, including those through an employer or on government exchanges.

Plenty make those decisions on autopilot: Ninety-three percent of employees choose the same benefits each year, and 56 percent spend less than 30 minutes researching their options, according to a report from Aflac.

“Most of the time we don’t think about our health care until we have some medical event,” said Jody Dietel, chief compliance officer for benefits administrator WageWorks.

Yet pregnancy is one of the rare opportunities where you can anticipate a major medical event (in this case, giving birth), and plan around the expenses related to it, she said.

“It’s important that people spend the time to understand their benefits,” Dietel said.

And open enrollment is the time to think about that coverage, whether you’re currently pregnant or plan to be next year. Why? Becoming pregnant typically isn’t a so-called “qualifying life event” that lets you change or enroll in coverage mid-year, said Cheryl Fish-Parcham, director of access initiatives for Families USA, a health-care advocacy group.

(Having a baby is considered a qualifying life event, with coverage retroactive to the date of birth. But that special enrollment is generally limited to obtaining coverage for that child by adding them to your plan or purchasing a new plan exclusively for them — not changing coverage for current family members.)

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For consumers buying a plan on the open market, missing the open enrollment window may mean they can’t get a plan with decent maternity coverage, Fish-Parcham said.

Under the Affordable Care Act, maternity care and childbirth are considered essential health benefits that all qualified plans must cover. But short-term health insurance policies, which are available year-round, don’t fall under ACA regulations — and so may exclude or limit maternity coverage, she said.

Here’s what an expecting parent should look for during open enrollment:

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