Insurance

Newborns and Mothers Health Insurance FAQs

Are you planning on having a baby? One of the things you may be worried about is your hospital stay. How long do you get to stay and will it be covered by your insurance? One law that may be able to provide you protection is called the Newborns' and Mothers' Health Protection Act. The US Department of Labor provides information about the act on its website. Here are answers to some frequently asked questions about health insurance for newborns and mothers.



Q:

Is there a federal law that provides hospital stay benefits to newborns and their mothers?



  • A:The Newborns' and Mothers' Health Protection Act is a federal law that provides hospital stay benefits to newborn children and their mothers. The act was signed into law in 1996.



Q:

How does the Newborns' and Mothers' Health Protection Act help me with my insurance?



  • A:

    If your insurer provides maternity benefits and is subject to the act, it must provide you hospital stay benefits for at least 48 hours for vaginal delivery births. For cesarean section births, your hospital stay benefits can't be restricted for 96 hours.



Q:

Can I be discharged earlier than 48 or 96 hours by my doctor?



  • A:

    Your attending provider can decide to discharge you or your newborn earlier after consulting with you.



Q:

Who's considered my attending provider?



  • A:

    Your attending provider is the licensed professional who's responsible for providing care to you or your newborn.



Q:

When does my hospital stay benefit start under the Newborns' and Mothers' Health Protection Act?



  • A:

    Your 48-hour or 96-hour time period starts at the time of delivery if you deliver in the hospital. It starts when you're admitted to the hospital if you deliver outside the hospital.



Q:

Can my insurer require me to pay a deductable or a percentage of my childbirth hospital stay expenses?



  • A:

    Your insurer can require you to pay part of the hospital stay expenses as long as it's the same amount throughout the entire stay. It can't require more money from you for the second half of your hospital stay.



Q:

How do I know if the Newborns' and Mothers' Health Protection Act applies to my insurance?



  • A:

    Whether the act applies to your coverage will depend on the type of insurance you have and your state law. If your insurance coverage is self-insured, the act always applies. Your benefits will depend on state law and not the act if your coverage is insured, and your state has an insurance coverage law for newborns and mothers.



Q:

Am I entitled to maternity benefits under the Newborns' and Mothers' Health Protection Act?



  • A:

    Your insurer isn't required to provide you with maternity benefits under the act. However, other laws may require childbirth coverage.

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