Childbirth costs

Childbirth costs in the US vary greatly depending on whether you have insurance. On this page, you will find how insurance covers childbirth, ways to get insurance while pregnant, Medicaid, the rights of uninsured families, and maternity leave rules. For immigrants’ Medicaid rights, also see 16.3 Medicaid and CHIP.

• All HealthCare.gov (Marketplace) plans and Medicaid cover pregnancy and childbirth. This applies even if the pregnancy began before the insurance started.
• Prenatal and postpartum care, along with newborn care, count as "essential health benefits." All qualified health plans inside and outside the Marketplace must cover them.
• Employer insurance: If the plan covers a hospital stay for childbirth, it cannot limit the stay to less than 48 hours for a vaginal delivery or 96 hours for a cesarean delivery.
• Learn the details of your plan before childbirth:
  • whether your doctor and hospital are in-network
  • the deductible and annual out-of-pocket maximum
  • copayments for prenatal checkups
• See 9.1 How the US health system works for these terms.

• Pregnancy alone does not create a special enrollment right. On HealthCare.gov, you cannot get a plan in the middle of the year solely because you are pregnant. Childbirth does create a special enrollment right.
• Open enrollment period: November 1 – January 15 every year. For 2027 plans, the period begins on November 1, 2026. For coverage beginning January 1, the deadline is December 15.
• You can apply for Medicaid and CHIP in any month of the year. If eligible, coverage may begin immediately.
• If you become pregnant while you have a Marketplace plan:
  • According to HealthCare.gov, if you want to keep your current plan, do not report the pregnancy. Update your application and add the baby after childbirth.
  • If you report it, you may qualify for free or low-cost Medicaid or CHIP. If you qualify, your information is sent to the state and you will not have the option to keep your Marketplace plan.
• Employer insurance: You can enroll during your employer’s open enrollment period or through the special enrollment right after childbirth (below).
• For insurance options, see 9.2 Insurance options and 9.3 Open enrollment periods.

• States set their own Medicaid income limits for pregnant people. Under the federal rule, this limit must be at least 133% of the federal poverty level. States may set a higher limit.
• If you are found eligible for Medicaid while pregnant, coverage continues for at least 60 days after childbirth. Some states have extended postpartum coverage to 12 months.
• Automatic enrollment for the baby: If the mother has Medicaid at the time of birth, the baby is considered enrolled in Medicaid from the date of birth. This coverage lasts at least until the baby’s first birthday.
  • This rule applies even if the mother’s Medicaid covers emergencies only.
• Immigration status: Since October 1, 2026, full Medicaid has been open only to certain statuses. Some states also cover pregnant people who are "lawfully residing." Details: see 16.3.
• Emergency Medicaid and childbirth: For people without an eligible immigration status who meet the state’s income and residency requirements, Emergency Medicaid may cover emergency labor and delivery.

1. Request a good faith estimate. If you are not using insurance and scheduled the service at least 3 business days in advance, the healthcare provider must give you a written estimate of the expected charges.
   • For services scheduled 3–9 business days in advance, the estimate is provided within 1 business day; for services scheduled 10 business days or more in advance, it is provided within 3 business days.
   • The estimate is separate for each provider. Request one separately from the doctor and the hospital.
2. Compare the bill with the estimate. If a provider bills at least $400 more than the estimate, you can dispute the bill.
   • Apply within 120 days of the date of the first bill.
   • The dispute fee is $25 and is nonrefundable. If you prevail, this amount is deducted from what you owe.
   • You cannot dispute the bill if you did not receive an estimate.
3. Ask about the hospital’s financial assistance policy. Tax-exempt (nonprofit) hospitals must have a written financial assistance policy.
   • The policy covers all emergency and medically necessary care. It may provide free or discounted care.
   • The policy, application form, and plain-language summary are available on the hospital’s website, in the emergency department, and in the admissions area.
   • The hospital must provide translations in the languages of major language groups in the area.
4. Request a payment plan. See 9.5 Bill disputes and payment plans.

1. Employer insurance: The plan must give you at least 30 days after childbirth to enroll. Coverage begins on the baby’s date of birth. During this period, you can also add yourself and your spouse to the plan.
2. HealthCare.gov: Apply within 60 days after childbirth. Coverage under the new plan begins on the baby’s date of birth.
   • If you already have a Marketplace plan, you can add the baby to the existing plan or choose a separate plan for the baby.
   • Report the birth immediately through the "Report a Life Change" section of your account. Your premium discount may change.
3. Medicaid: If you have Medicaid at the time of birth, the baby is automatically enrolled.
4. CHIP: You can apply for the baby at any time. See 8.6 Children’s health.
5. If your Medicaid ends after childbirth, you have a special enrollment right in the Marketplace because of losing other insurance.

• FMLA (federal family leave): Eligible employees can take up to 12 weeks of leave in total during a one-year period.
  • Requirements: having worked for the employer for at least 12 months, having worked at least 1,250 hours during the previous 12 months, and having at least 50 employees within 75 miles of the worksite.
  • Both the mother and father can take leave for childbirth and caring for the baby. This leave must be used within 12 months after childbirth.
  • If spouses work for the same employer, the total may be limited to 12 weeks.
  • FMLA leave is generally unpaid. You may count accrued paid leave toward this period.
• Pregnant Workers (PWFA): Employers with 15 or more employees must provide reasonable accommodations for pregnancy- and childbirth-related limitations, such as breaks or sitting while working. The accommodation cannot be denied unless it creates an undue hardship for the employer.
• Paid family leave in the states: Some states pay for bonding time with a baby.
  • California Paid Family Leave: up to 8 weeks within 12 months, with weekly payments between $50 and $1,765.
  • New Jersey Family Leave Insurance: To qualify in 2026, you must have earned at least $310 per week for 20 weeks or a total of $15,500.
  • Other states may also have programs; ask your state labor department.
• For employee rights, see 5.5 Employee rights.

• HealthCare.gov call center — Marketplace, Medicaid, and CHIP applications
  • Phone: +1 800 318 2596 (TTY: +1 855 889 4325)
  • 7 days a week, 24 hours a day (excluding federal holidays)
• Your state Medicaid agency — Medicaid applications for pregnant people
  • Web: List of state Medicaid agencies
• No Surprises help line (CMS) — questions about estimates and bill disputes
  • Phone: +1 800 985 3059 (in more than 350 languages)
• EEOC (workplace discrimination) — denial of a pregnancy-related accommodation request
  • Phone: +1 800 669 4000
  • The filing period is generally 180 calendar days. It extends to 300 days if a state or local agency enforces a law on the same matter.

• Assuming you can get a HealthCare.gov plan in the middle of the year after becoming pregnant.
• Missing the 30- or 60-day deadline to add the baby to insurance after childbirth.
• Not requesting separate estimates from the doctor and hospital for uninsured childbirth.
• Not asking about the hospital’s financial assistance policy before paying the bill.
• Not checking whether the doctor or hospital is in the plan’s network.
• Coming to the US on a visitor visa to give birth. See 8.1.

• I am pregnant and uninsured. Can I get a plan now? You can always apply for Medicaid or CHIP if eligible. For the Marketplace, you must wait for open enrollment or another special enrollment right.
• If I get a plan immediately after childbirth, will childbirth costs be covered? If you choose a plan through HealthCare.gov within 60 days after childbirth, coverage begins on the date of birth. Ask the call center whether it covers the costs on your side of the childbirth.
• Does my baby need separate insurance? If you have Medicaid at the time of birth, the baby is automatically enrolled. Otherwise, add the baby to your plan or apply for CHIP.
• Is maternity leave paid? Federal FMLA leave is unpaid. Paid leave depends on your employer’s policy or your state’s program.
• I am uninsured; the bill is much higher than the estimate. If the difference is at least $400, you can dispute it within 120 days of the date of the first bill.
• Who receives hospital financial assistance? Each hospital sets its own eligibility requirements in its policy. Request the policy and application form from the hospital.

• HealthCare.gov income-based eligibility checker
• HealthCare.gov special enrollment period
• State Medicaid and CHIP agencies
• Good faith estimate fact sheet (PDF, CMS)
• Bill dispute process (CMS)
• California Paid Family Leave
• New Jersey Family Leave Insurance
• EEOC filing portal