Illinois

In Illinois, various health insurance options are available to help cover the costs of pregnancy and childbirth care. These include private insurance plans, Medicaid, and specialized programs aimed at ensuring expectant parents have access to necessary medical services. Here are some key programs and services:

1. State Plans and Programs

a. Illinois Medicaid (Illinois Medical Assistance Program)
Illinois Medicaid provides health coverage for low-income pregnant individuals and children. Services covered include:

• Prenatal and postpartum care;
• Delivery services;
• Hospital stays; and
• Infant care up to one year after birth.

Eligibility is based on income and household size. Learn more and apply at the Illinois Medicaid.

b. Illinois All Kids Program
The All Kids program offers coverage for children up to age 19, including pregnant individuals. It provides comprehensive care, including prenatal visits, ultrasounds, and delivery services. All Kids also helps with prescriptions, doctor visits, and dental care for children. Learn more and apply at the Illinois All Kids.

1. Employer-sponsored Plans

Pregnant individuals can enroll in coverage through an offer of employer-sponsored coverage (ESC) from their own employer or a spouse’s job. Many employers offer health insurance that includes maternity and newborn care. Coverage typically includes:

• Prenatal visits;
• Ultrasounds;
• Labor and delivery; and
• Postpartum care.

1. Health Insurance Marketplace

Through the Health Insurance Marketplace, pregnant women can explore various health insurance plans that cover pregnancy and childbirth. Under the Affordable Care Act (ACA), all marketplace insurance plans are required to cover maternity and newborn care as essential health benefits. Illinois residents can compare and enroll in plans through the federal marketplace at the Healthcare.gov.

1. Private/ Individual Insurance Plans

Private health insurance purchased outside the marketplace may also provide coverage, though benefits can vary. Additionally, a parent’s health insurance plan (if that plan offers dependent coverage) can also cover pregnant dependents before their 26th birthday. Employer-sponsored coverage for dependents usually ends during the month of the child’s 26th birthday. If the dependent is covered under their parent's Marketplace plan, the dependent can stay on their parent's plan until December 31 of the year they turn 26.

1. Other Assistance Programs

a. Indian Health Service (IHS)
American Indian and Alaska Native individuals are eligible for healthcare services through the Indian Health Service (IHS) or tribal health organizations, which include maternity and childbirth care. Services are typically free or low-cost and available at these facilities.

b. Illinois Perinatal Care Program
The Illinois Department of Public Health offers a Perinatal Care Program aimed at improving the quality of care for expectant parents, especially in underserved areas. The program helps reduce maternal and infant mortality through education and increased access to prenatal care. Learn more at the Illinois Department of Public Health.

c. Sliding Fee Scale Clinics
Federally Qualified Health Centers (FQHCs) and community health clinics offer maternity care at reduced costs based on income.

For assistance, Illinois residents can get help navigating their insurance options from local health navigators or Certified Application Counselors. They can also contact the Get Covered Illinois program for assistance in applying for Medicaid or marketplace coverage.