Health Insurance for Maternity in Canada

Whether you have a little one on the way or are just thinking about having a baby, one thing that’s likely on your mind is maternity care.

In Canada, most expecting parents have medical coverage under provincial or territorial healthcare. But what exactly does it cover? And should you have additional health insurance for maternity?

Keep reading as we break down everything you need to know about health insurance for maternity in Canada.

Key Takeaways

For eligible Canadians, universal healthcare covers most of the basics when it comes to maternity care. But it doesn’t always cover all your medical needs throughout pregnancy.
Extended healthcare plans and health insurance provide additional benefits and services for expecting parents to maintain a healthy pregnancy.
PolicyMe can help expecting parents find the right health insurance for maternity in just a few minutes.

What is Health Insurance for Maternity Care?

Having access to maternity care is critical to ensuring a safe and healthy pregnancy and childbirth experience. This includes everything from prenatal care, hospital stays, labour and delivery, to postnatal care.

Luckily, most Canadians have access to maternity care through government healthcare plans. This generally covers all the essential medical needs for supporting mothers through every stage of their pregnancy.

The exact services covered can vary a bit between provinces but government plans typically cover costs associated with:

Doctor and obstetrician visits
Labour and delivery
Hospital stays
Ultrasounds and other laboratory testing
Medical surgeries
Ambulance services
Newborn care

Because most of the basics are covered by public plans, health insurance for maternity care in Canada often refers to extended health insurance that covers the additional services and medical costs throughout pregnancy that aren’t covered by existing government plans.

Put simply, it’s supplemental coverage that’s part of an extended health and dental plan you might get from your employer or purchase on your own.

What Services are Covered by Maternity Health Insurance?

When it comes to maternity, most of your basic needs are generally covered by government-funded health insurance. But because it only covers the essentials, many Canadians look to the maternity benefits of their extended health insurance plan to cover additional medical needs to support their pregnancy journey.

Additional maternity health insurance can provide expecting parents with access to services such as:

Prescription Medication: Most government health insurance plans do not cover the cost of prescription drugs throughout pregnancy. Private maternity health insurance can provide coverage for some or all of the costs associated with prescription medication.‍
Hospital Stays: While hospital stays are typically covered through provincial or territorial healthcare plans, private health insurance can help guarantee coverage for private or semi-private rooms for a more comfortable hospital visit during pregnancy. This can be particularly beneficial, as about 8% of women experience prolonged labour.‍
Paramedical Services: Many expecting parents benefit from the support of physiotherapists, registered dietitians, massage therapists, and other additional medical services to improve their maternity experience. Many private health insurance plans offer coverage for these types of paramedical services during pregnancy and beyond.‍
Mental Health Services: Many extended healthcare plans include coverage for counseling and psychotherapy as parents navigate the changes of becoming a parent. This includes treatment for postpartum depression.‍
Emergency Services: In some provinces, there is a co-pay for ambulance fees if you require emergency services during your pregnancy, which can sometimes be covered by private health insurance plans.‍
Life Insurance: Some health insurance plans are bundled with life insurance. Life insurance can provide long-term financial security for your family, complementing the immediate health benefits of maternity care coverage.

Benefits of Health Insurance for Maternity Care

One of the biggest benefits of health insurance for maternity care is knowing that you’ll have access to all the professionals and services who can best support you through your pregnancy journey—without all the unexpected medical bills.

The thing about pregnancy is the unexpected can often come up. You might experience new aches and pains that can make your maternity less comfortable than it needs to be.

Even though most of the essentials are taken care of through government healthcare plans, having extended healthcare can give you peace of mind knowing you have access to other services at every stage of your pregnancy—including chiropractors, physiotherapists, and other emergency services. For extended health plans that cover private or semi-private rooms, it can also improve your labour and delivery experience.

It also takes away the additional stress of having to make difficult financial decisions around your care during your pregnancy.

And because most of the benefits of maternity care for extended health care plans in Canada aren’t exclusive to pregnancy, you can enjoy the benefits as you navigate becoming a new parent following the birth of your child.

Choosing the Best Health Insurance Plan for Maternity Care

With the exception of Canadians who aren’t eligible for provincial or territorial plans, choosing a health insurance plan for maternity care is similar to choosing any other extended healthcare plan. You’ll just want to factor in any coverage or medical needs that might come up during your pregnancy.

Here are some key factors to consider when choosing the best health insurance plan for maternity care:

Premiums: This is the monthly cost required for you to maintain coverage. While it can be tempting to choose the plan with the lowest premiums, make sure to consider any other out-of-pocket minimums and coverage amounts to make sure you aren’t stuck with unexpected costs.
Comprehensive Coverage: Make sure the plan covers all services you might need throughout the term of your pregnancy and beyond.
Out-of-Pocket Costs: Evaluate the premiums, deductibles, co-pays, and out-of-pocket maximums associated with each plan. Choose a plan that fits your budget while offering the coverage you need.
Additional Services: Some maternity health insurance plans include coverage or discounts for additional services like lactation consulting or parenting classes which can help you navigate the challenges of early parenthood.

A platform like PolicyMe can help you get a quick quote and compare coverage, to find the best health insurance plan for your maternity care. By answering a few quick questions about your healthcare needs, you can get a personalized quote in just 60 seconds with 3 different coverage options to choose from.

Coverage Options in Maternity Health Insurance Plans

When exploring coverage options in maternity health insurance plans, it's important to understand the full range of services and protections available so you can choose the plan that’s best for you and your family.

Here are some key coverage options to consider:

Hospital Stays: While in most situations, you’ll have a private room for delivery, provincial healthcare plans typically only cover a hospital stay in a ward room shared with other patients. Depending on your health insurance coverage, your plan may cover a semi-private or private room during your stay. There are usually limits for the length of stay as well as the total costs insurance providers will cover.
Drug Coverage: Consider your potential medication needs throughout your pregnancy. You’ll want to make sure that your plan offers sufficient coverage for the different types of medication. Different plans have different co-pay amounts and may not cover all drugs and brands so be sure to review the details of your coverage.
Emergency Services: In some provinces, patients who require an ambulance are required to pay some costs out of pocket. Some health insurance plans will cover this cost, including if it’s medically necessary during pregnancy.
Dependent Coverage: Make sure to look at the coverage and costs available for adding your newborn to your insurance plan after they are born. You may also want to consider the costs and coverage that come with adding a spouse to the plan if necessary, so they can have access to the the benefits they need.
Life Insurance: While typically considered a separate insurance plan, many parents look to add on life insurance during pregnancy. Some plans may also offer options for life insurance for infants, which can provide additional financial security for your family in the event of unforeseen circumstances.

Prenatal and Postnatal Care Coverage in Maternity Health Insurance

Prenatal and postnatal care coverage is a cornerstone of any comprehensive maternity healthcare plan. Prenatal care begins as soon as you know you're expecting and includes regular check-ups, ultrasounds, blood tests, and screenings to monitor the health of both mother and baby.

These visits are crucial for detecting potential issues early, such as gestational diabetes or preeclampsia, allowing for timely intervention and care.

Postnatal care, which follows after the baby is born, is just as important. This typically includes follow-up visits for the mother to provide a smooth recovery and pediatric visits for the newborn.

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In Canada, most of these critical care needs are covered by universal healthcare. But other prenatal and postnatal services, such as psychotherapy or nutrition services are often not covered, but can help protect the long-term health of both you and your child.

Health Insurance for High-Risk Pregnancies

High-risk pregnancies can result from various factors, including pre-existing medical conditions, age, multiple pregnancies (twins or more), or complications that arise during pregnancy, such as gestational diabetes or high blood pressure.

When a pregnancy is classified as high-risk, it often requires more frequent doctor visits, specialized tests, and possibly advanced medical interventions. A comprehensive health insurance plan is crucial in covering these additional costs, providing peace of mind that you're supported throughout your pregnancy journey.

For example, a registered dietitian can help parents navigate gestational diabetes. Or longer coverage for private hospital stays can help keep parents comfortable if they find themselves needing inpatient services.

This type of coverage for high-risk pregnancies helps so you’re not burdened with excessive out-of-pocket expenses during what can already be a stressful time. With the right insurance, you can focus on what matters most: taking care of your health and preparing for your baby's arrival, knowing that your insurance plan has you covered.

Summary: Maternity Health Insurance

Health insurance for maternity as part of your extended healthcare plan can provide access to essential services that are often not covered by provincial and territorial healthcare plans.
Supplemental insurance for maternity can provide financial support and peace of mind throughout your pregnancy journey.
It’s important to review coverage to make sure that your plan covers the services and treatments that you think you might need during your pregnancy.
Finding and securing the right health insurance plan for maternity is easy with PolicyMe.

Frequently Asked Questions: Health Insurance for Maternity

Can I add maternity coverage to my existing health insurance plan?

For the most part, while private health insurance plans offer benefits for expecting parents, maternity coverage is not a separate part of your health insurance plan. So, the best thing to do is review your existing health insurance plan to see if it covers the services that you need throughout your pregnancy. Otherwise, you may be able to switch to a different plan or purchase additional coverage that meets your maternity care needs.

Keep in mind that certain plans may have a waiting period or reduced coverage amounts for certain types of services in the first few months or first year of a new plan.

Are there health insurance plans that cover fertility treatments?

Yes, there are health insurance plans that cover fertility treatments, but the availability and extent of coverage can vary widely. In Canada, some provincial health plans offer limited coverage for fertility treatments like in vitro fertilization (IVF), but this often depends on factors such as age, diagnosis, and whether the treatment is deemed medically necessary. There may also be limitations on eligible treatment centres and coverage amounts.

Private maternity health insurance policies may offer more comprehensive coverage, including fertility drugs, consultations, and advanced reproductive technologies. But these treatments can be expensive, and not all plans cover them fully. It's important to carefully review your insurance options and consider a plan that aligns with your fertility treatment needs.

How do I find out if my preferred hospital or birthing centre is covered?

In Canada, if you’re eligible for government-funded healthcare you can typically choose whichever hospital or birthing centre you prefer. You can choose between a home birth, hospital, or birthing centre within your province or territory.

Can I get health insurance for maternity care if I become pregnant before purchasing a plan?

Generally, yes you can get health insurance for maternity care even if you’re already pregnant, as provincial health plans cover most costs related to basic maternity care. But it's important to check the terms carefully if you're seeking additional private coverage.

Some private insurers may consider pregnancy a pre-existing condition and could exclude or limit coverage if you enroll after becoming pregnant. But many of the maternity benefits of extended health care, such as prescription drugs or paramedical services, typically aren’t exclusive to pregnancy and usually do not come with waiting periods.

Are there health insurance plans that cover home births?

Yes, many provincial health insurance plans do cover home births through midwifery services. The costs may vary depending on your province. For example, in British Columbia, midwifery care is covered under the BC Medical Services Plan. In Ontario, midwives are able to provide services free of charge to all expecting parents—regardless if they have access to OHIP.

If you do not have provincial healthcare coverage, it’s worth looking at private health insurance plans and asking if there is coverage for home births and midwife services. If you’re not eligible for universal healthcare and relying on private health insurance, it's essential to verify with your insurance provider whether home births are covered under your plan and what specific services are included, as this can help you plan for any out-of-pocket expenses.

How does maternity health insurance handle multiple births (e.g., twins, triplets)?

Typically, maternity health insurance does not distinguish between multiple pregnancies. The additional prenatal visits, ultrasounds, and potential complications that can come with multiple pregnancies are usually covered by government-funded healthcare plans, just like a single pregnancy.

This coverage also extends to the delivery, whether it's vaginal or cesarean, and includes postnatal care for both the mother and the newborns.

Can family members help manage the maternity health insurance plans?

Yes, family members can help manage maternity health insurance plans, providing valuable support during a time that can be stressful and overwhelming.

They can assist with tasks such as reviewing the coverage details, helping to file claims, coordinating care with healthcare providers, and ensuring that premiums are paid on time. In some cases, family members might also be authorized to speak directly with the insurance provider on behalf of the policyholder, especially if they are a spouse or have been given power of attorney. This assistance can help expectant mothers receive the care they need without having to worry about the administrative aspects of their insurance.

All About Health Insurance for Maternity in Canada