Does Medicare Cover Pregnancy?

Does Medicare Cover Pregnancy?

Pregnant women who are under age 65 and enrolled in a Medicare health plan will be eligible for Medicare coverage for health care services related to pregnancy.

Medicare will cover pregnancy-related services if you are a woman who is pregnant or is within the one-year period after having a baby.

What services are not covered by Medicare?

Medicare does not cover routine prenatal care or routine prenatal testing such as amniocentesis. Medicare will cover “routine” prenatal care or prenatal testing that a doctor says is medically necessary.

Medicare does not cover routine medical care for the baby after delivery, such as immunizations and eye exams for newborns. Medicare will cover medical care for a baby if a doctor says it is medically necessary.

Medicare does not cover routine childbirth or routine newborn care. Medicare will cover labor and delivery if a doctor says it is medically necessary.

Medicare does not cover routine postpartum care such as care for a woman's breasts or removal of the pregnant uterus. Medicare will cover postpartum care that a doctor says is medically necessary.

Medicare coverage for pregnancy services

Medicare will cover prenatal care from the first month of pregnancy to the end of the month in which your baby is born, if you are within the first 12 months after delivery.

Medicare will cover the following services:

Labor and delivery

Labor induction, if medically necessary

Caesarean section, if medically necessary

Postpartum care including care for your uterus and breasts

Medicare will not cover:

Labor and delivery if you are over 12 months after delivery

Labor induction, if not medically necessary

Caesarean section, if not medically necessary

Postpartum care, including care for your uterus and breasts, if more than one year after delivery

Lab tests, X-rays, and other diagnostic tests to diagnose and treat conditions related to your pregnancy, such as preeclampsia

Treatment for conditions related to your pregnancy, such as high blood pressure and diabetes

Treatment for infections that occur during pregnancy

Medicare will cover treatment for complications that may arise from childbirth, such as infections that occur after delivery, premature birth, and injuries to the mother

Medicare will cover treatment for complications that may arise from miscarriage or abortion

Medicare will cover emergency care for complications from pregnancy that arise after you are admitted to the hospital

Medicare will cover routine screenings for a pregnant woman and her baby, such as those for high blood pressure and diabetes

Medicare will cover routine prenatal care if pregnancy is medically managed, such as with insulin injections

Medicare will cover prenatal testing such as amniocentesis when it is medically necessary

Unnecessary prenatal testing such as amniocentesis

Treatment or services that should be provided through personal health insurance or Medicaid

Services not related to pregnancy or childbirth, such as immunizations for the child or routine eye exams for the baby

Hospital services, such as routine labor and delivery, if you are over the 12-month period after delivery

Medicare covers medically necessary postpartum care, which includes:

Postpartum care, including care for your uterus and breasts

Rehabilitation for your legs and feet

Cesarean section

Delivery by the person who usually delivers babies in your area

Services of a pediatrician for your baby within the first month of life

Delivery by someone other than the person who usually delivers babies in your area

Services of a pediatrician for your baby, if your baby is over one month old

Medicare covers routine prenatal care if you are under age 65 and enrolled in a Medicare health plan.

Medicare will cover testing for and treatment of infections that occur during pregnancy. If you are enrolled in a Medicare health plan, you may be covered for prenatal care for up to one year after having a baby.

Medicare will cover prenatal testing such as amniocentesis if it is medically necessary. You must be enrolled in a Medicare health plan to be covered for postpartum care.

Medicare will cover routine prenatal care if you are under age 65 and enrolled in a Medicare health plan.

Medicare Part A covers hospital stays up to 60 days when you are admitted to a hospital for a pregnancy complication, such as:

Preeclampsia

Eclampsia

Premature labor

Premature birth

If you are under age 65 and enrolled in a Medicare health plan, you may be covered for hospital stays for up to one year after having a baby.

Medicare Part A covers hospital stays if you are under age 65 and enrolled in a Medicare health plan.

Medicare Part B covers diagnostic and treatment services for conditions related to your pregnancy. Medicare Part B will cover:

Diagnostic tests

Treatment for complications related to your pregnancy, including infection

Medicare Part B will cover:

Labor and delivery if you are under age 65 and enrolled in a Medicare health plan

Birth by cesarean section, if you are under age 65 and enrolled in a Medicare health plan

Labor induction, if you are under age 65 and enrolled in a Medicare health plan

Medicare Part B covers:

Labor and delivery if you are under age 65 and enrolled in

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