Illinois requires all health maintenance organizations to cover all medical costs associated with pregnancy. But, Illinois does not require insurance companies to provide normal maternity benefits in either group or individual policies. However, insurance companies are required to provide benefits for complications of pregnancy such as toxemia or latent diabetes.
Federal law (Pregnancy Discrimination Act of 1978 which amended Title VII of the Civil Rights Act) requires employers with 15 or more employees to treat pregnancy as any other illness. Those employers must provide benefits for maternity care. The employer may provide the benefits directly or through an insurance company. To find out if you have maternity coverage, ask your employer, check your insurance policy, or call your insurance company’s customer service representative.
Post Parturition Care Requirements:
If an accident and health or HMO group policy provides maternity coverage that is renewed or issued on or after July 1, 1997, the insurance company or HMO may not exclude or limit maternity as a preexisting condition.
Insurance companies that provide maternity coverage and all HMOs must pay for:
at least 48 hours of inpatient hospital care for mom and baby after a normal delivery;at least 96 hours of inpatient hospital care for mom and baby after a cesarean section delivery.
Your doctor is the only person who can decide to discharge you before the minimum time. If he or she decides you and the baby can be discharged prior to the minimum time, your insurance company or HMO must then provide coverage for:
a home nurse visit for you and the baby within 48 hours after discharge; or a doctor’s office visit to check the baby within 48 hours after discharge.