Confirm prenatal insurance coverage
Verify OB visits, delivery, newborn hospital care, and NICU tiers match what you expect on your plan.
Pull your plan's Summary of Benefits and Coverage (SBC) or member portal details. Confirm prenatal visits, labor and delivery, anesthesia, and inpatient newborn care are covered at in-network facilities. If your plan has tiered hospitals, know your out-of-pocket exposure before you are in labor.
Maine paid leave — Maine Paid Family and Medical Leave (PFML): Maine's PFML program launches May 1, 2026 for private employers of all sizes (at least 1 employee in Maine). Provides up to 12 weeks of paid leave for bonding with a new child. Payroll contributions began January 2025. Wage replacement is on a sliding scale — higher earners receive a lower percentage. An earnings threshold applies: employees must have earned wages at least six times the state average weekly wage during the prior year. Typical maximum duration (bonding / combined benefits): up to 12 weeks for relevant benefits (verify your situation). Wage replacement: Sliding scale based on income; higher replacement for lower earners. Benefits begin May 1, 2026.
Action checklist
- Confirm your plan year deductible and out-of-pocket max for individual vs family
- Verify in-network hospitals and estimated member cost for vaginal vs cesarean delivery
- Confirm newborn is covered as a patient under your policy from birth
- If offered, review NICU coverage tiers and transfer rules
- Save screenshots or PDFs of key coverage pages for your delivery folder
What you'll need
- • Member ID
- • Plan SBC or benefits booklet
- • List of in-network hospitals you are considering