Finding out you’re expecting is exciting, and it’s also the moment a few important EverTrust deadlines start running. This guide is meant for members earlier in that journey, from the moment you see a positive test through bringing your baby home, so you know what to expect and when to act. For the step-by-step mechanics of actually submitting bills and documentation, see our companion piece, EverTrust Maternity Sharing Request Process, and download our Maternity Guide for a complete reference you can keep on hand throughout your pregnancy.
The moment you find out, the clock starts
As soon as your pregnancy is confirmed, you have 30 days to submit your Maternity Sharing Request. This is one of the shorter deadlines in the Member Guidelines, so it’s worth acting quickly rather than waiting until your first prenatal appointment is further along. Submitting early doesn’t mean you need every bill in hand, it just starts the request so your care is being tracked from the beginning.
If you’re planning a family and considering EverTrust before conceiving, there’s a waiting period worth knowing about: conception occurring within 30 days of your membership start date is not eligible for sharing, and a pregnancy that already exists prior to membership isn’t eligible either. Medical records are used to confirm the conception date, so this isn’t something to try to work around.
One Member Responsibility Amount applies to the whole pregnancy
Unlike some conditions that can trigger multiple MRAs over time, a Maternity Sharing Request uses a single Member Responsibility Amount for all eligible expenses connected to the pregnancy itself, from prenatal care through delivery and postpartum follow-up. Maternity requests also don’t count toward, or benefit from, EverTrust’s two-MRA safeguard limit for other conditions, since maternity already works under its own rules. One exception worth knowing ahead of time: if your newborn needs NICU care, that’s handled as its own separate Sharing Request for the baby, with its own MRA, rather than folding into your maternity MRA.
There’s also a built-in incentive to keep costs reasonable: if your total maternity-related expenses stay under $10,000, your MRA is automatically reduced by $1,500 after the fact, based on your actual costs. This is separate from the general MRA-change process, and it isn’t something you need to request ahead of time. Choosing fair-cost providers and being a proactive self-pay patient during prenatal care isn’t just good practice, it can directly lower what you owe.
What is shared during pregnancy
Once your MRA is met, EverTrust provides a prenatal and postnatal sharing allowance of up to $6,000 per Maternity Sharing Request, with an additional $1,000 available if your pregnancy is diagnosed as high-risk. This allowance applies to a wide range of care, including:
- Routine office visits and routine lab work
- Ultrasounds, including 2D, 3D, and 4D
- Midwives and doulas, including doula tub services
- Chiropractic care and acupuncture
- Prenatal vitamins
- Pelvic floor services
- STD and STI screenings performed as part of routine prenatal care
- Gestational diabetes care and medications
- Breast pumps and lactation consultant services
- Postpartum counseling
- Your six-week postpartum visit and, if applicable, your two-week cesarean follow-up appointment
Delivery itself has no sharing limit
It is important to confirm with the hospital that you will be a self-pay patient for your delivery, and that all available self-pay and prompt-pay discounts should be applied to your bills. At least two months prior to delivery, you should request a self-pay pre-payment agreement with the hospital and send that documentation to EverTrust as soon as it’s available. This way, EverTrust can arrange to send you a virtual card for any delivery prepayments that are required.
It’s worth knowing early, since it can ease a lot of financial anxiety heading into your due date, that medically necessary delivery services are not subject to a sharing limit. This includes OB-GYN labor and delivery, cesarean delivery, premature birth, multiple births, hospital labor and delivery, anesthesiology, home birth, maternal complications, maternal-fetal specialist consultations, and one in-hospital pediatric evaluation for your newborn, including routine newborn testing.
Once you and the baby are discharged from the hospital, no additional services are shared for the baby under the Maternity Sharing Request. From that point forward, your newborn’s own membership enrollment is what determines eligibility for their future care.
After the baby arrives
A few things need to happen within specific windows once your baby is born:
Enroll your newborn within 30 days of birth. If your baby’s birth is connected to an eligible Maternity Sharing Request, add them to your household membership within 30 days. If adding your newborn changes your membership tier, your monthly contribution adjusts automatically starting the next billing cycle. Miss the 30-day window, and any condition present at birth or arising before your newborn’s membership effective date will be treated as a pre-membership condition, subject to the same limitations as any other pre-existing condition.
Six months of diapers are provided. As part of an eligible Maternity Sharing Request, EverTrust shares in a six-month supply of diapers for your newborn, a practical benefit worth knowing about ahead of time.
NICU care is eligible for up to 35 days, but it’s a separate Sharing Request for the baby. If your newborn needs NICU care and their birth is connected to an eligible Maternity Sharing Request, NICU services are eligible for sharing for up to 35 days following birth. This is not part of your Maternity Sharing Request, though. Your baby will need to be added to your membership, and a separate Sharing Request must be submitted for the baby, with its own MRA due. Beyond 35 days, continued eligibility falls under the Congenital Conditions allowance, if applicable.
Congenital conditions are eligible up to $125,000, once per membership lifetime, if the condition was unknown prior to membership. A condition known prior to membership is not eligible for sharing.
What isn’t shared
It’s worth knowing this before you’re in the middle of trying to grow your family, not after: fertility treatments, including IVF and other infertility treatment, are not eligible for sharing, and neither is surrogacy. Elective contraception is also not eligible. Contraceptive services are only eligible when required to treat an already-approved Sharing Request. If any of these apply to your family planning, it’s worth talking with EverTrust’s Advocacy Team early so you understand exactly where the lines are.
How this fits with your Sharing Request
Submit your Maternity Sharing Request within 30 days of pregnancy confirmation, and don’t wait until every bill or record has arrived to do it. As your pregnancy progresses, add itemized bills, visit notes, and other documentation to the existing request as they come in, the same way you would for any other Sharing Request. For a full walkthrough of what documentation to gather and when, see our companion article, EverTrust Maternity Sharing Request Process, and for more on how requests move through review, see Understanding the Determination Process.
If you’re ever unsure what applies to your situation, EverTrust’s Advocacy Team can walk you through your specific timeline, from your first prenatal visit through your newborn’s enrollment.
Frequently Asked Questions
How soon do I need to submit my Maternity Sharing Request? Within 30 days of pregnancy confirmation. Submitting early doesn’t require having every document ready, it simply starts your request so your care can be tracked from the beginning.
Do I need a new MRA for delivery, separate from prenatal care? No. A single Member Responsibility Amount applies to all eligible expenses connected to the pregnancy, from prenatal visits through delivery and postpartum care.
Is NICU care included in my Maternity Sharing Request MRA? No. If your newborn needs NICU care, it’s handled as a separate Sharing Request for the baby, not part of your Maternity Sharing Request. Your baby will need to be added to your membership, a separate Sharing Request submitted on their behalf, and a separate MRA will be due for that request.
Is there a limit on what EverTrust will share for delivery? No. Medically necessary delivery services, including cesarean delivery, complications, and hospital labor and delivery, are not subject to a sharing limit.
When should I set up a self-pay pre-payment agreement with the hospital? At least two months before your due date. Confirm with the hospital that you’ll be a self-pay patient, ask for all available self-pay and prompt-pay discounts to be applied, and send the pre-payment agreement to EverTrust as soon as you have it so a virtual card can be arranged for any required prepayments.
What happens if I don’t enroll my newborn within 30 days of birth? Any condition present at birth, or arising before your newborn’s membership effective date, will be treated as a pre-membership condition and subject to the same limitations as any other pre-existing condition. Enrolling on time avoids this.
Are fertility treatments or IVF eligible for sharing? No. Fertility treatments, including IVF and other infertility treatment, are not eligible for sharing under EverTrust’s Member Guidelines.
Can I lower my MRA during pregnancy? Generally, members may change their MRA once per membership year, and lowering it comes with a 60-day waiting period before the new amount applies, except in the case of accidents. That waiting period also means you can’t lower your MRA for a Sharing Request that’s already in process, including an open maternity request.
Maternity works a little differently, though. Rather than asking to lower your MRA, there’s a built-in incentive already in place: if your total maternity-related expenses stay under $10,000, your MRA is automatically reduced by $1,500 after the fact. This isn’t something you request ahead of time, it’s applied based on your actual costs, so choosing fair-cost providers throughout your pregnancy is the most direct way to qualify for it.
Final Takeaway
Bringing home a new baby involves a handful of important dates: submitting your Maternity Sharing Request within 30 days of pregnancy confirmation, and enrolling your newborn within 30 days of birth. In between, EverTrust’s prenatal and postnatal allowance, unlimited delivery sharing, and even a diaper benefit are designed to support your family through the whole journey, not just the birth itself. Knowing what to expect early, and acting on these timelines as they come up, is what it looks like to navigate healthcare as a self-pay patient with full transparency, and it’s exactly what a modern healthcare cooperative like EverTrust is built to support.