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Health coverage if you’re pregnant, plan to get pregnant, or recently gave birth

All plans that are part of the Health Insurance Marketplace (r) or Medicaid cover childbirth. Even if your coverage ends before your pregnancy starts, this is true.

Essential health benefits include newborn and maternal care, which is provided before and after the birth of your child. All qualified health plans, inside or outside the Marketplace, must include them.

Select your situation below to get more information:

If youre pregnant or intending to get pregnant

If your health insurance is not available

  • Pregnancy coverage allows you to obtain the screening tests and medical checks that will help to keep your baby healthy.
  • You may be eligible for a Special Enrollment period if you have experienced a life event such as a death or moving, and you can enroll in a Marketplace plan right away. You are not eligible if you’re pregnant, but you can be if your child is born.
  • Register to create an account and apply for Marketplace coverage during the Open Enrollment period or Special Enrollment period. You will be asked to confirm your pregnancy if you choose the option of getting help paying for coverage. Your family may be able to get the best coverage if you report your pregnancy.
  • You can apply for Special Enrollment Period coverage if you are not eligible right now. You can also enroll in 2021 coverage during this fall’s Open Enrollment Period.
  • You can start coverage as soon as you are eligible for Medicaid/CHIP.

If your Marketplace coverage is currently available

  • If you wish to maintain your Marketplace coverage, don’t tell the Marketplace about your pregnancy. To learn more about Marketplace coverage, click the “Learn More” link in your Marketplace application.
  • You may be eligible for low-cost or free coverage through Medicaid or the Children’s Health Insurance Program. Your information will be sent directly to the state agency if you are determined eligible for Medicaid/CHIP. You will not have the option to continue your Marketplace plan.
  • To keep your Marketplace coverage, make sure you update the application after giving birth to add the baby or enroll them in Medicaid or CHIP coverage.

You may be eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

  • Medicaid or CHIP offer free or very low-cost coverage to millions of Americans. This includes low-income families, children and pregnant women.
  • These programs are eligible depending on the size of your household, income, citizenship, or immigration status. Each state has its own rules and benefits.
  • Anyone can apply for Medicaid and CHIP at any time throughout the year.
    • There are two ways to apply: You can either directly contact your state agency or fill out a Marketplace application, and select that you need help paying for coverage.
    • How to Apply for Medicaid and CHIP
  • You’ll be covered up to 60 days after your baby is born if you are found eligible during pregnancy. After 60 days, you may no longer qualify. If your coverage ends, your state Medicaid agency or CHIP agency will inform you. To avoid losing your coverage, you can sign up for a Marketplace plan.
  • Your newborn will automatically be enrolled in Medicaid coverage if you have Medicaid at the time of birth. They’ll also remain eligible for Medicaid for at least one year.

If your child was born

If your health insurance is not available

Important: You are eligible for the Special Enrollment Period

This means that you can change or enroll in Marketplace coverage after your baby is born, even if it falls outside of the Open Enrollment Period. Your coverage will start the day your baby is born if you sign up for the new plan. Find out more about special enrollment periods and how you can apply.

  • Access to healthcare services is essential for both mom and baby. Apply within 60 days of your baby’s arrival. Your baby and you can be covered by your plan.
  • Marketplace coverage is available to anyone who had Medicaid or CHIP coverage before you gave birth, or if the state has told you that it will soon end. You are eligible for special enrollment if you have lost any other coverage. Select the state agency that found you ineligible to Medicaid or CHIP when you fill out your application.

If your Marketplace coverage is currently available

Important: You are eligible for the Special Enrollment Period

  • You can use if you have Marketplace coverage before your baby is born.
    • You can keep your current plan, add your baby, or
    • You can create a separate enrollment group to enroll your baby in any plan throughout the year. You can choose any plan for your baby. Changes to plans are generally not allowed.
  • You should notify the Marketplace about your child’s birth as soon as you can. As a result, your coverage options and savings could change. You might be eligible for greater savings than you are currently receiving, which could reduce your monthly premiums.
  • We’ll let you know if your baby or you may be eligible for Medicaid.
  • Log in to your account to “Report A Life Change”

If your Medicaid or CHIP is available

  • You’ll be covered up to 60 days after your baby is born if you are found eligible during pregnancy. After 60 days, you may no longer qualify. If your coverage ends, your state Medicaid agency or CHIP agency will inform you. To avoid losing your coverage, you can sign up for a Marketplace plan.
  • Your newborn will automatically be enrolled in Medicaid coverage if you have Medicaid at the time of birth. They’ll also remain eligible for Medicaid coverage for at least one year.

 

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