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

• If you’re pregnant or planning to get pregnant:
  • If you don’t have health coverage
  • If you currently have Marketplace coverage
  • If you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP)
• If you recently gave birth:
  • If you don’t have health coverage
  • If you currently have Marketplace coverage
  • If you have Medicaid or CHIP

If you’re pregnant or planning to get pregnant:

If you don’t have health coverage

• Health coverage makes it easier to get the medical check-ups and screening tests to help keep both you and your baby healthy during pregnancy.
• If you qualify for a
  Special Enrollment Period

  A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

  due to a life event like moving or losing other coverage, you may be able to enroll in a Marketplace health plan right now. Being pregnant doesn’t make you eligible, but the birth of a child does.
• Create an account now to apply for Marketplace coverage through the Open Enrollment Period or a Special Enrollment Period. If you select the option to get help paying for coverage on your application, you’ll be asked if you’re pregnant. Reporting your pregnancy may help you and your family members get the most affordable coverage.
• If you don’t qualify for a Special Enrollment Period right now, you’ll be eligible to apply within 60 days of your child’s birth. You can also enroll in coverage for the next plan year during the next Open Enrollment Period this fall.
• If eligible for Medicaid or CHIP, your coverage can begin at any time.

If you currently have Marketplace coverage

• If you want to keep your current Marketplace coverage, don’t report your pregnancy to the Marketplace. When filling out your application for Marketplace coverage, select the “Learn more” link when we ask if you’re pregnant to read tips to help you best answer this question.
• If you report your pregnancy, you may be found eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). If you are found eligible for Medicaid or CHIP, your information will be sent to the state agency, and you will not be given the option to keep your Marketplace plan.
• If you keep your Marketplace coverage, be sure to update the application after you give birth to add the baby to the plan or enroll them in coverage through Medicaid or CHIP, if they qualify.

If you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP)

• Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, and pregnant women.
• Eligibility for these programs depends on your household size, income, and citizenship or immigration status. Specific rules and benefits vary by state.
• You can apply for Medicaid or CHIP any time during the year, not just during the annual Open Enrollment Period.
  • You can apply 2 ways: Directly through your state agency, or by filling out a Marketplace application and selecting that you want help paying for coverage.
  • Learn how to apply for Medicaid and CHIP.
• If found eligible during your pregnancy, you’ll be covered for 60 days after you give birth. After 60 days, you may no longer qualify. Your state Medicaid or CHIP agency will notify you if your coverage is ending. You can enroll in a Marketplace plan during this time to avoid a break in coverage.
• If you have Medicaid when you give birth, your newborn is automatically enrolled in Medicaid coverage, and they’ll remain eligible for at least a year.

If you recently gave birth

If you don’t have health coverage

• It’s important to have access to health care services for both new mom and baby. Make sure you apply within 60 days after your baby’s birth. Your plan can cover you, your baby, and any other household members.
• If you had Medicaid or CHIP coverage that ended after you gave birth (or if your state told you it’ll end soon), you can apply for Marketplace coverage. Losing other coverage qualifies you for a Special Enrollment Period. When you fill out your application, select that you were found ineligible for Medicaid or CHIP by the state agency.

If you currently have Marketplace coverage

• If you already have Marketplace coverage when your baby is born, you can:
  • Keep your current plan and add your baby to your coverage, OR
  • Create a separate enrollment group for your baby and enroll him or her in any plan for the remainder of the year. Note: The ability to select any plan only applies to your baby. You will generally not be allowed to change plans
• No matter when your child is born, you should report their birth to the Marketplace by updating your application as soon as possible. Your coverage options and potential savings may change as a result. You may qualify for more savings than you’re getting now, which could lower what you pay in monthly premiums.
• When you update your application, we’ll also tell you if you or your baby may be eligible for Medicaid or CHIP.
• Log into your account to “Report a Life Change”.

If you have Medicaid or CHIP

• If found eligible during your pregnancy, you’ll be covered for 60 days after you give birth. After 60 days, you may no longer qualify. Your state Medicaid or CHIP agency will notify you if your coverage is ending. You can enroll in a Marketplace plan during this time to avoid a break in coverage.
• If you have Medicaid when you give birth, your newborn is automatically enrolled in Medicaid coverage, and they’ll remain eligible for at least a year.