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

All Marketplace and Medicaid plans cover pregnancy and childbirth. This is true even if your pregnancy begins before your coverage starts.

Maternity care and newborn care — services provided before and after your child is born — are essential health benefits. This means all

An insurance plan that’s certified by the Health Insurance Marketplace®, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements under the Affordable Care Act. All qualified health plans meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage.”

Refer to glossary for more details.

• 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 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

  Special Enrollment Period
  A period of time outside of Open Enrollment when you can enroll in or change Marketplace plans.

  Open Enrollment Open Enrollment Period
  November 1 - January 15 each year
  • You'll be asked if you're pregnant if you select the application option to get help paying for coverage and select "Female" for the question about your sex.
  • Reporting your pregnancy may help you and your family members get the most affordable coverage.

  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 keep your Marketplace coverage, 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 report your pregnancy, you may be eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). If you're found eligible for Medicaid or CHIP, your information will be sent to the state agency, and you won't be given the option to keep your Marketplace plan.

  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.
    • Some states offer coverage for a full 12 months after you give birth. Check with your state, or view states (in blue) that offer extended coverage.
    • When your state’s coverage period ends, you may no longer qualify.
    • Your state will notify you if your coverage is ending. If your coverage will end, you can apply and enroll in a Marketplace plan.

    If you recently gave birth

    If you don’t have health coverage

    Having a baby qualifies you for a Special Enrollment Period

    This means that after you have your baby you can enroll in Marketplace coverage even if it’s outside the Open Enrollment Period. When you enroll in the new plan, your coverage will start the day the baby was born. You can call the Marketplace Call Center to request that your coverage start later. Learn more about Special Enrollment Periods and how to apply.

    • It’s important to have access to health care services for both new parents 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

    Having a baby qualifies you for a Special Enrollment Period
    • 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 them in any plan for the remainder of the year.

      The ability to select any plan only applies to your baby. You're generally not allowed to change plans until the Open Enrollment Period.

      • No matter when your child is born, 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. If you're found eligible (or possibly eligible) for Medicaid or CHIP, and other household members are still eligible for Marketplace coverage, wait until you have confirmation from the Medicaid or CHIP agency about your eligibility and coverage start date before you make updates to your Marketplace plan.
      • 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 at least 60 days after you give birth, depending on your state.
        • Some states offer coverage for a full 12 months after you give birth. Check with your state, or view states that offer extended coverage.
        • When your coverage period ends, you may no longer qualify.
        • Your state Medicaid or CHIP agency will notify you if your coverage is ending. As soon as you find out that your Medicaid coverage is ending, you can apply and enroll in a Marketplace plan.