All Marketplace and Medicaid plans cover pregnancy and childbirth, regardless of when your pregnancy begins. Maternity and newborn care—services provided before and after your child is born—are essential health benefits. This means all qualified health plans, both inside and outside the Marketplace, must include these services.

If You’re Pregnant or Planning to Get Pregnant:

If You Don’t Have Health Coverage:

• Health coverage is crucial for accessing medical check-ups and screening tests that help ensure a healthy pregnancy for both you and your baby.
• If you experience a life event like moving or losing other coverage, you may qualify for a Special Enrollment Period to enroll in a Marketplace plan. Note that pregnancy alone doesn’t qualify you for a Special Enrollment Period, but the birth of your child does.
• You can apply for Marketplace coverage during the Open Enrollment Period or a Special Enrollment Period. Reporting your pregnancy might help you access the most affordable coverage.
• If you don’t qualify for a Special Enrollment Period now, you’ll be eligible to apply within 60 days after your child is born, or during the next Open Enrollment Period.
• If you qualify for Medicaid or CHIP, your coverage can begin anytime.

If You Currently Have Marketplace Coverage:

• To keep your current Marketplace coverage, do not report your pregnancy. Instead, when completing your application, click “Learn more” under the pregnancy question for tips on how to best answer it.
• After giving birth, update your application to add your baby to your plan or enroll them in Medicaid or CHIP if they qualify.
• If you report your pregnancy, you may become eligible for free or low-cost coverage through Medicaid or CHIP. If you’re found eligible, your Marketplace plan will be discontinued, and your information will be sent to your state agency.

If You May Qualify for Medicaid or CHIP:

• Medicaid and CHIP provide free or low-cost health coverage to millions, including low-income individuals, families, children, and pregnant women.
• Eligibility depends on your household size, income, and citizenship or immigration status. Benefits and rules vary by state.
• You can apply for Medicaid or CHIP anytime during the year.
• If found eligible during your pregnancy, you’ll be covered for at least 60 days after giving birth, with some states offering coverage for up to 12 months. Your state will notify you if your coverage is ending, allowing you to apply for Marketplace coverage.

If You Recently Gave Birth:

If You Don’t Have Health Coverage:

• Having a baby qualifies you for a Special Enrollment Period, allowing you to enroll in Marketplace coverage even outside the Open Enrollment Period. Your coverage can start from the day your baby was born.
• It’s essential to apply within 60 days of your baby’s birth to ensure coverage for you, your baby, and other household members.
• If your Medicaid or CHIP coverage ended after giving birth, or if your state informed you that it will end soon, you can apply for Marketplace coverage.

If You Currently Have Marketplace Coverage:

• Having a baby qualifies you for a Special Enrollment Period. You can:
  • Keep your current plan and add your baby, or
  • Enroll your baby in a separate plan for the remainder of the year.
• Remember, this option only applies to your baby. You generally can’t change plans until the next Open Enrollment Period.
• Report your child’s birth to the Marketplace by updating your application as soon as possible. Your coverage options and potential savings may change. You might also qualify for additional savings that could lower your monthly premiums.
• After updating your application, the Marketplace will determine if you or your baby qualify for Medicaid or CHIP.

If You Have Medicaid or CHIP:

• If you’re found eligible during pregnancy, Medicaid or CHIP will cover you for at least 60 days post-birth, and potentially up to 12 months, depending on your state.
• Your state agency will notify you if your coverage is ending. If your Medicaid coverage ends, you can apply for a Marketplace plan.
• If you have Medicaid when you give birth, your newborn will automatically be enrolled in Medicaid and remain eligible for at least a year.