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Health Care Reform:

Health Insurance & Affordable Care Act

Insurance When You're Pregnant: FAQ

The Affordable Care Act makes it easier for pregnant women to get insurance to help pay for the medical care they need.

Can a health plan refuse to let me enroll because I'm pregnant?

No. In the past, insurance companies could turn you down if you applied for coverage while you were pregnant. At that time, many health plans considered pregnancy a pre-existing condition.

Health plans can no longer deny you coverage if you are pregnant. That's true whether you get insurance through your employer or buy it on your own.

What's more, health plans cannot charge you more to have a policy because you are pregnant. An insurance company can't increase your premium based on your sex or health condition. A premium is the amount you pay each month to have insurance.

How can I get health insurance while I'm pregnant?

First, see if your employer -- or your partner’s employer -- offers health insurance. You will probably get the most coverage at the best price from a health plan from an employer. That's partly because most employers share the cost of insurance premiums with employees.

You can also shop for coverage in the health insurance Marketplace, which is also called an Exchange. You may also qualify for Medicaid  in your state based on your income.

In the Marketplace, you can:

  • Compare health plans side by side.
  • See if your income is in the range for financial help from the government. If it is and you otherwise qualify, you can use that money to lower the cost of your premiums. You may also qualify for lower out-of-pocket costs, such as deductibles, copays, and coinsurance.

You can also shop for coverage outside your state's Marketplace, but you will not qualify for financial help to lower the cost of premiums or out-of-pocket costs unless you are eligible and purchase coverage through the Marketplace.

You can enroll in a Marketplace plan only during the annual open enrollment period unless you meet special circumstances. The open enrollment period is from November 15 through February 15 each year. Your employer may also require you to sign up for insurance during an annual open enrollment period. If you qualify for Medicaid, you can enroll at any time during the year.

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