Shuman Roy is an entrepreneur, business owner, and musician. He started RoysNoys, LLC in 2013 as a music production and education service company. He also offers small business consulting and advisory services to help businesses get from start-up mode to turn-key operations. Shuman earned his M.B.A from the Stern School of Business in 2001 and has an undergraduate degree from Manhattan College in ...

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Joel Ohman is the CEO of a private equity-backed digital media company. He is a CERTIFIED FINANCIAL PLANNER™, author, angel investor, and serial entrepreneur who loves creating new things, whether books or businesses. He has also previously served as the founder and resident CFP® of a national insurance agency, Real Time Health Quotes. He has an MBA from the University of South Florida. Joel...

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Reviewed by Joel Ohman
Founder, CFP®

UPDATED: Aug 25, 2021

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Pregnancy is a natural facet of life, and one that many people find themselves looking forward to. Families who are expecting a baby are experiencing more than just excitement however. There’s a lot of nervousness and many expectations. Everyone wants the mom and baby to be get through it with a safe and healthy pregnancy, which can sometimes be a little more complicated if mom isn’t doesn’t have any type of health care coverage. While this situation may arise frequently, it remains a difficult position to be in.

In the past, there weren’t many options out there for women who became pregnant and didn’t already have health insurance in place.

What was it like before the Affordable Care Act?

Before the Affordable Care Act was passed in March 2010, one of the best available options to obtain health insurance after you became pregnant was to get a job with a company that offered a health insurance plan.

Of course, you probably had to be a full-time employee in order to qualify for the employer plan, which typically takes three months, so the timing would have needed to be ideal.

At that time, the Health Insurance Portability and Accountability Act (HIPAA) did not force insurance companies to insure women who were pregnant (as it was often seen as a pre-existing condition).

Rather, it stated that you couldn’t be turned down for coverage by a new employer if you were pregnant and changed jobs. There tends to be a lot of confusion regarding this matter. It was seen as a longshot, but was at least a way to cut the costs of pregnancy. A lot of employers would be aware that a woman was looking for a job in order to support her pregnancy rather than just looking for a stable form of income, though sometimes the two did go hand in hand.

So even though eligibility wasn’t a question, it was left up to the employer whether or not they would offer a health plan and maternity leave for a new hire. Luckily, things have changed, and for the better.

[Check out some health insurance options if you don’t have a job.]

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Does the Affordable Care Act protect pregnant women?

Today, thanks to the Affordable Care Act, affectionately (or not) known as Obamacare, pregnant women can’t be denied healthcare coverage.

The ACA essentially forced insurers to cover all individuals, regardless of whether they had pre-existing conditions, including pregnant women.

And the law also stated that you couldn’t be rejected, charged more, or hung out to dry for any essential health benefits you had prior to your coverage date.

The exception is grandfathered healthcare plans, which may not cover pre-existing conditions or preventive care.

If you have one of these old plans, you may need to wait until your baby is born before switching to a Marketplace plan during open enrollment.

Or buy a Marketplace plan outside open enrollment when your grandfathered plan year ends, thereby qualifying you for a special enrollment period.

Also note that having a baby grants you a Special Enrollment Period at which time you can keep your current plan and add your child, or switch to a different Marketplace plan.

Some savvy women may make changes around this time if they found a health insurance plan that offered cheap prenatal care and delivery, but wasn’t as great for postnatal stuff.

What other options are there?

Medicaid insurance is another available option for the uninsured pregnant woman.

However, you must meet certain low-income criteria to be a candidate for Medicaid, so it’s not always a viable solution for expecting mothers with no existing healthcare coverage.

Along the lines of Medicaid, the Children’s Health Insurance Program, or CHIP, is available in some states for those who earn too much money for welfare programs, but too little money to be able to afford healthcare.

If you do not qualify for, or cannot obtain healthcare through the means discussed above, you have the option of receiving care and delivery services at a county hospital.

You also have the option of using a midwife and going the natural route.

Unexpected pregnancies are a perfect example of why you need health insurance, even if you’re young and perfectly healthy. You’ll want to make sure that you don’t struggle through it alone.

Fortunately, thanks to the passage of the ACA, most individuals can carry health insurance today.

Related: Can I get health insurance for my girlfriend?

(photo: SuhelSheikh)