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Can I Get Health Insurance If I’m Pregnant?

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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...

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Reviewed byJoel Ohman
Founder, CFP®

UPDATED: Mar 13, 2020

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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 It Used to Be Like…

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.

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

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Affordable Care Act Protects 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.

Or by 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.

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

Related: Can I get health insurance for my girlfriend?

(photo: SuhelSheikh)

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