Margaret Huntley Last Updated On: August 1, 2023

Pregnant? Here’s Some Helpful Information Regarding Pregnancy Health Insurance

First a little history lesson: prior to the Affordable Care Act a pregnant woman would have found it nearly impossible to purchase an insurance policy. Indeed, even group employee health plans were not required to include maternity benefits.

Under the pre-existing conditions section of the Affordable Care Act, insurance companies may no longer deny a pregnant woman insurance because she is pregnant.

Many other options for pregnant women also exist to help provide prenatal care and a healthy mother and baby.

  • Individual health plans are available through your state’s marketplace and it does not require that you disclose your pregnancy at the time you sign up. The open enrollment period currently begins November 1st for coverage beginning January 1 of the following year.
  • Husbands who wish to add coverage for their wife need not disclose the pregnancy when making the change
  • Men who acknowledge parenthood can add a child they fathered  to a family policy in some cases
  • CHIP and Medicaid programs are available to cover pregnancy until the child is born and provide postpartum care for the mother and child.

Occasionally there are unique situations that raise questions of coverage and pregnancy. For example, let’s say that you have coverage through an employer based insurance plan and you lose or change jobs. In the event of a job loss an expectant mother should immediately look into CHIP and Medicaid benefits in her state. A job change that results in a lapse of coverage because of a wait until coverage begins may necessitate using COBRA benefits to cover until the new employer’s insurance is in force.

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How Does Pregnancy Health Insurance Work?

Whether you’re considering taking that next step or you’ve just found out you’re pregnant, you’re wise to start considering your options in terms of health insurance for pregnant women. But what exactly is pregnancy health insurance and how is it different from typical health insurance?

While it might sound strange, pregnancy is considered a pre-existing condition. If you’re searching for health insurance and are already pregnant, you’re going to have fewer options than if you’re still trying to conceive. But the good news is that you do still have plenty of options available to you, no matter your income or pregnancy stage.

Keep reading to find out your options for pregnancy health insurance and how they work.

Best Health Insurance For Pregnant Women

The best health insurance for pregnancy will depend on your individual situation, but generally, it should cover regular doctor visits during your pregnancy, ultrasounds, blood work, labor and delivery, and ideally prenatal testing.

Just like anyone else needing health insurance, you have options for coverage:

  • Marketplace plans: the Affordable Care Act (ACA) made it possible to get guaranteed health insurance with essential care in an easy-to-use marketplace. You can browse plans to find the best coverage versus costs for your needs. You can enroll in a plan during each year’s open enrollment, which takes place every November-December, typically. You can also enroll during qualifying life events, like a birth or marriage, but becoming pregnant doesn’t count.
  • Employer-sponsored plans: this is one of the best options for you, if available. You can enroll in your employer’s health insurance group plan and they typically pay some or all of the costs. You usually don’t get to choose the coverage, but it’s usually the most affordable option out there for pregnancy health insurance.

    If you lose your job or switch jobs and don’t yet have health insurance coverage, COBRA can help you retain your coverage for a certain number of months afterward, although you’ll now have to pay for all healthcare costs (instead of your employer paying for some or all). You can also take advantage of your spouse/partner’s plan through their work, as a dependent. 

  • Medicaid: if you’re eligible for Medicaid because of your income level, this can be a great option for pregnancy health insurance. It’s affordable, offers comprehensive coverage, and you can enroll any time of the year.
  • CHIP: the Children’s Health Insurance Plan is an option for those who don’t qualify for Medicaid but can’t afford a Marketplace plan. It covers children under the age of 19 and pregnant women, and several states even waive the premiums/coinsurance.

Note, that pregnancy is considered a pre-existing condition that, in previous years, could have made it harder for you to get health insurance. Luckily, the law now requires all Marketplace, employer-provided, and Medicaid plans to cover pregnancy. This means you can’t be denied coverage because of your pregnancy. 

Unfortunately, short-term health insurance and other private health insurance plans don’t need to follow those rules and so you’ll be hard-pressed to find a short-term insurance plan that offers maternity coverage.

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Does Health Insurance Cover Abortion?

The short answer is that the answer varies by state and insurance plan. It’s likely that you’ll have to pay for some portion or all of the cost of abortion, but it’ll really depend on your situation. However, if the life of the pregnant woman is in danger, there’s often more flexibility for abortion when it comes to health insurance.

Key Takeaways For Pregnancy Insurance Coverage

Whether you’re hoping to conceive or in the last few months of your pregnancy, you have options for pregnancy health insurance. The best health insurance for pregnancy will cover as many services as possible while staying affordable for you. 

The sooner you look into your options for pregnancy health insurance, the better: since pregnancy is considered a pre-existing condition, you’ll have better luck finding the best plan for you before you conceive. However, it’s never too late to find health insurance for pregnant women and you’ll always have options for the care of you and your soon-to-be bundle of joy.


Nov. 1st each year begins the open enrollment period for coverage beginning in January, it closes currently on Dec 15th. There are also certain other periods based on life events, check the ACA website.​

No, and she does not have to disclose her pregnancy when applying for coverage. Thanks to the Affordable Care Act coverage cannot be denied.​

Medicaid or CHIP coverage lasts through the pregnancy and up to 60 days after the birth of the child. Evaluation of mother and child for further eligibility takes place at that time.​


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