Special Enrollment for Pregnancy
Beginning January 1, 2025, persons who have a medically confirmed pregnancy will be eligible to enroll in a Qualified Health Plan outside of Open Enrollment through a Special Enrollment Period.
Individuals must attest that they are pregnant, and that this pregnancy has been confirmed by a medical provider.
The effective date for coverage can begin the first day of the first calendar month in which a medical professional determines that the pregnancy began or a later date if directed by the enrollee.
If the coverage begins in previous months, the enrollee will be responsible for all premiums.
This Special Enrollment applies to the pregnant person, and any individual who is eligible for coverage because of their relationship to the pregnant person (spouse and/or dependents)
They may also be eligible for Financial Assistance through the Advance Premium Tax Credit to reduce premiums or Cost Share Reductions to reduce out of pocket expenses, as determined by the household size and income.