Special Enrollment for Pregnancy
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
Enrolling January 2025 through February 2025:
A Banner on SSP Will Direct Persons on How To Enroll Through Exceptional Circumstance
‘If anyone in your household is pregnant, you are eligible to enroll in a qualified health plan using the Special Enrollment reason for exceptional circumstance.’
Enrollees will then use the Special Enrollment Reason:
- "A qualified individual or enrollee demonstrated to the Exchange, in accordance with guidelines issued by HHS, that the individual meets other exceptional circumstances as the Exchange may provide "
- “This SEP reason can only be used if you or someone in your household is pregnant and that pregnancy has been confirmed by a medical professional.”
Enrollees will then be asked the date they wish coverage to begin.
Please call the kynect Contact Center at 855-459.6328 or send email to kynectESE@ky.gov
Please write “Pregnancy” in the subject line of the email