Your Resource for Everything Related to Benefits, Insurance and HR


Your Resource for Everything Related to Benefits, Insurance and HR

Can you switch health insurance when pregnant? Yes, you certainly can, but only if it’s during the open enrollment period (the open enrollment period will depend on if you have an individual plan or get insurance through a group plan).

If you want to change insurances outside of the open enrollment period, you’d need to experience a qualifying life event in order to do so (pregnancy is not considered a qualifying life event).

Examples of qualifying life events include:

There’s a change in your legal marital status (you get married or have a divorce)

Your spouse passes away

There’s a change in the number of dependents you have (you give birth to a child or adopt a child)

You or your spouse have a change in employment status (leaving a job or starting a new job, for example)

You move to a new address that’s in a different zip code or county that no longer allows for access to in-network providers

You turn and no longer have coverage from the insurance of your parents

You no longer qualify for Medicaid, Medicare, or Children’s Health Insurance Program (CHIP)

You become a citizen of the US

If you do experience a qualifying life event while you’re pregnant and qualify for a special enrollment period, make sure to let your insurance know as soon as the event happens, as you typically will have up to days to enroll in your new plan.

You also may be asked for documentation related to your qualifying life event, so make sure you have those ready to go in order to avoid delays.

Benefits of Switching If you meet the criteria for switching, there are several potential benefits to switching health insurance while pregnant. First, you may be able to find a plan that better meets your needs. Perhaps your current plan doesn’t cover maternity benefits or has a high deductible. If this is the case, going with a new plan could save you a lot of money.

Additionally, you may be able to find a plan with a lower premium. This setup can be especially helpful if you’re currently on an individual or family plan and are looking to switch to a group plan through your (or your spouse’s) workplace.

Group plans, offered through an employer, tend to have lower premiums than individual plans, saving you a significant amount each month.

Another potential benefit of switching is that you may be able to find a plan with a better network of doctors and hospitals. If you’re unhappy with your current provider, moving to a new plan could give you access to the care you want and need.

Moreover, if you’re worried about your current coverage, switching to a new plan can put your mind at ease while helping you avoid any stressful surprises down the road.

Consider the ACA Rules If you’re currently covered by an individual plan offered through your state or federal healthcare exchange under the Affordable Care Act (ACA), there are a few things to remember when switching health insurance.

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