“You’re having a baby.”
It is life’s most significant event. Giving birth to a newborn child dramatically changes the life of the mother. Do you set up a room for the new member of your family, or do you start shopping for a larger place to live?
What about work and pregnancy? The Family Medical Leave Act (FMLA) provides you with up to 12 weeks of unpaid family leave. Now, we get to the most complicated part of having a baby.
What are you going to do about health insurance?
The open enrollment period for purchasing health insurance through the Marketplace runs from November 1 to December 15, 2021. You can buy health insurance on your own or work with a registered insurance agent or broker. However, what happens if you miss the open enrollment period. Are you stuck with the coverage you currently have, which does not account for the newest member of your family?
The answer is you might qualify for health insurance through the marketplace if you enroll during a Special Enrollment Period (SEP). You have 60 days before or 60 days after an event to enroll in a health insurance plan that is available in the marketplace. An employer-based health insurance plan must allow you 30 days to enroll for health insurance.
What Are the Life Changes That Qualify You for a Special Enrollment Period?
If you or anyone in your household lost qualifying health insurance coverage in the past 60 days or expects to lose coverage during the next 60 days, you might qualify for a Special Enrollment Period. Because FEMA declared the COVID-19 pandemic to constitute a national emergency, anyone that missed a Special Enrollment Period because of the pandemic might be eligible for a SEP.
Qualifying Because of Change in Household
The most common reason for qualifying to participate in a SEP is because of a change in a household.
- Having a baby: Your coverage begins on the day you give birth, even if you enroll in a health insurance plan up to 60 days after the life-changing event. You can also qualify for a SEP by adopting a child or having a child placed in your home for foster care.
- Marriage: Pick a plan before the last day of the month and health insurance coverage for marriage begins on the first day of the next month.
- Divorce: You qualify if you lost health insurance coverage after getting divorced or legally separated.
- Death: You qualify if someone on your Marketplace plan dies and the death no longer makes you eligible for your current health insurance plan.
Change in Residence
Household moves that can qualify you for a SEP:
- Relocate to a new home located in a different county or zip code
- A seasonal worker moving to or from a place where you live and work
- Moving to or from transitional housing
- Relocating to the United States from an American territory or foreign nation
- Student moving to or from the location where you attend school
How Does the Special Enrollment Period Work for Having a Baby?
When you have a baby, adopt a child, accept a foster child, or gain a dependent because of the legal order issued by a court, you might be eligible for a dependent Special Enrollment Period. Both you and the new dependent enroll in health insurance coverage that is offered in the Marketplace.
The period for how long the new dependent Special Enrollment Period lasts is 60 days from the date of child’s birth, adoption, or court order. New coverage typically goes into effect retroactive to the date of the birth, adoption, or court order.
If you already have a health insurance policy that is offered via the Marketplace, then you can add the new dependent to your current plan or purchase a separate plan for the new dependent. If your current Marketplace plan does not cover dependents, you and your new dependent enroll in a new plan that is at the same metal level as your current health insurance coverage.
How Do I Discover Whether I Qualify for a Special Enrollment Period?
To see if you can get health coverage during a SEP, use the screening tool provided by the HealthCare.gov website. Answer a few questions to determine whether you qualify to change plans or purchase a new health insurance policy. You can also determine if you qualify for health insurance coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
If you’re looking for advice and options for health insurance after having a baby, look no further than Insurance Broker Hub. Our free service gives you access to an independent network of national brokers who have the experience and expertise to design a plan around your needs and budget. Ready to get started? Simply request a no obligation health insurance quote here.