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Is Pregnancy a Qualifying Life Event? Rules for 2027

Is Pregnancy a Qualifying Life Event? Rules for 2027

What this means for you: In most states, pregnancy is not a qualifying life event, so being pregnant doesn't let you buy a plan mid-year. Giving birth is. Here's when you can sign up:

  • Now, during open enrollment: You can enroll in a 2027 plan from November 1, 2026 to January 15, 2027. Pick a plan by December 15 to be covered January 1 (HealthCare.gov).

  • During pregnancy, in 10 states and DC: Colorado, Connecticut, DC, Illinois, Maine, Maryland, New Jersey, New York, Rhode Island, Vermont, and Virginia let you enroll because you're pregnant. You'll usually need a note from your doctor.

  • After the birth: On HealthCare.gov, you have 60 days after your baby is born to enroll, and coverage can start on the birth date. Plans through your work give you at least 30 days to add your baby.

Is pregnancy a qualifying life event?

Pregnancy is not a qualifying life event on HealthCare.gov, but it is in 10 states and DC. Most of the year, you can't just sign up for health insurance. You have to wait for open enrollment, the yearly sign-up window. The exception is a qualifying life event. That's a big change, like losing your coverage or moving. It opens a special enrollment period, which is extra time to sign up mid-year.

On HealthCare.gov, pregnancy doesn't count. HealthCare.gov says it plainly: "Being pregnant doesn't qualify you for a Special Enrollment Period."

Having a baby does count. Once your baby is born, you can sign up for a plan, even if you couldn't while pregnant.

Some states run their own marketplace and set their own rules. In 10 states and DC, pregnancy does count. See the list below.

Which states count pregnancy as a qualifying life event?

These state marketplaces let you enroll because of pregnancy. Rules differ, and most apply only to people who don't already have coverage. If your state is not on this list, pregnancy alone won't let you enroll mid-year. Birth will. Check your state's site before you apply.

  • Colorado: Pregnancy certified by a health care provider counts. The window is generally 60 days. Source: Connect for Health Colorado

  • Illinois: You have 60 days after the pregnancy is confirmed. Coverage can start the first of that month or the next month. Source: Get Covered Illinois

  • Maryland: You have 90 days after you learn you're pregnant. You can ask for coverage back to the first of the month you found out. Source: Maryland Health Connection

  • New Jersey: Pregnancy counts for new enrollees. You usually have 60 days, and coverage may start earlier than usual. Source: GetCoveredNJ

  • New York: Pregnancy certified by a health care practitioner counts. You generally have 60 days to report it. Source: NY State of Health

  • Virginia: You can enroll any time during pregnancy and up to 60 days after birth. Source: Virginia's Insurance Marketplace

  • Connecticut: Becoming pregnant counts. You generally have 60 days to apply. You'll need a letter that certifies the pregnancy. Source: Access Health CT

  • District of Columbia: Becoming pregnant counts. You usually need to act within 60 days. Source: DC Health Link

  • Maine: Becoming pregnant counts if you don't already have a CoverME.gov plan. Coverage starts the first of the month after you pick a plan. Source: CoverME.gov

  • Rhode Island: State law lets you enroll any time after the pregnancy begins. Coverage starts the first of the month you apply. Source: Rhode Island law, section 27-18.5-10.1

  • Vermont: New enrollees can sign up any time from reporting the pregnancy until the birth. Coverage starts the first of the month after you pick a plan. Source: Vermont Health Connect

How birth opens a special enrollment period

Birth opens a special enrollment period on HealthCare.gov. You should apply within 60 days after the birth. Your baby's coverage can start the day they were born. State marketplaces set their own birth rules, so check your state's site.

Plans through work have their own rule. Under federal law, you must ask to add your baby within 30 days of the birth. Coverage then goes back to the date of birth. Many people miss this window. Our guide on what to do if you missed the window to add your baby walks through the next steps.

Federal rules for job-based plans name birth and adoption, not pregnancy. Ask HR whether your plan, or your state, adds a pregnancy rule.

Common problems when adding a baby to insurance

Our health advocates see the same few problems after a baby arrives:

  • The first bill is the first warning. Many families learn something went wrong weeks after the birth, when a bill or denial for the baby shows up.

  • The baby's care goes to the wrong plan. Charges can land under the mom's claims or on the other parent's plan. Ask the insurer what date the baby's coverage started. Then ask the provider to send the claims again to that plan.

  • Adding the baby late leaves the first days uncovered. If your baby was added after the deadline, care in the first days, like a NICU (newborn intensive care unit) stay, may be denied.

If a bill or denial for your baby already showed up, send it to us. We'll check which plan should have paid and help get it fixed. Check your bill

How to get coverage if you're pregnant without insurance

  1. Check the calendar first. If it's between November 1 and January 15, you can enroll now. Pick by December 15 for coverage on January 1.

  2. Check your state's list. If your state counts pregnancy, ask your OB (pregnancy doctor) or clinic for a note confirming the pregnancy. Then apply on your state's site.

  3. Look for other qualifying events. Did you recently lose job coverage, move, or get married? Each one can open a special enrollment period, usually for 60 days.

  4. Check job-based coverage. See if you or your partner can get a plan through work. Ask HR when its enrollment window is.

  5. Plan for the birth. If nothing else works, the birth opens a 60-day window on HealthCare.gov. Enroll quickly so coverage starts on the birth date.

  6. Save every bill. If you get care without insurance, keep each bill. Before planned care, ask for a good faith estimate, a written cost estimate for people paying without insurance.

Your pregnancy coverage decision path

Use this to find your next step.

  • Is it November 1 to January 15? Yes: enroll in a 2027 plan now. No: go to the next line.

  • Does your state marketplace count pregnancy? Yes: apply with proof of pregnancy, inside your state's window. No: go to the next line.

  • Did you have another life change in the last 60 days? Yes: apply for a special enrollment period for that change. No: go to the next line.

  • Can you get a plan through your job or your partner's job? Yes: ask HR about enrollment dates. No: go to the next line.

  • Has your baby been born? Yes: apply within 60 days for coverage back to the birth date. Not yet: plan to apply right after the birth.

How Granted can help

We help with the bills that come from these gaps. If you had care before your coverage started, we check whether any of it should have been covered. If you got care without insurance, we review the bill for errors and check whether you qualify for income based discounts. If your baby's claims get denied after you add them, we look at why. With your OK, we can file an appeal.

Learn more about how we help with pregnancy bills.

If you are looking at a bill like this one, upload it and get a second look before you pay. Free to start. You only pay if we lower your bill.

Check your bill

Frequently asked questions about pregnancy and special enrollment

Can I get health insurance while pregnant?

You can get health insurance while pregnant during open enrollment, which runs November 1 to January 15 on HealthCare.gov. Outside that window, you need a qualifying life event. In 10 states and DC, pregnancy itself counts. Every marketplace plan covers pregnancy and childbirth.

Is birth a qualifying life event?

Yes, birth is a qualifying life event on HealthCare.gov. You get 60 days to enroll after the birth, and your baby's coverage can start on the birth date. Job-based plans are required to give you at least 30 days to add a newborn. State marketplaces set their own windows.

How long do I have to add my baby to my insurance?

How long you have to add your baby depends on where your plan comes from:

  • Plan through work: 30 days from the birth. Some plans give you longer, so ask HR.

  • Marketplace plan (HealthCare.gov or your state's site): 60 days from the birth.

If you add your baby in time, coverage goes back to the day they were born. If you miss the deadline, you may have to wait until the next open enrollment. Close to the deadline? Call your plan today.

Does my deductible reset if I switch plans while pregnant?

Yes, your deductible usually resets if you switch plans while pregnant. Your deductible is the amount you pay before your plan starts paying. What you paid on your old plan doesn't carry over to the new one. The plan you have on the day of the delivery is usually the one that pays for it.

What counts as proof of pregnancy for special enrollment?

Most states that allow a pregnancy enrollment period ask for a pregnancy confirmed by a health care provider. A note from your OB, midwife, or clinic usually works. Connecticut asks for a letter certifying the pregnancy. Illinois says it needs no extra documents. Check your state's site for the exact rule.

Who is Granted?

Granted (Granted Health) is a digital health advocate that reviews medical bills and EOBs, finds billing errors, negotiates bills, appeals denied claims, and checks eligibility for income based discounts. If a gap in coverage left you with pregnancy or newborn bills, we can review them with you. Granted is free to start.

Key terms in this post

  • Qualifying life event: A life change, like a birth or losing coverage, that lets you enroll outside open enrollment.

  • Special enrollment period: A time outside open enrollment when you can sign up for a health plan.

  • Open enrollment: The yearly window to sign up for or change a marketplace plan.

  • Marketplace: The place to buy your own health plan, through HealthCare.gov or your state's site.

  • State marketplace: A marketplace a state runs itself, with some of its own rules.

  • Job-based plan: Health insurance you get through your employer or a family member's employer.

  • Good faith estimate: A written cost estimate for people paying without insurance.

  • Income based discounts: Lower prices some providers offer based on your household income.

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Last reviewed: November 9, 2026. We update this page when the rules change. This is general information, not legal or tax advice.

Check your eligibility

Save 50% or more on your hospital bills

Check eligibility

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Check your eligibility

Save 50% or more on your hospital bills

Check eligibility

Learn more

Check your bill

Check your eligibility

Save 50% or more on your hospital bills

Check eligibility

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