Pregnant or planning a baby? What Marketplace plans cover and when to enroll

Every Marketplace (ACA) plan covers pregnancy, labor and delivery, and newborn care. These are essential health benefits, and a plan can't deny you or charge you more because you're pregnant. The part people miss is timing.

Pregnancy alone usually doesn't open enrollment

On HealthCare.gov, becoming pregnant is generally not a qualifying life event. If you're uninsured and planning a baby, Open Enrollment — November 1, 2026 to January 15, 2027 — is the time to get covered. Enroll by December 15 for coverage that starts January 1.

The birth of your baby is a qualifying event. After the birth you have 60 days to add your baby to your plan or switch the whole family to a different plan, and coverage for the baby can start on the date of birth.

What to check before you choose

• Your OB-GYN and the hospital where you plan to deliver are in the plan's network.
• The hospital's NICU is in-network. A premature birth can mean weeks of intensive care.
• The out-of-pocket maximum. It caps what you pay in a year for covered in-network care — the number that matters most if a pregnancy gets complicated.
• Pediatricians for after the baby arrives.

Medicaid and CHIP

Depending on household income, you may qualify for Medicaid for pregnant women or CHIP perinatal coverage in Texas instead of a Marketplace plan. HealthCare.gov checks this when you apply.

See our page for planning a baby, or use the plan comparison tool to see plans and estimated prices for your ZIP code. Roman Shopin, a licensed Texas agent, can check your doctors and hospital before you enroll — free.