Options If You're Pregnant With No Maternity Insurance

Resources for Affordable Pregnancy Care and Maternity Insurance

If you’re pregnant and don’t have health insurance, you probably feel vulnerable and overwhelmed.

While individual health insurance plans that include maternity coverage are available through the Affordable Care Act's (ACA) health insurance exchanges, you can normally only enroll in those plans:

But in 2021, the rules are different, due to the ongoing COVID pandemic and the additional premium subsidies provided by the American Rescue Plan. To give people an opportunity to get insured and take full advantage of the extra subsidies, there's a one-time special enrollment period that continues through August 15, 2021 in most states. But this window isn't like a normal special enrollment period: It's available to anyone eligible to use the marketplaces in most states, and people do not need a qualifying event in order to use it.

So if you're pregnant in 2021 and need health insurance, you likely have an opportunity to enroll in a health plan through the marketplace in your state, as long as you do so by August 15 (a few states have different deadlines). Depending on the circumstances, you might be eligible for subsidies that will offset some or all of the monthly premiums, assuming you're not eligible for coverage under an employer's plan.

After August 15, 2021, in most states, the normal rules will again be in effect. Here's an overview of how they work:

Pregnant young mom getting sonogram
pixelfit / Getty Images

If you're pregnant during open enrollment, you can sign up for a plan that will be effective in the coming year. All new plans are required to have maternity benefits under the ACA.

Pre-existing conditions—including pregnancy—are no longer an obstacle. Routine prenatal care is covered in full, but there will be cost-sharing—copays, deductible, and/or coinsurance—for other services, including delivery).

But if you find yourself uninsured and pregnant early in the year, after open enrollment has ended but many months ahead of the start of the next year's enrollment period, certain circumstances could provide you with another chance to enroll.

Although some pregnant women might be eligible for special enrollment periods due to qualifying events, pregnancy itself is not a qualifying event. But there's an exception in New York, Connecticut, and the District of Columbia.

Legislation was enacted in 2015 (effective January 2016) in New York to make pregnancy a qualifying event for plans purchased via the state-run exchange, New York State of Health.

That means a pregnant woman in New York can enroll in coverage for the first time, or switch to a different plan once she becomes pregnant.

Similar legislation was enacted in Connecticut in 2018 and took effect in January 2019.

D.C. implemented a similar rule in 2020. A special enrollment period starts when a medical provider confirms the pregnancy. It runs for 60 days in the individual market, and for 30 days if you have access to an employer's plan.

But New York, Connecticut, and DC are the only areas that have such a provision. In the rest of the country, pregnancy is not a qualifying event.

The birth of the baby is a qualifying event, and allows both the baby and parent(s) to enroll in a health plan. However, that doesn't help with prenatal care or the cost of the delivery itself.

If you're not eligible for insurance through the ACA (Obamacare) or your job, or if you need prenatal care before the next open enrollment period, you do have some options.

Local Health Department

Your first stop should be your local Health Department. Many Public Health Departments provide maternity care.

Usually, these services are limited to lower-income individuals, but if you don’t meet the income criteria, they can still provide a wealth of information on what other resources are available in your area.

Community Health Center

Community Health Centers provide affordable care to people with limited access to health care.

While they don’t provide maternity insurance, they do provide comprehensive primary and prenatal care with fees based on your income and ability to pay.

Since not all communities have one, check to see if there is a Community Health Center near you.


Medicaid is a government program that provides health insurance to low-income people. If you qualify, Medicaid’s maternity insurance coverage can be retroactive, covering prenatal care you got even before you applied for Medicaid. Also, when you qualify, your baby will be covered when it’s born. And Medicaid enrollment is available year-round, as opposed to the annual enrollment windows that apply to private individual/family plans and employer-sponsored plans.

Medicaid eligibility levels are generally higher for pregnant women than for others. Your unborn baby is counted as a household member when the eligibility determination is made. (More people in a household raises the income range for Medicaid eligibility.)

Even in states that haven't expanded Medicaid under the ACA, pregnant women are eligible for Medicaid with incomes above the poverty level. Eligibility ranges from 133% of the poverty level in Idaho, Louisiana, Oklahoma, and South Dakota, to 375% of the poverty level in Iowa.

Medicaid allows enrollment all year long, so you're not constrained by an open enrollment period.

Children’s Health Insurance Program

The Children’s Health Insurance Program provides health insurance to uninsured children, but it also provides coverage to pregnant women in several states:

  • Colorado
  • Missouri
  • New Jersey
  • Rhode Island
  • Virginia
  • West Virginia

Although it focuses on people who can’t afford health insurance, CHIP programs allow higher incomes than Medicaid does.

All six of those states have eligibility thresholds of 200% of the poverty level or above for pregnant women to qualify for CHIP. Even if you don’t qualify for CHIP, your baby might qualify when it's born. Like Medicaid, CHIP allows enrollment all year long.

Hill-Burton Facility

As of 2020, 131 hospitals and health clinics nationwide were obligated to provide free or low-cost care because they accepted grants or loans under the Hill-Burton Act.

Go to the admissions office of one of these facilities and tell them you want to apply for Hill-Burton free or reduced-cost care. You’ll need to meet low-income requirements, but you don’t have to be a U.S. citizen.

The facility is only obligated to spend a limited amount of money each year on Hill-Burton care, so you’ll have to use their services before that year’s money is gone.

This covers the hospital’s charges, but not necessarily the healthcare provider’s charges since it isn’t truly maternity insurance; it’s a type of charity care.

Charity Care Organizations

Organizations like Catholic Charities and Lutheran Services offer programs to help women with maternity care. Services vary by location.

Basic services include counseling and referrals. However, some locations provide services as extensive as maternity homes that provide free maternity care, postpartum care, parenting classes, and room and board.

At the very least, they’ll educate you on what other resources are available in your local area.

Young Adult Coverage Under Parent’s Policy

If you’re less than 26 years old, you might qualify for coverage under your parent’s insurance. Even if you’re married or living on your own, you can be included in the health insurance your parent gets from his or her job.

You'll likely have to wait until your parent's plan's open enrollment to sign up, but the plan might have an open enrollment that doesn't coincide with the calendar year. This could be helpful if it allows you to enroll sooner than you'd be able to if you had to wait until the annual open enrollment period for individual coverage.

However, you'll want to make sure the plan offers maternity insurance coverage for dependents, as health plans are not required to do so. Dependents must be offered coverage that includes preventive care benefits, including prenatal care. But health plans are not required to cover labor and delivery costs for dependents. 

Planned Parenthood

Planned Parenthood isn’t just for family planning and checkups. Some, but not all, Planned Parenthood locations provide prenatal services. And some Planned Parenthood locations base their charges on your income.

If your local Planned Parenthood doesn’t provide prenatal care or have a sliding-scale fee structure for self-pay patients, they’ll be able to refer you to other resources within your local community.

Negotiate a Self-Pay Rate

If you end up paying out of pocket, negotiate discount rates in advance and set up payment plans. Frequently, hospitals have a rack rate, a self-pay discount rate, and an even lower charity rate. If you don’t ask about the charity rate, they might not volunteer it.

Asking what the charity rate is, as well as how to qualify for it, will help you negotiate because you’ll know the bottom line, even if you don’t qualify for it.

Discount Medical Plan Organization

If negotiating your own self-pay discount scares you, you can work with a Discount Medical Plan Organization. These companies provide pre-negotiated discounts to their members for a monthly fee.

This isn’t true maternity insurance since you’re paying the healthcare provider and hospital yourself, but the discount has already been negotiated for you by the DMPO.

Before you enroll, make sure your practitioner and hospital participate, as many plans have a severely limited selection of participating healthcare providers. If you haven't yet selected a medical professional or hospital, however, you can limit your selections to providers who participate in the DMPO.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Norris, Louise. healthinsurance.org. Five Ways the American Rescue Plan Might Slash Your Health Insurance Costs. March 18, 2021.

  2. National Health Law Program. Well-women visits and prenatal care under the ACA’s women’s health amendment. July 23, 2013

  3. New York State Senate. Senate Bill S5972. 2015-2016 Legislative session

    relates to permitting pregnant individuals to enroll in the state health insurance exchange at any time.

  4. Connecticut General Assembly. Senate Bill 206, session year 2018. Enacted June 2018, effective January 2019.

  5. DC Health Link. DC Health Link to Offer Even More Opportunities for Residents to Get Covered. February 11, 2020.

  6. Chen, Amy. National Health Law Program. Q&A on Pregnant Women’s Coverage Under Medicaid and the ACA. September 5, 2018.

  7. Medicaid.gov. Medicaid, children's health insurance program, & basic health program eligibility levels. October 1, 2020.

  8. Health Resources and Services Administration. Hill-Burton facilities obligated to provide free or reduced-cost health care. August 2019

  9. Palanker, Dania. National Women's Law Center. Covered through a parent’s plan? Your prenatal services are covered. May 12, 2015