by Chris Huckins Google+ Email 


15 May 2014

Is Pregnancy a Qualifying Life Event?

Posted in Health Insurance 101

Is Pregnancy a Qualifying Life Event?

If you missed getting insurance during open enrollment it's likely tough luck for you. But there's a silver lining at end of the tunnel. And that tunnel is the uterus. 

For most uninsured Californians, waiting until the next enrollment period on November 15, 2014 is the only option to get insurance, unless you qualify for Medi-Cal or group insurance through an employer. 

Plan B (not "that" Plan B) would be to have a child, which qualifies the mother and the child to get insurance outside of open enrollment. Under Obamacare, giving birth is a qualifying life event.

For the mother to get insurance outside of the open enrollment period, she must wait until the date of the child's birth.

A newborn is considered an addition to the family, and changes in family size is a qualifying life event. In fact, the family can enroll for a new plan because its insurance costs would change when more family members are added.

Adopting a child is of course a qualifying life event as well. The adopted child can get insurance from the date he or she is in the parent's custody.  

If Mom didn't have insurance prior to giving birth, but enrolled shortly after, the baby's medical bills from its date of birth and after would be covered by the insurance, but nothing related to the mother's pregnancy would be covered. 

If the mother already had insurance and gave birth, she can place the baby on her existing plan. She has a 30 day grace period to change her mind, in case she opts for a Covered California plan, which may grant her premium assistance

Premium assistance benefits an individual with a gross income between $16,000 and $44,000. The amount changes depending on family size and income. 

If Mom claims her baby on her taxes and sends it on the child star circuit, that income from diaper commercials must be claimed on the health insurance application, just in case you're wondering. 

If women are kicking themselves for not getting insurance while pregnant and during open enrollment period, please don't aim for the baby-maker.