Insurance Qualifying Event Pregnancy
Pregnancy is not a qualifying life event for private health insurance under the affordable care act.
Insurance qualifying event pregnancy. Unless you re in new york. A qualifying life event qle is a major life change that may affect your health insurance needs or impacts your qualification for existing health insurance or subsidies. The rules vary slightly for individual plans group coverage at work and after you have your baby. This means that expectant women must have a different reason to be eligible for maternity coverage without waiting for the annual enrollment.
From the birth of a new child to turning 65 it s important to know just what counts as a qualifying life event or qle. See if you qualify for a special enrollment period. You will learn what a special enrollment period is and how long you have before and after a qualifying life event to add or modify your health insurance coverage. The irs states that a qualifying event must have an impact on your insurance needs or change what health insurance plans that you qualify for.
Contrary to what many believe should be the case a woman who finds out she s pregnant but doesn t have coverage and wants pre natal care can t sign up for insurance outside of open enrollment in the rest of the country. 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. What this page covers.
In either case the qualifying life event would trigger a special enrollment period that would make you eligible to select a new individual insurance policy through the state marketplace. When you enroll in your employer s group health insurance plan you are told that you can only make changes during the annual open enrollment period or if a qualifying event occurs. The only time an employee can add a non spouse domestic partner to a group plan is at open enrollment and that is only if the plan allows for it. After reading this page you will know more about which life events are considered qualifying life events.
Understanding qualifying events will help you plan for changes in the future. Here s everything you need to know about what counts as a qualifying event and how to help your employees reevaluate and change their healthcare insurance selections. Money budget shop travel stories career advice. Understanding qualifying events will help you plan for changes in the future.
Qualifying life events may make you eligible for a special enrollment period to purchase health insurance outside the open enrollment period. The father cannot use his insurance policy to file any claims for the uninsured mother. If they are married though then he can use money from his health savings account to pay her medical bills if he has an hsa. Similar legislation was enacted in connecticut in 2018 and took effect in january 2019.
Pregnancy is not considered a qualifying event.
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