The Navigator Resource Guide has not been updated for 2025 Open Enrollment. For more current information please visit:
cms.gov/marketplace/in-person-assisters/information-partners.
QUESTION

Does pregnancy trigger a special enrollment opportunity to buy or change coverage?

Individuals with no coverage | Open and Special Enrollment Periods |
ANSWER

No, pregnancy is not a triggering event for a special enrollment opportunity in the federally facilitated Marketplace, nor in most state-based Marketplaces. When the baby is born, however, you will be eligible for a special enrollment opportunity. You can enroll your baby in coverage at that point. A few states do consider pregnancy a qualifying event for a special enrollment period. To see if your state is one of them, visit our state fact sheets here. (45 C.F.R. § 155.420.)

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues