What to Know If You're Pregnant and Uninsured (2024)

First things first: Congratulations on your pregnancy! You’re already doing the right thing by recognizing how important good prenatal care is, even though it can be costly. But as you’re no doubt learning, it’s tough to stay excited about your little bun in the oven when you don’t know how you’ll pay for a healthy pregnancy and delivery. A typical delivery varies widely across the United States and can cost as much as $18,000, and that doesn’t account for complications such as an emergency C-section.

The good news: Insurers cannot deny coverage to uninsured moms-to-be. Thanks to the Affordable Care Act (ACA), also called Obamacare, private insurance companies are required to cover preexisting conditions, including pregnancy. However, there's always a chance that Congress could overturn Obamacare and pregnancy may once again become a pre-existing condition, so it's a good thing you're pregnant now, while the coverage is available for you.

If your employer or your partner's employer doesn't offer insurance or you're unemployed, you may be able to apply for a health plan through the Health Insurance Marketplace. But you must enroll during the open enrollment period, which happens on an annual basis, unless you are eligible for special enrollment. While pregnancy itself is not considered a qualifying life event, giving birth — along with marriage, divorce and moving — count. Find out more, including how to get in touch with a local marketplace representative, at healthcare.gov.

Otherwise, there are still several other options that can help you pay for high-quality care now. Here are some ways to keep this baby from breaking the bank:

• Double-check your Medicaid eligibility. Even if you haven’t qualified in the past, many states increase their income requirement during pregnancy to help more pregnant women get coverage. The Kaiser Family Foundation also has a list of each state’s income limits. Or call your local Health Insurance Marketplace representative or your local health department to ask whether you’re eligible.
• Check COBRA eligibility. If you or your partner was recently unemployed and you previously had health insurance, you may be able to get coverage for up to 18 or 36 months (depending on the circ*mstances) through a program called COBRA (Consolidated Omnibus Budget Reconciliation Act). Unfortunately, COBRA premiums are usually very high since they don’t include employer contributions, but it may still save you money compared with paying out of pocket. Contact your former employer’s human resources department for more information.
• Check in with your parents. Under the ACA, if one of your parents has a health plan, they should be able to add you as a dependent until you’re 26 years old — even if you don’t live with them, whether you’re married or not and regardless of whether they’ve declared you as a dependent or not on their taxes. The catch? You may have to wait for an open enrollment period to be added, and many health plans do not cover maternity services for dependents — so make sure you look into that first.
• Negotiate for discounts. If you’ve investigated the other insurance options and it turns out you still have to pay out of pocket for your care, call your health care providers — they may be able to help. Many doctors and hospitals will give you a discount, sometimes as much as 20 or 30 percent, if you’re paying cash. They also usually offer payment plans that give you the option of paying the bill over time. Another possibility: health care discount services or discount cards, which negotiate price cuts on health care services for a monthly fee. Just make sure you read the fine print to see whether your health care providers and services are covered and there are no hidden fees.
• Consider a birthing center and midwife. If you’re healthy, at low risk for complications, and want an unmedicated childbirth, you can save a bundle by delivering at a birthing center instead of a hospital. At a birthing center, the average vagin*l birth with no complications usually costs about half of what the same type of delivery at a hospital would cost. You’ll save even more if you use a midwife instead of a doctor — and you increase your chances of getting that natural birth you’re hoping for. But keep in mind that your comfort during labor is worth the high cost, so if your heart is set on a hospital birth, don’t compromise to save cash.

Here’s to your healthy pregnancy (and baby-to-be),