Women’s Health

How do I project my household size/income for next year if I’m pregnant now? I’m married and this pregnancy will be our first child. We want to find subsidized coverage in the Marketplace.

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During Open Enrollment, you and your spouse will apply as a household of two. When the baby is born, you can update your family information with the Marketplace to reflect that you have become a household of three. At that point, you will qualify for a larger premium tax credit, assuming your income stays the same.  Subsidies for a family of 3 are larger than for a family of 2 with the same income. When you report your new family status to the Marketplace you will also have a 60-day special enrollment opportunity to add the baby to your plan and increase your advanced premium tax credit amount.  You will also have the option of enrolling your baby in a different plan.  However, you and your spouse generally will not be able to change health plans as a result of the “newborn” special enrollment period.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.