No, you don’t need to contact your health insurance plan to let them know your wife is pregnant if she’s already covered by the plan. She is automatically covered for maternity benefits.
The Affordable Care Act (ACA) requires health insurance marketplace and employer-sponsored health insurance plans cover 10 essential health benefits. Those benefits include pregnancy, maternity, childbirth and prenatal care health benefits for pregnant women and their newborns. The ACA doesn’t allow health insurance companies to consider pregnancy a pre-existing condition. Instead, health plans must provide pregnancy-related health coverage.
Even if your wife’s pregnancy began before she was insured under your health insurance policy, her maternity care must be covered.
Also, having a child qualifies you for a special enrollment period. So, if your spouse isn’t on the health plan, you can add her to the coverage if she’s pregnant.
Once your baby is born, you need to call your health insurance company to add the newborn to your policy within a given time frame, normally 30 days. If you miss this window, you’ll have to wait until the next open enrollment period to add your baby. If you miss the deadline, your baby will be uninsured.
However, there’s one exception. If you face a qualifying life event during the year, such as losing coverage, moving to another state or getting divorced, you could be eligible for a special enrollment period. A special enrollment period allows you to make changes to your health plan outside of the open enrollment window.