Health Insurance Market Place Vs Medicaid What Moms Need to Know

Are you pregnant and trying to figure out your health insurance options?

Do you qualify for Medicaid but want to know if you should keep your market place plan?

Have you been trying to figure out what your health insurance market place vs Medicaid options are?

A Fiorella Insurance Agent can help you choose insurance that’s right for you.

Becoming a mother comes with its fair share of trials and tribulations, but health insurance shouldn’t be one of them.

Whether you’re a first-time mom or you’re just new to the market place, the health insurance portal gives you access to a variety of coverage options depending on your situation.

This blog looks at the differences in the health insurance market place vs Medicaid coverage limits and tells you what you need to know about getting coverage while pregnant.

  • Save

Health Insurance Market Place vs Medicaid: An Overview

There are some key differences in applying for the health insurance market place vs Medicaid. First, you need to know the timeline for applying to either option:

  • Health Insurance Market Place: Open enrollment for the health insurance market place is from November 1, 2020, through December 15, 2020, for coverage that begins on January 1, 2021.
  • Medicaid/CHIP: If you qualify for Medicaid, or have a child that qualifies for CHIP, there is no open enrollment period. You may apply and begin coverage at any time.

To apply for the health insurance market place, you can fill out an application online, over the phone, or in person or by contacting a Fiorella Insurance agent. All health insurance market place plans cover pregnancy, so if you already have a market place plan, you don’t necessarily need additional coverage.

However, if you’re pregnant and find that your health insurance market place plan won’t be sufficient due to financial circumstances, you can apply for Medicaid through the health care portal as well. Depending on where you live and your financial situation, you may qualify for low- to no-cost healthcare.

Health Insurance Market Place vs Medicaid: What You Need to Know

Depending on your situation, the best health insurance option for you will vary. Here’s what you need to know about the health insurance market place vs Medicaid.

Fiorella Insurance Agency will help you figure out the right path to take for you and your family.

1. Medicaid is Considered Qualifying Coverage  

Though there is no longer a penalty for not having health insurance coverage, Medicaid is considered qualifying health coverage should you need to prove you have health insurance. Because it requires the minimum essential coverage, you can apply for a market place plan after your eligibility expires.

If you have a limited Medicaid policy, that does not count as qualifying coverage. That means, if you get pregnant, you may be able to apply for standard Medicaid coverage.

2. You Can Have Both Types of Plans at Once

If you already have a health insurance market place plan and you have recently become pregnant, you can still apply for Medicaid. There is no penalty or law against having health insurance coverage through both platforms.

Depending on the state you live in, you may qualify for Medicaid because you’re pregnant. It’s a good idea to fill out the application just in case.

3. You Cannot Receive Savings on Both

The only thing you need to watch out for with both a health insurance market place plan vs Medicaid plan is that you cannot receive a tax credit for the health insurance market place plan while you’re receiving Medicaid.

If you are receiving tax credits, you can cancel your plan and reapply after you’ve been approved for Medicaid. This will allow you to pay the full price for the market place plan.

4. Pregnancy is Fully Covered by Both Types of Coverage

Here’s the thing: The Affordable Care Act was designed to include pregnancy regardless of whether women go through the health insurance market place or Medicaid. With your health insurance market place plan, you may still have copays and deductibles.

Having both types of coverage isn’t necessarily going to put you in a financially better position. If you qualify for Medicaid, skip the market place plan and save that money for the baby.

Health Insurance Market Place vs Medicaid: Which to Choose

Deciding between the health insurance market place vs Medicaid doesn’t have to be a tough decision. Ultimately, you need to choose the plan that provides the most coverage with the least out-of-pocket cost to you.

Here are a few things to consider when choosing a health insurance market place vs Medicaid plan:

  • Minimum coverage: If you just need to cover pregnancy, Medicaid will suffice. But if you have ongoing health concerns that Medicaid may not cover, it may be wise to have the health insurance market place plan instead.
  • Out-of-pocket costs: Depending on your financial situation, are the out-of-pocket costs of going to a doctor for nine months going to be a burden? If so, you definitely want to consider applying for a Medicaid plan during your pregnancy.
  • Limitations: There are limitations to Medicaid and plans provided by the health insurance market place. Be sure you cover those fully to make sure any other conditions you have will be fully covered by the plan you choose.

These are the primary considerations when choosing between the health insurance market place and Medicaid. Carefully weigh your options as once you cancel a market place plan, you won’t qualify again until you have a special enrollment period.

Health Insurance Market Place vs Medicaid for a New Baby

Aside from figuring out health insurance for yourself, new moms also have to think about health insurance for their children. Fortunately, Medicaid and CHIP are available to children that live in households with qualifying income limits.

And once you have your baby, you’ll qualify for a special enrollment period. This means that, if you are using a health insurance market place plan, you’ll be able to apply and potentially save money by having a larger household.

Need help figuring out the best health insurance options for moms? Fiorella Insurance Agency will help you figure out the right path to take for you and your family.

Request a Free Health Insurance Quote

Find Affordable Health Insurance In Your Area.

1Zip Code
2Tell Us About You
3Your Contact Info
4Where Do You Live

Your Zip Code:

Leave a comment

Your email address will not be published.

Health Insurance

Get a Quick Quote Today

Speak to an Expert Licensed Insurance Agent Now. Only takes a few minutes.


9 am to 7 pm ET Mon - Fri.
9 am to 5 pm ET Sat.

About Fiorella

We will steadfastly pursue a work environment that fosters growth both on an individual and corporate level.

Our culture will support and inspire friendships, responsible work-life balances, positive attitudes and open communication.

Recent Posts

Health Insurance Tips

How to Choose a Health Insurance Plan in 3 Easy Steps

Without health coverage, medical emergencies can bankrupt you. You may feel fine today, but no one knows the future. If you and your family don’t currently have health insurance, you’ll need to find coverage during the upcoming open enrollment period (Nov. 1 to Dec. 15) or risk potential penalties from the federal government.

Read More »

The Insurance Blog

Subscribe to Our Blog and Receive Notifications About Insurance.

Tu Privacidad

Al enviar mi información, incluido mi número de teléfono y / o teléfono móvil y presionar en continuar, acepto la Política de Privacidad de este sitio y doy mi consentimiento para que Fiorella Insurance y / o sus Afiliados se comuniquen con nosotros de forma gratuita, cotizaciones de seguros sin obligación, y comunicación de seguimiento, incluyendo pero no limitado al seguro de salud, seguro de vivienda, seguro de salud y seguro de vida, así como a productos relacionados. Reconozco que estas compañías pueden llamar a través de un sistema de marcación automática, usar un mensaje pregrabado o enviar mensajes SMS. Reconozco y comprendo que no estoy obligado a proporcionar esta autorización para comprar bienes o servicios.

Haga click o toca para llamar:

(772) 283-0003

About your Privacy

By submitting my information, including my home and/or wireless number, and pressing Continue, I agree to this site’s Privacy Policy and consent to be contacted by Fiorella Insurance and/or its Affiliates for free, no obligation insurance quotes, and follow up communication, including but not limited to health insurance, homeowners insurance, Health insurance and Life Insurance, as well as related products. I acknowledge these companies may call via an automated dialing system, use a pre-recorded message or send SMS messages. I recognize and understand that I am not required to provide this authorization in order to purchase goods or services.

Click or touch to call:

(772) 283-0003

0 Shares 2.9K views
2.9K views 0 Shares
Share via
Copy link