Amazing expirience! The agent is very professional and friendly. Definitely recommend!!
Health Insurance for Pregnancy in Florida: Coverage Before and After Baby
Help with coverage for prenatal care, delivery and your baby’s first months. Call or text 813-302-7151.
On this page
Contact us
Phone and WhatsApp
813-302-7151
Email
Rguzman@coveredbyguzman.com
7 months ago
Excellent service and very professional staff. They made the process easy, answered all my questions, and helped me find the right coverage. Highly recommended!
3 months ago
I’ve worked with Ray for years and he’s always reliable and has been able to help my clients in need! I can always count on him to provide the best insurance advice and service
7 months ago
Great service, and always looking out for my commercial insurance. Thank you Ray
3 months ago
Great insurance agent to work with. Ray is the best!
3 months ago
Reviews reflect individual customer opinions and experiences. They do not guarantee specific coverage, pricing, service timing, or claim outcomes.
If you are pregnant or planning a pregnancy in Florida, you have two main paths: a Marketplace plan or Florida Medicaid for pregnant women, which has much higher income limits than Medicaid for most other adults. Whichever you use, check the whole care team: your OB-GYN, the delivery hospital, any specialists and the baby’s doctor after birth. Maternity care being covered does not make every provider in network or every service free.
What ACA-compliant health plans cover for maternity care
Marketplace plans cover pregnancy, childbirth and newborn care, even if you were already pregnant when the coverage started. Each plan still sets its own network, deductible, copays and coinsurance. Ask which prenatal visits count as preventive care and which ones you pay part of. A “maternity package” price from a doctor’s office usually does not include the hospital or other clinicians’ bills. See HealthCare.gov: coverage if you are pregnant.
Pregnancy, Open Enrollment and Special Enrollment rules
In Florida, pregnancy by itself does not open a Marketplace Special Enrollment Period. Another life event, such as losing job coverage or getting married, can, and the birth opens its own 60-day window. Otherwise, you enroll during Open Enrollment: for 2027 coverage it starts November 1, 2026, and you must enroll by December 15 for coverage that starts January 1 (check HealthCare.gov for the final end date).
Medicaid is different. You can apply for Florida Medicaid for pregnant women at any time of year.
Florida Medicaid for pregnant women: income limits
Florida Medicaid covers pregnant women with monthly household income up to the amounts below, for example $2,608 a month for a household of one. These limits are from Florida DCF’s chart effective April 2026 to March 2027:
| Household size | Monthly income limit |
|---|---|
| 1 | $2,608 |
| 2 | $3,537 |
| 3 | $4,463 |
| 4 | $5,391 |
| 5 | $6,320 |
| 6 | $7,246 |
Source: Florida DCF Medicaid income limits, April 2026. We update this page when the new figures are published.
Once you qualify, coverage lasts through the pregnancy and for 12 months after the birth. In DCF’s words, a pregnant woman “remains eligible throughout her pregnancy and for a 12-month post-partum period, regardless of any change in income.” DCF decides eligibility; apply through Florida DCF: help for expecting mothers.
Checking your OB-GYN, hospital and specialists
Check that your OB-GYN’s office location and the hospital where you plan to deliver are in network for the exact plan. If your pregnancy is high risk, check maternal-fetal medicine specialists and the right hospital too. Include labs, imaging and the pediatrician. Ask what happens if a different doctor delivers the baby; your doctor’s recommendation alone does not confirm the network.
Deductibles, coinsurance and the out-of-pocket maximum
Ask for a cost estimate for prenatal visits, delivery and the hospital stay, then compare it with the plan’s deductible and coinsurance. Every Marketplace plan has a yearly out-of-pocket maximum, the most you pay for covered in-network care, not counting premiums:
| Year | Individual | Family |
|---|---|---|
| 2026 | $10,600 | $21,200 |
| 2027 | $12,000 | $24,000 |
Source: HealthCare.gov: out-of-pocket maximum. Many plans set a lower limit. The baby’s bills can count separately from the mother’s, and if the pregnancy crosses into a new plan year, the deductible and out-of-pocket totals start over.
After birth: adding the newborn to coverage
Report the birth and enroll the baby right away. On the Marketplace you have 60 days, and the baby’s coverage can start on the day of birth. Employer plans must give at least 30 days, and many set a short deadline, so call the benefits office within days. The hospital does not enroll the baby for you. Our newborn guide has the steps.
Medicaid and Florida KidCare referrals
We don’t file Medicaid or KidCare applications, but we can tell you where to go. For pregnancy coverage, apply with Florida DCF. For the baby and older children, Florida KidCare’s 2026 chart shows Medicaid with no premium for families up to 133% of the poverty level and $15 or $20 a month per family up to 200%. The state or program decides eligibility. Confirm the start date of any new coverage before you remove anyone from a current plan.
What to compare before choosing a plan
Tell us your due date, your current coverage, your preferred OB-GYN and hospital, and whether you expect to lose any insurance soon. We compare the plans and enrollment dates available to you, and we will tell you if your income looks close to the Medicaid limits so you can apply there. If you are thinking about switching plans during pregnancy, check that your doctors and approvals carry over first.
Official resources: HealthCare.gov: preventive care benefits; Florida KidCare 2026 income guidelines.
Frequently Asked Questions
Can I enroll just because I am pregnant?
Not on the Marketplace. Pregnancy alone is not a qualifying event in Florida, so you need Open Enrollment or another life event. You can apply for Florida Medicaid for pregnant women at any time.
What is the income limit for pregnancy Medicaid in Florida?
It depends on household size. Under Florida DCF’s chart for April 2026 to March 2027, the limit is $2,608 a month for a household of one, $3,537 for two and $4,463 for three.
How long does pregnancy Medicaid last after the baby is born?
12 months. Once you qualify, Florida Medicaid covers you through the pregnancy and for 12 months after the birth, even if your income changes.
Can a Marketplace plan exclude an existing pregnancy?
No. Marketplace plans cannot treat pregnancy as a pre-existing condition, but the normal enrollment windows and start dates still apply.
Does the maternity benefit include the baby's enrollment?
No. You must enroll the baby separately: within 60 days on the Marketplace, or by the employer plan’s deadline, which must be at least 30 days.
Will all delivery bills use one deductible?
Not always. The mother’s and the baby’s bills can count separately, and a new plan year resets the deductible. For 2026, the most any Marketplace plan can make you pay in network is $10,600 for one person.
Who handles a pregnancy Medicaid application?
Florida DCF does. You apply with DCF, and DCF decides eligibility. We can point you to the right place and help the rest of the family with Marketplace coverage.
This guide is general information, not legal, tax or medical advice. Your plan documents, including the Summary of Benefits and Coverage, control what is covered and what you pay.
About the Author
Raymundo Guzman
I am Raymundo Guzman, a licensed independent insurance agent and the owner of Covered by Guzman. On the health side, I help Florida individuals, families and small businesses compare ACA Marketplace plans, Medicare Advantage and Part D, and dental and vision coverage, checking doctors and medications before anything is submitted. I work in English and Spanish, and a member of our team speaks Arabic. We usually meet by phone or video, and I stay available after enrollment.
Independent Insurance Agent · License #W512374 | NPN #18906048 · 813-302-7151
Talk to a licensed agent
Let's talk
Review your options with a licensed agent
Send your county, household, doctors and medications and we will check the plans available to you. Call or text 813-302-7151.
