(Closed) If pregnancy is a pre existing condition….

posted 6 years ago in Pregnancy
Post # 3
Member
1043 posts
Bumble bee
  • Wedding: November 2012

How exciting, congrats on your impending pregnancy.  πŸ™‚  I work in health benefits so I might be able to help.  In general, group insurance plans (those offered through an employer) do not have pre-existing conditions clauses.  It’s the individual market that has these clauses.

In a perfect world, you would wait to get pregnant until he officially finds a new job.  Many women actually get pregnant very soon after going off BCP.  However, if you don’t want to wait, another option would be for your FH to be sure that he asks this question after being offered a new job (i.e. ask about benefits and pre-exisiting conditions clauses BEFORE officially accepting the new job – I wouldn’t tell the potential employer about you being pregnant).  

 

Post # 4
Member
7904 posts
Bumble Beekeeper
  • Wedding: March 2012 - Pelican Grand Beach Resort

This will depend on your state laws. Here in Florida, insurance companies are required to cover the cost of your entire pregnancy through to the delivery if you were insured with them when you got pregnant, even if you change insureres or become uninsured because you are dropped from an employer’s provider. So if New York has a similar law, your husband’s current insurer will be responsible (assuming you have maternity coverage under that plan).

Post # 5
Member
7904 posts
Bumble Beekeeper
  • Wedding: March 2012 - Pelican Grand Beach Resort

Also, under HIPAA, group plans that cover maternity care cannot consider pregnancy a pre-existing condition. That’s federal law.

Post # 7
Member
10367 posts
Sugar Beekeeper
  • Wedding: September 2010

Obamacare makes insurance denial due to pre-existing conditions illegal, but i’m not sure if that clause has taken effect yet (the law is being rolled out over several years).

Pregnant women are also eligible for Medicaid, so if you have a gap you may want to look into that.

Post # 8
Member
1043 posts
Bumble bee
  • Wedding: November 2012

Unfortunately, or rather – fortunately – if her husband makes six figures, she won’t qualify for Medicaid.  And the Health Care Reform pre-existing conditions clause for ALL plans isn’t set to go into effect until 2014 (except for children), when the individual mandate was set to go into effect.  However, as we all know, the Supreme Court is voting in this right now and all signs point to some sort of disruption if not total elimination of those 2014 clauses.  

But @mrsSonthebeach: is right about HIPAA, that will protect almost all large-group plans from having pre-existing conditions clauses.  Just be careful to double check, because your FH may not work for a large group, he may end up at a small company where all the rules are different.  And I’m not a small-group expert…  πŸ™‚

Post # 9
Member
10288 posts
Sugar Beekeeper
  • Wedding: October 2011

I can only speak for my policy but the insurance plan that DH and I have through my company does not cover preexisting conditions, which includes pregnancy. I was surprised to hear this when I first started and had to enroll in my benefit package. Now, it has been 5 years since I initially enrolled so I guess things could be different now but I doubt they are. 

Post # 10
Member
4194 posts
Honey bee
  • Wedding: July 2012 - Baltimore Museum of Industry

It may be worth getting an individual plan- especially since you’re going to be without health insurance when you leave your job. I’d had an individual plan three times through BlueCross BlueShield, and they’ve been pretty good. You can get insurance that has maternity coverage-made sure that mine did.

 

Post # 11
Member
3175 posts
Sugar bee
  • Wedding: May 2012

I seem to remember that the rule is that, generally, for group plans (i.e. those through employers), you will be covered for many pre-existing conditions (pregnancy included) as long as you have had coverage previously (i.e. you had coverage for at least 12 months on another plan, and the gap between coverage does not exceed 60 days).

Post # 12
Member
1513 posts
Bumble bee
  • Wedding: June 2013

@mrsSonthebeach:  thats what i was going to say, so i would say, yeah, your good!

Post # 13
Member
996 posts
Busy bee
  • Wedding: August 2012

@crayfish:  that only means they can’t deny to insure you because of the pre-existing condition–they can stll deny paying for treatment for that condition–for the 1st 6 months

Post # 15
Member
1043 posts
Bumble bee
  • Wedding: November 2012

I think it’s pretty awesome that you can throw out a question like this, and get opinions and responses from women all over the country.  πŸ™‚  The Bees are so helpful!!

Post # 16
Member
1252 posts
Bumble bee
  • Wedding: November 2011

I think that HIPPA prohibits exclusions in the case of continuous coverage & pregnancy.  You should confirm that, but I don’t think that in your case this could be excluded as a preexisting condition under the current Federal Law.

The topic ‘If pregnancy is a pre existing condition….’ is closed to new replies.

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