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Is Pregnancy Considered a Pre-Existing Condition?
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Anonymous
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We are planning to try for DC #2 in late fall 2011. The baby wouldn't be born until sometime in 2012, if all goes as planned (ha). For non-maternity items, we really like our insurance, but we would likely want to switch for the time period of most of my pre-natal care and the birth, because we were not happy with their pre-natal/birth coverage last time.
Would it be possible to do this if I'm a couple months pregnant during open season 2011, or is pregnancy considered a pre-existing condition of some sort? |
Anonymous
| I started a new jobs while pregnant with my first and third child and neither time did I have problems with getting on the company insurance. This was years ago so things may have changed. |
Anonymous
| You can switch. |
Anonymous
| I'm not sure this has a simple answer. When I was looking to pick up an insurance policy as an individual, most insurers had rules about pregnancy. The most common restriction was that they would not cover any maternity care for a pregnancy that started less than 6 months before the policy went into affect. I know that when you start a new job, a pregnancy cannot be considered pre-existing, by law. You don't fall directly into either above category, so I would call and ask the insurer directly and ask for whatever they tell you in writing to back it up. |
Anonymous
| If you're talking about switching into a different group policy during open enrollment then you are fine. Individual insurance is different. |
Anonymous
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OP,
What 7:57 said. If it's individual, you may not get coverage. |
Anonymous
| under HIPAA, pregnancy can NEVER be a pre existing condition. |
Anonymous
. It can be if the plan is state sponsored/run. |
Anonymous
This is my understanding as well. |
Anonymous
Yes. I did this at 36 weeks because our insurer upped our deductibles, co-pays, hospital admission etc. I asked the new insurer about five times if I would be covered and they said yes. And I was. |
Anonymous
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It might depend on the state, but in VA, if you have had no lapse in insurance coverage, it is definitely not considered a pre-existing condition when you switch to another group plan. I know this because I got laid off from a job, got a cheap, basic individual policy to get me through to the next job, and then got pregnant, so I was about 5 months pregnant when I was eligible for insurance at my new job. No problems whatsoever.
if you were to buy an individual policy, the kind that involves blood tests and weigh-ins and all that, then yes, it would probably affect your rate and ability to get a policy. |
Anonymous
| Wasn't that one of the provisions in the new health care law -- that an insurer can't deny coverage for pre-exisiting conditions? |
Anonymous
Yes but I believe it doesn't take effect until 2014. |
Anonymous
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I'm not sure if this is directly on point, but I got burned by it, so I'm passing on the info. For short term disability insurance, you will not be covered for childbirth if your policy became effective in the nine motnhs prior to the birth. Essentially, pregnancy is a pre-existing condition that disqualifies you for childbirth benefits through short term disability.
As far as I know this is true of all policies. (And really makes perfect sense when you think about it.) |
Anonymous
yeah, I don't think that'll help OP in time. But OP's situation (where she is putting off switching to a plan w/ great prenatal/OB coverage until she's actually pregnant when she could presumably switch now instead) underscores why so many insurance companies have tried to do all they can to discourage this. |