My Dh's employeer just added me to the account in November, and said there would be "no problem" adding me at any time. Now I call Kaiser, and I can only be added during open enrollment, in August. Period. No ifs ands or buts.
Not only have we been paying $100 a paycheck x 4 checks now for my insurance, I just found out YESTERDAY that I'm pregnant! Re-tested today, the line is slightly darker, its pretty clear that yes indeedy I am pregnant.
We would have enrolled in August if we knew! If Dh's boss hadn't told us we could enroll ANYTIME, no problemo. I have NO idea what we're going to do now! Yes, I was hoping for a midwife, if we had the $, but having insurance to back up any problems is critically important to us!
Dh is contacting the person who does the medical stuff, so hopefully they can help in SOME way... its a small business, and they don't really have a handle on the whole insurance thing, gave us the wrong paperwork a couple of times, but this is a HUGE screw-up! For Pete's sake, I'll be due in September, I can't hold off on insurance til August! Arggggggg! Thanks for letting me vent.... Hope this situation gets better...
Warm Squishy Feelings...
We actually had this problem when dh quit his job to start his own biz and work from home.. The HR dept at his old work didnt get the paper work right, and the insurance co was denying our COBRA benefits.. I had to call the insurance carrier to see what the prob was then call the HR lady, then have the HR lady call the insurance carrier.. IT was a pain in the @ss, but we did get our coverage continued until we had found insurance we were confortable with and discontinued it...
Warm Squishy Feelings...
I had a similar scary insurance experience at the beginning of a pregnancy that ended in miscarriage a year ago. I enrolled in a plan the day I found out, and then we switched to DH's work plan a few months later when we were eligible. That way we had no lapse of coverage, and the pregnancy wasn't considered a "pre-existing condition". It made my dates a little off, but my midwife was willing to work with me on it.
Good luck...try and breathe easy!
Went through something similar. I was on independant insurance through BCBS. No maternity coverage. Wasn't planning on having another! Well. stupid us....
On independant insurance there is NO WAY to add maternity coverage once you ARE pregnant. My DH's plan has maternity coverage no matter what, but we'd gotten me and DD off that to save $. (Hard to believe that individual would have been cheaper than group, but...) Any way, we missed open enrollment which was in Sept. Thought we were screwed. There are laws that prevent pregnancy from being a pre-exisitng condition. If you can get around open enrollment, they might not be able to shut you out unless they have a seedy loophole. When my DH talked to the benefits counselor, (and was totally honest as to our situation) at his employer, he was told that if we had a "qualifying event" we could enroll anytime outside of open enrollment, and that we'd be ok. What we did was 'close my business' which wasn't really a big deal, I was headed that way anyhow. The thing that I was skeptical about was that anyone could have gotten this insurance, it wasn't just because I had my own business. If you can fabricate some way to have a 'qualifying event,' whatever that means to your insurerer, maybe you'll be in luck too. Ironically, this group plan is with BCBS too!
By the way, the uncomplicated "normal" hospital birth would have cost us about $8500 out of pocket without insurance, yet the uncomplicated "normal" birth center/MW birth would have been about $4200 out of pocket without insurance. SO I KNOW WHAT YOU'RE FEELING! I hope so much that the benefits people can fix their hideous mistake!!!
|I know this is a bit sneaky, but can you quickly enroll in your own personal plan, and then "find out" you're pregnant in a few weeks, once you're enrolled?|
But you know what? I know that somehow this all is going to work out. I'm nervous and churning the brain, but I have faith that this is all somehow going to get worked out. If I had checked into our insurance, we would have had to stop TTC, and I DID mean to check into it all last month. There was a *reason* I didn't find out... this little life growing in me is meant to be. Right now, not in August after I'm comfortable. We will somehow, someway, do this. Course, Dh is not going to be thinking this way... He's already freaking out at work... and I *am* still worried myself, so don't let this whole 'it'll be ok' speech make anyone think i'm not!
After 4 m/c, our is here!
He suggested the following, in addition to working through the company's HR folks:
1. Have you had a qualified family status change, which entitles you to enroll within 30 days regardless of when open enrollment is? These changes include loss of other coverage or a significant change in the cost of other coverage.
2. Use the formal appeal process provided by the employer. Make sure to document all misinformation, providing copies of any inaccurate documents and summarizing conversations in which bad information was provided.
Unfourtuantaly we don't meet and of the requirements to get in with a status change...
I just wanted to add that in CA insurers cannot deny your pregnancy as a preexisting condition as long as it is through work (the personal advantage can, but not your hubby's plan). Worst case scenario, you will be covered in August for the Sept. birth. At least that's one thing you won't have to worry about.
|Originally posted by Lisa_Lynn
Only problem would be I wouldn't have coverage til Feb 1st, by which time I'll be 5 and a half weeks pregnant, and I doubt I could get them to buy I didn't know that...
you never know. they wouldn't even THINK of seeing me in the dr's office until I was at least 6 weeks pg (with a clinical test) and 8 wks pg with a home test.
If all else fails, you should be able to get benefits through the state (in WA all pregnant women qualify for state medical) although I am not sure if DH's income would be enough to disqualify you... ?
You'll find a way. Ooooh, September baby!
Unless you are having problems, there is no reason for you to be seen until February anyhow. Take a good prenatal, eat healthily, get enough rest, and enjoy the beginning of your pregnancy!
I would encourage you to "not remember" when your last period was (especially with a history of irregular periods) and slide yourself in. You should not be punished for being on the ball and for company mistakes.....
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