Is pregnancy a "pre-existing condition"??? - Mothering Forums

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Old 08-19-2010, 02:01 PM - Thread Starter
 
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I was just reading that "pregnant with no maternity coverage" and it got me wondering..... is pregnancy generally considered pre-existing? So if you're pregnant before you get on the insurance they won't cover it? Is there generally a waiting period before you can get pregnant and have it covered?

I never even thought about all of that. Currently I have no insurance. When dp and I get married in January I will be on his (Humana).

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Old 08-19-2010, 02:20 PM
 
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If he's on group insurance through his job, it should be fine. If it's personal insurance, you may have a problem. We actually couldn't get anything but state insurance for our family because of my pregnancy, the companies wouldn't insure anyone in the family because of me.

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Old 08-19-2010, 02:20 PM
 
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I'm pretty sure there's a law stating that insurance companies can't use pregnancy as a pre-existing condition...

~Brandon Michael (11/23/03), Jocelyn Lily Nữ (2/4/07, adopted 5/28/07 from Vietnam), Amelia Rylie (1/14/09), & Ryland Josef William (9/7/05-9/7/05 @ 41 wks). 
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Old 08-19-2010, 02:22 PM
 
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Here you go....apparently federal law prohibits insurance companies from claiming pregnancy as a pre-existing condition, but hippa regulations become the loophole...

http://www.ivillage.com/pregnant-wit...age/6-n-145593

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Old 08-19-2010, 02:27 PM
 
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When I filled out my insurance paperwork for a new job, it specifically asked if I was pregnant and my due date, and I answered as appropriate. A week or two later, I received a letter from the insurance company (Anthem BC/BS in this case) stating that my preexisting conditions would not be covered until the waiting period had lapsed. At the bottom of the letter, it listed "pregnancy" and then an effective coverage date of two months past the due date I had provided.

But... they paid the claims (well, they paid once I finally hit my deductible, which took the whole of my pregnancy). So I'm really not sure what happened there, but it definitely freaked me out, thinking that I was going to have to foot the bill for all the prenatal and hospital care!

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Old 08-19-2010, 02:31 PM - Thread Starter
 
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If he's on group insurance through his job, it should be fine.
Yes, he is on group insurance through his work.

Allison- a quote from that link

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So if you had no insurance, got pregnant, then landed a new job with insurance, your new health plan would not have to immediately cover your pregnancy. You might have to sit out a preexisting condition waiting period, a period that could be longer than your pregnancy and in the meantime pay for your visits yourself.
Obviously it wouldn't be me getting a new job and getting insurance but it's basically the same- I have no insurance and then will go on DP's current insurance. So.... does that mean it wouldn't cover me? Hmmmm....

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Old 08-19-2010, 02:31 PM
 
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Hopefully this has changed by now- but in 2005 when I was pregnant with DD, I just came off my moms insurance because I graduated college, and had not yet gotten married, so I was stuck. NOBODY would cover me. I had to go on Medicaid, which I didn't need financially, but thankfully I qualified for it- I went off it once I was not pregnant anymore, but what a hassle. Too bad I didn't have a homebirth with my first- problem would have been solved, lol.

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Old 08-19-2010, 02:33 PM
 
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Obviously it wouldn't be me getting a new job and getting insurance but it's basically the same- I have no insurance and then will go on DP's current insurance. So.... does that mean it wouldn't cover me? Hmmmm....
LOL...is this still hypothetical?

~Brandon Michael (11/23/03), Jocelyn Lily Nữ (2/4/07, adopted 5/28/07 from Vietnam), Amelia Rylie (1/14/09), & Ryland Josef William (9/7/05-9/7/05 @ 41 wks). 
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Old 08-19-2010, 02:35 PM - Thread Starter
 
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LOL...is this still hypothetical?
Yes, yes it is We are discussing our options

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Old 08-19-2010, 02:39 PM
 
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Just to clarify, HIPPA is the law that says pregnancy cannot be considered a preexisting condition, but it only applies in limited circumstances, mainly if you are moving from one insurance to another. It doesn't apply if you had no insurance and get insurance (even group insurance), and it doesn't apply to personal insurance. You need to check to see if your husband's insurance has a waiting period for pre-existing conditions and what it is.

Under Obama's Affordable Care Act, this will change. Starting in 2014, new individual plans and all job-based plans won’t be allowed to turn anybody down or charge them a higher premium because of pregnancy or other health conditions. Until then, they started a program called Pre-existing Condition Insurance that may be of help to you. You can read more here.
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Old 08-19-2010, 02:55 PM
 
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Just to clarify, HIPPA is the law that says pregnancy cannot be considered a preexisting condition, but it only applies in limited circumstances, mainly if you are moving from one insurance to another. It doesn't apply if you had no insurance and get insurance (even group insurance), and it doesn't apply to personal insurance. You need to check to see if your husband's insurance has a waiting period for pre-existing conditions and what it is.

.[/URL]
Exactly. It all depends if that insurance policy has a waiting period.

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Old 08-19-2010, 03:12 PM
 
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When I was pregnant we had no insurance and went on state insurance. DH got insurance through his new job (BCBS insurance) when I was about 6 months pregnant. They covered the pregnancy with no problems.

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Old 08-19-2010, 05:02 PM
 
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It is usually excluded from individual policies. Group policies usually do not have a waiting requirement.
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Old 08-19-2010, 07:27 PM - Thread Starter
 
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Okay, dp called his insurance company and talked to them and for once we got great news from them! We've been butting heads with them a lot lately (over ds's therapy) so this was a welcome relief! They said that the plan dp is on has NO pre-existing clause (which explains why it costs so freaking much). So it shouldn't be a problem at all if I were to be pregnant before I got on the insurance.

Steph, DH Jason (1-1-11), DS Owen (10-3-03) and DS Kai (10-13-11)

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Old 08-19-2010, 07:58 PM
 
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Congratulations Steph!

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Old 08-19-2010, 08:17 PM
 
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Congratulations! That is amazing!

My dp's insurance would not cover me because the pregnancy was a "pre-existing condition" and I did not qualify for insurance through my company until right before I left... so the only insurance we could get was Medicaid and I only qualified for that because DP and I are not married.

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Old 08-19-2010, 10:21 PM
 
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LOL...is this still hypothetical?
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Yes, yes it is We are discussing our options
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Old 08-19-2010, 10:43 PM - Thread Starter
 
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LOL! Ally was the first one I told when I found out I was pregnant with my son (well, ex was the first one- Ally was the second).

But no, not pregnant yet DP and I have been discussing if/when and various scenarios. I wouldn't mind trying for December (we are getting married January 1st) but didn't want insurance to refuse to pay for any pregnancy/delivery stuff. I don't think we want to try in the next couple months because I want to enjoy our wedding/honeymoon without a belly and/or morning sickness But if we were to try in December I would be able to test right around Christmas (maybe 2-3 days before Christmas) so I would only be like 5-ish weeks pregnant during our wedding/honeymoon.

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Old 08-20-2010, 05:34 PM
 
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Uh, I was puking like crazy at 5ish weeks pregnant. Might want to wait for the honeymoon to try. LOL!

~Brandon Michael (11/23/03), Jocelyn Lily Nữ (2/4/07, adopted 5/28/07 from Vietnam), Amelia Rylie (1/14/09), & Ryland Josef William (9/7/05-9/7/05 @ 41 wks). 
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Old 08-26-2010, 09:01 PM - Thread Starter
 
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LOL.... I had no morning sickness with Owen I'm bragging now but it'll probably come back and bite me in the butt some day

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Old 08-27-2010, 01:03 AM
 
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Yeah, it might. I had hyperemesis for the first 26 weeks with Brandon, practically no morning sickness with Ryland, and moderate morning sickness for the entire pregnancy with Amelia--not nearly bad enough to be hyperemesis but annoying. So, you never know. :

~Brandon Michael (11/23/03), Jocelyn Lily Nữ (2/4/07, adopted 5/28/07 from Vietnam), Amelia Rylie (1/14/09), & Ryland Josef William (9/7/05-9/7/05 @ 41 wks). 
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Old 08-28-2010, 08:36 PM
 
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Glad you got it sorted out, and I third the waiting until the honeymoon... I was pregnant on two excursions - one was our honeymoon, second was in Venice (using the vaporettos to get around). I wouldn't recommend it. Plus a honeymoon baby is just such a cute story.

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Old 08-28-2010, 10:43 PM
 
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If he's on group insurance through his job, it should be fine.
Both of the jobs where I had insurance required a 6-month waiting period before they would cover pregnancy and maternity-related expenses.

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Old 08-28-2010, 11:36 PM
 
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Plus a honeymoon baby is just such a cute story.
I agree!!!! It's not that far off the December date (what, 5 weeks?) So hold out and go to town!! That's what the honeymoon is for

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Old 08-28-2010, 11:49 PM
 
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If he's on group insurance through his job, it should be fine. If it's personal insurance, you may have a problem. We actually couldn't get anything but state insurance for our family because of my pregnancy, the companies wouldn't insure anyone in the family because of me.
This has been my experience.

Holy wow, was I fuming mad when I found out nobody in my family could get insurance because I was pregnant. Absolutely ridiculous! We couldn't even upgrade our current insurance plan, which is why we wanted to switch.

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Old 09-02-2010, 05:56 PM - Thread Starter
 
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I third the waiting until the honeymoon
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I agree!!!! It's not that far off the December date (what, 5 weeks?) So hold out and go to town!! That's what the honeymoon is for
I just saw these comments and have to laugh. If I had to be picky I would say January is the one month out of 12 that I wouldn't want to get pregnant. LOL! My ds was conceived in January and his birthday is October 3rd. Another baby conceived at that time would likely be due around the same time. Since ds is an only child and if we have another one that will likely be it I don't really want both the birthdays right next to each other. But.... that's me being picky and if I happened to get pregnant on our honeymoon I certainly wouldn't be upset about it

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