Advice on Insurance Issue
PSUBecky23
member
Another good first world problem to have: My husband and I got married last year. Since we both had insurance through our employers (he pays a percentage of each paycheck and I don't pay anything) we decided to just stick with our own plans. Along comes baby and after weighing the pros and cons, we've decided I need to go on his plan because he has a PPO and I have a high deductible plan. We are now getting the run around by the idiots in his HR department. We submitted the paperwork because we were told that a change in condition (like marriage) meant immediate coverage. Then, we were told it could not be submitted until open enrollment in November and then I wouldn't be covered until the new insurance year in January. Regardless, I have insurance and I'll be on his insurance prior to the baby coming. However, I'd like to go on now because of the better coverage. My first thought is that my husband should contact his insurance company personally to see if it can be sorted out on that end. And if that doesn't work, he should get his union involved. His union contract essentially says "all employees and their dependents will be covered by the group health plan" or something along those lines. Any advice for a plan of attack or anyone dealt with anything similar?
And please don't tell me I'm not going to be covered because I'm pregnant and that's a pre-existing condition. That's not true.
Re: Advice on Insurance Issue
You need a life changing event to become eligible (e.g. marriage, lose of job/insurance, etc.) Also, you have to elect coverage within 30 days of the life event happening. I am 99.99% sure that "becoming pregnant" is NOT a life event. Definitely call your DH's insurance to check. If the new plan year starts 1/1/13 that's at least soon!
ETA: spelling
I have a PPO now and I miss my high deductible plan. Are you sure that the PPO is better after you weigh everything?
HD: For me I paid $160 per paycheck into my health savings account (for 2 people). My employer deposited $1200 per year and paid the premiums. I paid for each appt after the insurance discounts were applied out of the HSA. I also paid for prescriptions, glasses, and dental work out of the HSA. I never paid any money out of pocket and I had a baby. I still have $2000+ in my HSA after leaving there a year ago.
Now with PPO: I pay $280+ per paycheck for premiums (for 3 people), plus $20-$100+ per appointment for deductibles, plus a 10% copay on services/labs/hospital charges, plus I pay deductibles on prescriptions, and I have to guess on my flex account how much I will end up with out of pocket each year.
Being in HR myself I am sorry to hear they did not communicate this! It's very fundamental in out field.
Makes me mad when people assume others should know something so they don't communicate it; like leaving a person a voicemail but no return #.. not helpful! Just because its "common sense" for me does not mean others know too. Like I don't know how to build a car engine but a mechanic does, so it would not helpful for a mechanic to say just screw the top knob to the lower valve.. huh?. Lol sorry for my rant of the day!
Baby on Board - My Blog
This is SO important. Pack the form in your hospital bag, so that the Dr can just get it submitted for you.
I'm surprised they said that pregnancy would be covered if you switched now - or before baby.
I was explicitly told that I had to wait 9 months (After being added to his plan) before I got pregnant in order for them to cover pregnancy on my husbands plan.
I would call them to double check.
NOT your husband's HR - his insurance.
Usually the employee's company knows nothing about it, but if you contact the insurance company themselves, they have what they call a 'trial-period' or waiting period before certain things are covered.....
Honestly if you don't have to pay I would stay on both plans. Many times secondary ins will help pay copays and deductibles that primary ins does not.
ETA I should have read all the replies before posting cause I just repeated what the lovely ladies already told you.
you will need to confirm if you are able to get on your hubby's insurance even though you are pregnant. i know obamacare covers preexisting conditions, but i think there are some caveats to that.
also see if your hubby's hr department needs your baby's info prior to you giving birth. there are some insurances that won't cover newborn care if there is not record of you adding it. my hr rep informed me it's best to do it no later than 30 days before your est. delivery date.