Anyone out there that understands insurance...

sydsmom04

Okay so DH will be eligible to sign up for insurance in a couple of days. I was going through the information booklet and it says that maternity is included 100% covered. Umm first of all WOW. Second, does this mean that if he signs up for family coverage that it would cover me when I get pregnant? Or is that just for the primary member? 

I hate insurance. It gives me a headache.

TIA! 

Mrs.Slick

You would need to be on the plan to be covered. 

sydsmom04

Mrs.Slick:

You would need to be on the plan to be covered. 

 

So if he gets the employee/family (which includes spouse and children) my maternity visits and hospital would be covered? 

LLS1215

From what it sounds like yes unless you have a deductible or copayment. Also many insurance carriers will not cover maternity for someone who is already pregnant so just make sure you get the insurance before you get a BFP.

KdgTeacher

sydsmom04:

Mrs.Slick:

You would need to be on the plan to be covered. 

 

So if he gets the employee/family (which includes spouse and children) my maternity visits and hospital would be covered? 

Are you his spouse?

eatdrinkstretch

Everyone on the family plan has the same coverage - the employee does not get better coverage than the spouse.

KdgTeacher

LLS1215:

From what it sounds like yes unless you have a deductible or copayment. Also many insurance carriers will not cover maternity for someone who is already pregnant so just make sure you get the insurance before you get a BFP.

Unless you have a gap (over 30/60 days I think) this is generally not a problem to continue being covered. 

Mrs.Slick

sydsmom04:

Mrs.Slick:

You would need to be on the plan to be covered. 

 

So if he gets the employee/family (which includes spouse and children) my maternity visits and hospital would be covered? 

According to what you have explained here, yes. As long as he names you on the paperwork and signs you up, then you'll be covered. However, I would still have him call someone in his hr department who deals with insurance to find out specifically if you're concerned.  

sydsmom04

LOL yes. And now I realize how silly this question was. I have just had a lot of mis-understandings in the world of insurance and thought one thing, but ended up that wasn't the case.

 ETA: this was supposed to quote KDG but I failed. 

sydsmom04

KdgTeacher:

LLS1215:

From what it sounds like yes unless you have a deductible or copayment. Also many insurance carriers will not cover maternity for someone who is already pregnant so just make sure you get the insurance before you get a BFP.

Unless you have a gap (over 30/60 days I think) this is generally not a problem to continue being covered. 

I am still covered under my insurance, but his is going to be soooo much better. 

Switzerland87

As PP said, as long as you're on the plan with him, you should be receiving exactly the same coverage as your DH is. Also, you shouldn't need family coverage, just spouse coverage, unless you already have children. You should be able to add your baby after it's born. 

sydsmom04

Thanks ladies! You all have been super helpful!

qt030603

GhostMonkey:

Switzerland87:

As PP said, as long as you're on the plan with him, you should be receiving exactly the same coverage as your DH is. Also, you shouldn't need family coverage, just spouse coverage, unless you already have children. You should be able to add your baby after it's born. 

Some plans make no difference between adding a spouse and adding a spouse and 8 kids.

The only issue I can see is having to pay for two plans, you have to keep both after the baby is born - you can't drop off his (or drop yours) until one of you has a change in employment that alters your existing coverage until you hit open season again, so you may want to do some number crunching to see if you are even going to come out ahead. If you have to pay more once baby is born, that may be a huge deal breaker and be good reason not to have it if yours covers maternity, just not as well as his.

 

I'm not sure if this is different in other states, but in PA you can drop your insurance to go on H insurance. All you would have to do is get on H insurance and go to your employer and be taken off yours. Check with your hr department about how to go about doing that.

qt030603

GhostMonkey:

qt030603:

GhostMonkey:

Switzerland87:

As PP said, as long as you're on the plan with him, you should be receiving exactly the same coverage as your DH is. Also, you shouldn't need family coverage, just spouse coverage, unless you already have children. You should be able to add your baby after it's born. 

Some plans make no difference between adding a spouse and adding a spouse and 8 kids.

The only issue I can see is having to pay for two plans, you have to keep both after the baby is born - you can't drop off his (or drop yours) until one of you has a change in employment that alters your existing coverage until you hit open season again, so you may want to do some number crunching to see if you are even going to come out ahead. If you have to pay more once baby is born, that may be a huge deal breaker and be good reason not to have it if yours covers maternity, just not as well as his.

 

I'm not sure if this is different in other states, but in PA you can drop your insurance to go on H insurance. All you would have to do is get on H insurance and go to your employer and be taken off yours. Check with your hr department about how to go about doing that.

Yeah, you can't. I thought that too because having a child is a qualifying life event. It qualifies you to add the child- not make other changes. Common misconception.

You can do it during open season, sure. But between open seasons? No.

 

I'm thinking perhaps this is different depending on where you live. The only reason I know my statement to be true is a couple girls at work just did it. Their H recently got insurance and both got off our crappy medical and onto their H. Our open enrollment is Jan. As far as adding someone to your insurance it would need to be open enrollment (which it was for both of their H). A paper was filled out with our HR dept and they each showed proof of their H putting them on his plan.

 

PenelopePond

If you have your own insurance, you'll have to make sure your insurance and your DH's insurance coordinate. Just because you have both doesn't mean they'll work together. One will be primary insurance and the other will be secondary.

holly321

Your maternity coverage being covered 100% most likely means your ob appts and u/s are covered.  Not necessarily the hospital stay.