- Pregnancy
- Baby & Toddler
- Parents
- Getting Pregnant
- Baby Names
- Product Reviews
-
Registry
- Community
-
More
Want a personalized experience?
Download the free app
2nd Trimester
Weird insurance situation-thoughts? Suggestions? Ideas?
EDD is April 11th. DH was laid off just prior to our BFP, and it was his insurance we were using. Since that new COBRA subsidy was in place, it made sense for us to keep COBRA for as long as possible...it is costing us way less than any policy we could buy on our own.
So, that means that when LO is born, we'll be paying the higher COBRA amount (no more subsidy after 9 months, which means the government stops paying 65% of the COBRA cost). We figured it's worth keeping the COBRA, even at the higher amount, because I don't want to change insurances just before or just after LO is born. I THINK the higher rate will kick in just about the same month or a month before LO is born.
So, here are the thoughts running through my mind and, since I know very little about how insurance works, I thought maybe someone here might know or have some thoughts:
-Will we be able to add LO onto a COBRA policy (even if it means paying more $)?
-If we can't add LO to COBRA, can we get a policy JUST for LO somewhere (even though there's no 'applicant info' yet) until we can consolidate the two policies?
-IF we decided to switch insurances prior to LO's birth (which I doubt, but it's a thought as long as we can keep the same doctors. I thought it'd be worse if I had to change LO's pediatrician because of an insurance change than if we had to find new primary docs), would they consider the pregnancy a 'pre-existing condition' and not cover the pregnancy?
-SHOULD we consider changing prior? Would you?
-I know NJ offers healtcare at lower cost through some program, but I'm wondering if anyone else buys insurance on their own...where did you get it from? Anyone have a broker/insurance carrier they suggest?
It's just a weird situation but with this economy I'm sure we're not the only people in this situation. Obviously I don't expect anyone to have a miracle reply....just thought I'd ask for input and hope someone knows something that can help. TIA!!!!!
Sandi
This discussion has been closed.
Re: Weird insurance situation-thoughts? Suggestions? Ideas?
HTH!
Sorry, but you are 100% wrong. You can't even get life insurance if you are over 7 mos.
Yes, you can add the baby to your COBRA insurance. COBRA is meant to work just like your prior group plan so qualifying events are allowed. You can verify this with the COBRA Administrator - whether that is the prior employer or a third-party admin.
If you try to buy insurance on your own in the individual market place, YES they can can (and probably will) consider the pregnancy pre-existing. If you are able to obtain a GROUP policy then they are not permitted to treat it as pre-existing under the HIPAA regs. If it were me, I would only switch prior if I could get a less expensive group policy.
Hope that helps. I work in employee benefits. FYI -- there is pending legislation that could extend the COBRA subsidy. No one know whether it will go through but that could help you if it does!
A few thoughts (I was on COBRA briefly with this pg & looked into private insurance):
-COBRA is just the name of the law that allows you to continue coverage without being employed. It is the exact same policy as you had before, which means that you can do the same things you could do if your DH was still employed & being covered by his old job. So adding your LO shouldn't be a problem.
-If you decide to change your insurance, your pg shouldn't be considered a pre-existing condition bc you had continuous coverage throughout it. HOWEVER, individual policies will often not cover maternity for a period of time after you first get it. I'd think getting a private policy for you while you are pg would be prohibitively expensive if it'd be covered at all.
-also if you decide to change insurance carriers, you may have to meet a whole new set of deductibles, etc.
-Do you have a job that would offer insurance? You could look into getting on that with your LO when s/he is born.
-The only federal program I know of that insures kids is CHIP, but I have no experience with that at all.
Disclaimer: This was my experience & may be different in different states (I'm not in NJ). I also made lots of phone calls to get the details, but those are the basics that I learned.
https://wiki.answers.com/Q/Is_being_pregnant_considered_a_pre-existing_condition_when_changing_insurance
Yes and no to it being a pre-existing condition.
I wish I had asked you when I went through my insurance issues early in this pg! You said incredibly clearly & concisely what I gathered from about 25 phone calls. Great advice!
I agree with carrotcake-great answer and THANK YOU.
EVERY time I see something in the paper about health care reform/COBRA, etc, I get hopeful. DH tried for months to get a job after he got laid off and nothing panned out. As of now he's going to head back to school, so that means no job with benefits as of now. My work 'offers' coverage but it's a 50/50 split in terms of cost. I work for SIL/BIL...in a small office. For individual it's over $300 a month (our portion cost). Can't imagine what it'd be for a family.
I did look at the site once but I guess I need to call. I didn't see how I could apply BEFORE LO is born. Looked like you had to have a SSN and everything to apply.
Thank you
In the state I live in, if you tried to apply for an Individual Policy you would be declined. If you were joining another group policy, the pregnancy would be covered. You can always apply your LO for their own Individual policy after they are born.
"I can't answer any of your other questions, but I do know that pregnancy CANNOT be considered a pre-existing condition by any insurance company. I hope that helps in making your decision. Hopefully, someone else has more information for you."
YEP, Pregnancy IS considered a pre-existing condition if you have private insurance (not through an employer). which is why I had to apply for medicaid. I was paying 200$ a month being self employed, I was told that I had to add on a maternity rider - a seperate policy at least 6 months prior to conception- that is Golden Rule, but other companies require one year....at least this is in FLorida anyway.
Because of this- you would not likely be able to just sign on with another company that would cover your pregnancy.
Even with the gov't plan, Cobra has always been outrageous. Could you just start LO under a plan like Blue Cross. they seemed to have decent rates and coverage when I was shopping.
Good Luck, it sucks that we live in a place where we have to worry about this.
THIS EXACTLY !!!!