Is pregnancy a pre-exisiting condition?

marissabourgeois · October 2010

Hi everyone,

My husband and I are considering moving because he was just offered a great job closer to our families. We currently have health insurance through my employer. We would plan to both go under his insurance when we moved. He just spoke to HR and they told him that I might not be covered because pregnancy is a pre-existing condition. I have NEVER heard of this and found mixed answers on the web. Has anyone been in this situation?

Thanks ladies!

*BlackSheep* · October 2010

I think if there is no gap in coverage then no it's not. I would talk to the ins. person rep.

Good luck

Clotho! · October 2010

I think it varies from insurance to insurance but I think that if it is a group plan through work then they have to cover it. The only way to find out for sure is to call the insurance company and ask.

akemrose · October 2010

I am fairly sure with most health insurance companies pregnancy is a pre-existing conditon. As for short term health its completely excluded.

pawcall · October 2010

*BlackSheep*:
I think if there is no gap in coverage then no it's not. I would talk to the ins. person rep.

Good luck

This is what I was told as well, but it's worth a call to the insurance company (not HR) to find out for sure.

armandos_girl · October 2010

It depends on your insurance and the reason for the change.

My husband's company was bought out during my last pregnancy and the insurance changed. For that reason, they had to accept and cover the pregnancy. If you change jobs voluntarily, it is up to the insurance company and their policies. Some will say that you can't get pregnant within a year of joining.

TG508 · October 2010

yes it is pre-existing but it all depends on the company and insurance policy as to if they will cover it.

i got new insurance right after my first appt and they are gonna cover my pg. the rules were if it was within the last 6 months. not all illness, just pregnancy. i think there are some laws (depending on your state) on what they have to cover.

ackiser · October 2010

My company just switched insurance companies when I was around 9 weeks or so. If there is no gap in converage there should not be a problem. Some insurance companies will try to claim that it is a pre-existing condition but pregnancy doesn't fall into that category. You don't have cancer . . . you're pregnant. Just makes sure you talk to the insurance company that you will be with though to verify that 1) your new doctor is covered and 2) you are covered.

kilissa · October 2010

If it's a group plan they have to cover, but if it's an individual plan it could be deemed a preexisting condition.

yourmom5309 · October 2010

*BlackSheep*:
I think if there is no gap in coverage then no it's not. I would talk to the ins. person rep.

Good luck

This is my understanding of my state's insurance laws. It may vary from state to state. I switched jobs in September and did not have any problems.

on_the_move · October 2010

We are changing insurance company's in January because DH wasn't able to get on the new one until 6 months into his new job. I called the new insurance company and made sure there wasn't going to be a problem. If it is a pretty good job you are moving for you could continue with COBRA, but that can get expensive. We got DH's new company to pay for COBRA until we are able to get on the new insurance.

sandrajeant · October 2010

uuuummmmm...isn't this why healthcare reform now doesn't allow insurance companies to deny coverage based on a pre-existing condition. If you are moving with your husband and he enrolls you in his open enrollment (new hire time) then there shouldn't be a problem anyway.

marissabourgeois · October 2010

babyTaylor2011:
uuuummmmm...isn't this why healthcare reform now doesn't allow insurance companies to deny coverage based on a pre-existing condition. If you are moving with your husband and he enrolls you in his open enrollment (new hire time) then there shouldn't be a problem anyway.

That's what I thought too, but who knows... We are moving from Rochester, NY back home to MA. He hasn't officially accepted the job offer and we are awaiting the insurance package to make sure I'd be covered-- that's the only thing that's holding us back. I'm 5 months and probably would not be working until after the baby is born unless I find something part time (which I'm sure would not be benefited). But, if I can't be covered under his new insurance there's just no way that I could leave...The HR guy told him I probably would NOT be covered under his new insurance because of my "pre-exisiting condition". Once we receive the packet, we'll be calling the insurance company. I hate insurance, it's so confusing.

jweste · October 2010

I know when i signed up for my health insurance a few months back it had a gap policy. It would cover you if you had an excisting health insurance plan. But like someone just mentioned, its part of the healthcare reform. They cant deny you if you have a preexisting condition, i'm just not sure when that goes in effect. You just need to call your future insurance company and see. You also need to check into the changes that the new insurance might have as far as coverage. Health insurance companies are such a pain in the a$$.

drpayne · October 2010

It's not pre-existing condition. However, that does not mean the maternity coverage kicks in immediately.

MichelleL1118 · October 2010

kdodge423:

babyTaylor2011:
uuuummmmm...isn't this why healthcare reform now doesn't allow insurance companies to deny coverage based on a pre-existing condition. If you are moving with your husband and he enrolls you in his open enrollment (new hire time) then there shouldn't be a problem anyway.

That doesn't go into effect until 2014.

I'm fairly sure the pregnancy-as-preexisting condition clause went into effect immediately... off to find documentation of that, will edit with link if I find it...

Edit: kdoge was right - the portion of healthcare reform that prohibits insurance companies from denying coverage based on pregnancy doesn't kick in until 2014. The things that kicked in immediately were coverage for certain preventative screenings, and requiring employers to provide a non-bathroom private place for pumping as well as time during the day to do so.

johjstc · October 2010

Pregnancy complicates health insurance options. Federal law bars pregnancy from being considered a preexisting condition, which means if you change health plans while you're pregnant, your new insurer can't deny claims related to your pregnancy. But a variety of loopholes means pregnant women could still lack insurance coverage for their prenatal care if they don't do some careful planning.

Here is the link I found

https://www.ivillage.com/pregnant-without-health-coverage/6-n-145593

magdalina.h · October 2010

It used to be, but now as long as there is no gap in coverage it's not.

RunningGal900 · October 2010

HIPPA requires pregnancy to be covered as long the group coverage includes maternity coverage. They cannot legally consider pregnancy a pre-existing condition.

https://www.insure.com/articles/healthinsurance/pregnancy.html

Keep in mind though that you may still have a waiting period for coverage. My DH is switching jobs in January and we will have to do COBRA for that month because his insurance doesn't kick in until Feb 1.

TheCricket · October 2010

kilissa:
If it's a group plan they have to cover, but if it's an individual plan it could be deemed a preexisting condition.

Exactly this.

marissabourgeois · October 2010

TheCricket:
kilissa:
If it's a group plan they have to cover, but if it's an individual plan it could be deemed a preexisting condition.

Exactly this.

This makes sense to me, and I'm really hoping this is the way it is. His future insurance is definitely group coverage and we will know more once we receive the packet/talk to the insurance company. So stressful!!

Thank you everyone for the advice and research, I really appreciate it.

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