Getting on DH's insurance while pregnant??

CA_EAM · May 2011

I know we have to call and ask, but I thought I would check on WM's knowledge:

DH launched his own company and until now has yet to pay himself or get benefits (he has a plan in place for for few employees). We have been covered under my employer so it made sense to keep more money in his new company. Anyhow now he says he thinks it might be better to get coverage through him since my 80/20 PPO means having this baby will be expensive. Is it easy/possible to get on a new plan in this situation given that I am already pregnant?

Also, I will have to look at the numbers regarding how much his policy will cost monthly. Mine is about $300/month and I can't cancel this year. Having DS cost us $9k which was the out-of-pocket max of my insurance. This year's OPM is $7k. However, DS was c-section, NICU and extended hospital stay for me so our total hospital bill was close to $150k. If we have a normal birth this time, even a c-section would put us at 20% of $15k so $3k which is not bad compared to the last go-around...

vmm0016 · May 2011

I think it is too late to get on your DH's insurance but it doesn't hurt to call and ask.

Lillygrrl78 · May 2011

You have to look at the pre-ex. Usually pregnancy is not considered a pre-ex for medical insurance. Additionally, if you are already covered under existing insurance you are considered continuously covered and thus a pre-ex wouldn't apply anyway.

I take it this is an individual policy, correct? Depending on your state they may have to cover you anyway under the state's mandated benefits, regardless of pre-ex or continuous coverage.

Either way you should be covered if you switch insurance now.

celiabwatson · May 2011

I'm planning to switch to my husband's insurance mid-pregnancy this time. I called them up before getting pregnant and asked all these questions. They said that pregnancy is never a pre-existing condition (which I would verify with your insurance to be sure, because I don't completely believe it). They said I can always add at open enrollment or with a qualifying event. In my case the qualifying event is going to be "loss" of prior insurance, even though I'm choosing to loose it. I'm a little nervous about that but I'm hoping it'll work out ok. Good luck. Definitely talk to both companies first.

JDoe11111 · May 2011

we just switched ins and have zero maternity coverage for 1 year, when I was researching that was on the standard to good end of self-pay policies. Pre natal is covered, but nothing for the delivery even after the huge deductible is met if I get KU in less than a year.

stromtobe · May 2011

I know it's not an issue for group plans if there is a qualifying event and/or open enrollment as I have switched from DH's policy to mine while pregnant as my company offers better covereage (but at a higher cost)~ so basically I buy up for the year when I know I am going to be incuring expenses and use his cheapy HSA the years we don't have much going on. I'm not sure how an individual policy would work though, so I would definately be sure you check with the provider before dropping your current coverage.

naflmj · May 2011

I switched insurances (due to job change) when I was PG. As long as there is no lapse in coverage it's not considered a pre-existeing condition. I would call and ask but you should be fine.