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1st Trimester
Pre-existing condition insurance question
Hi gals,
So I have been on Hudson Health Plan of NY (Gov't insurance for lower income) for over a year now. I had it as a student and was unemployed for a few months after that. I recently accepted a new job about 2 wks ago and I am about 8 wks pregnant as well.
My question is, my new company offers Oxford for health coverage. Because of the nature of my job, they require a physical and PPD shots. I'm worried that they will find out I'm pregnant and consider this a pre-existing condition. I obviously really need health insurance and was hoping to get it through my new job and get rid of my other insurance since i prob won't qualify for it any more w/the new job. ANy thoughts? Thanks!?
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Re: Pre-existing condition insurance question
From what I understand, HIPPA prevents pregnancy from being considered a pre-existing condition.
There are exceptions to this rule. It definitely applies when going from a group plan to another group plan, but I don't know that what she's on right now is considered a group plan.
OP, whether they find out through your testing or when you have the baby, they'll know eventually that you're pregnant and were so before getting the insurance. I'd call and talk to an HR rep or someone from the insurance company to find out if the pregnancy will be covered.
I don't think you should have a problem getting the group insurance. There are ways group plans can exclude people with pre-existing conditions, but pregnancy doesn't appear to be one of those ways.
This is from a Department of Labor FAQ about HIPAA and pregnancy:
https://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
In addition, HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children.
Are there illnesses or injuries that cannot be subject to a preexisting condition exclusion?
Yes, as follows:
Pregnancy, even if the woman had no prior coverage before enrolling in her current employer's plan
generally when you are joining a group plan from an employer they do not worry about pre-existing conditions.
everyone's insurance is different (even within the same plan b/c each employer group decides what the plan will cover)... so you need to speak to your particular plan/HR person.
You really just need to call your new insurance company and find out from them. Every company/state etc... is going to be different. There are in fact some insurance companies that see pregnancy as pre-existing and some that do not. When I got pregnant I was on a health plan that saw my pregnancy as pre-existing because I had lapped on my coverage. They said that if I would have not lapped then I would be covered.
In the end it did not matter with my insurance company since I had just gotten married. I was switiching to my husbands plan anyways, but it was interesting to find out. My husbands insurance did not see pregnancy as pre-existing.
My point is that yes some insurance companies do see pregnancy as pre-existing.
Also, there is no getting around when your due date is with the new insurance company. At your first appointment your Dr will send in paperwork to your insurance company which will have you EDD on it and if you did not tell them before had and there are issues with your insurance company reguarding such matters they will catch you on it.?