Getting Heath insurance when already pregnant

[Colleens 40]

My hubby and I found out just after I POE'd that we are expecting. We thought that he would be able to add me to his work insurance, but since he was moved to part time, it will only cover him. So I am looking for a company that will cover pre-existing pregnancy. I will need coverage in Tennessee.

[redBlue 1]

My hubby and I found out just after I POE'd that we are expecting. We thought that he would be able to add me to his work insurance, but since he was moved to part time, it will only cover him. So I am looking for a company that will cover pre-existing pregnancy. I will need coverage in Tennessee.

as far as I know most companies do not accept a new patient with pregnancy.you will have to do lots of phone calls to find one.

if u can't find anything,make sure to check www.plannedparenthood.com

[tbaygrrl 2]

A law was passed a while back that makes it illegal, by federal law, for insurance companies to deny coverage for a woman who is pregnant. They cannot view it as a pre-existing condition. May people are not aware of this law change. THe only plans that can deny coverage are the ones for individual coverage. Family/group plans cannot deny you! You and your husband should look into a family plan. Humana is a good umbrella company to look at plans they offer.

I was 6.5 months pregnant when I POE'd, and it was with a Humana plan that I had coverage. I'm not in your state so I can't give you specifics, but Here is a bit of info that you may find interesting. You can also google, can insurance companies deny coverage for pregnancy. Hope this helps and congrats on the upcoming bundle of joy

Many women are faced with the dilemma of becoming pregnant with no medical insurance or switching jobs or plans when they are already pregnant. The following information comes from an organization called Consumer Insurance Guide: Insurance News Network. Their mission is to deliver accurate, unbiased insurance news for consumers. They offer tips, in-depth stories, and expert guidance on auto, homeowners, health, life, and business insurance, plus annuities. They are an independent news site that does not sell insurance and are not owned or operated by an insurance company.

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.

Under a law known as HIPAA, the Health Insurance Portability and Accountability Act of 1996, health insurers cannot consider pregnancy a preexisting condition. So, unlike illnesses such as diabetes, they can't deny you coverage when you go from one job to another and switch health plans.

"It was not good public policy to have a pregnant woman with no access to health insurance," says Kansas Insurance Commissioner Kathleen Sebelius. "We want to encourage prenatal care and regular checkups during the course of a pregnancy and having pregnancy as a preexisting condition would block access to health care." There are exceptions to the rules, however.

Unfortunately, there are a lot of "buts" to HIPAA. For one thing, HIPAA doesn't apply to someone who previously had no health coverage at all and then gets into a group health plan through a new job. So if you had no insurance, got pregnant, then landed a new job with insurance, your new health plan would not have to immediately cover your pregnancy. You might have to sit out a preexisting condition waiting period, a period that could be longer than your pregnancy and in the meantime pay for your visits yourself.

Second, HIPAA applies only to group health plans. So if you have individual insurance and are pregnant, then buy group health insurance, you again could be subject to a preexisting condition waiting period. Likewise, if you move from one individual health plan to another individual health plan, you might not get pregnancy coverage at all. You might have to sit out a waiting period, or if you are offered insurance that covers your pregnancy, you might find it's very expensive.

"HIPAA is really the only protection against pregnancy being treated as a preexisting condition, and there are lots of people to whom HIPAA rules don't apply," Sebelius notes. Eligibility waiting periods are possible.

Here's another scenario. Say you have group health coverage and then switch jobs. Your new health plan has a one month eligibility period before it begins and you're pregnant. What can you do? "Probably nothing," Sebelius warns. The health plan isn't required to cover your pregnancy until the plan takes effect. While that might not be a problem if you're early in your pregnancy and you don't mind paying for a prenatal visit or two out of your own pocket, it could be trouble if you're in your eighth or ninth month and have no coverage.

If you find yourself without insurance, organizations such as Catholic Charities and Lutheran Social Service often have reduced cost prenatal services available[/b]Read More http://parenting.ivillage.com/pregnancy/phealthcare/0,,midwife_46wb,00.html#ixzz0mbLqCcBp

Sign up for iVillage Special Offers

[Moosker 7]

My husband has his own business, so I searched for "Maryland Health Insurance" and found a site that would spit out all kinds of different health insurance companies. A lot of times at the bottom it'll show a little baby highlighted, saying that maternity is covered. Even though it might be a little pricier ($100+ per month) consider getting one that covers as much as possible.

Congrats on the future baby!!!

The site was this I believe: http://www.ehealthinsurance.com/tennessee-health-insurance

[Colleens 40]

I have been further researching this the past week, and have found out that since I come from a country that has a national health care plan (Canada) and had coverage for at least 18 months before I left that I qualify under the HIPPA law, and that means insurance companies can not deny me because of a pre-exisiting (pregnancy) condition. So this is a relief....now just to find something that is affordable. I was in at Blue Cross Blue Sheild and they wanted $2450 a month with the maternity rider!!!!!!!!!!!!!!!!!

[Empress of Groovy 373]

I have been further researching this the past week, and have found out that since I come from a country that has a national health care plan (Canada) and had coverage for at least 18 months before I left that I qualify under the HIPPA law, and that means insurance companies can not deny me because of a pre-exisiting (pregnancy) condition. So this is a relief....now just to find something that is affordable. I was in at Blue Cross Blue Sheild and they wanted $2450 a month with the maternity rider!!!!!!!!!!!!!!!!!

Whoa...you'd be better off paying for the birth out of pocket! Is the crazy premium because you're already pregnant? I was under the impression that it's nearly impossible to get individual coverage that covers maternity if you're already pregnant. As I understand it, the HIPAA law applies mainly to group plans. Is there any way you can get on your husband's plan (assuming it's an employer-sponsored group plan that offers maternity coverage) and pay the difference to the employer? I'm sure that would be cheaper than $2450 a month.

Edited May 5, 2010 by Empress of Groovy

[Colleens 40]

Whoa...you'd be better off paying for the birth out of pocket! Is the crazy premium because you're already pregnant? I was under the impression that it's nearly impossible to get individual coverage that covers maternity if you're already pregnant. As I understand it, the HIPAA law applies mainly to group plans. Is there any way you can get on your husband's plan (assuming it's an employer-sponsored group plan that offers maternity coverage) and pay the difference to the employer? I'm sure that would be cheaper than $2450 a month.

Unfortunetly he is only part-time right now, so only qualifies for individual coverage. His manager is trying to get him approved for full-time, then I could be added to the group benefits, so hopefully that happens soon. But I did the calculations as well and it would definitely be better to pay out of pocket then go for the benefits.....barring any sort of complications during delivery!!

[toogroove 3]

Congratulations on the pregnancy!!!

private or individual insurance policies require that you pay for a maternity rider for a period of time (in my experience 12 - 18 months) before you conceive. This guarantees them minimum 21 months of super expensive premiums. I'm assuming that the crazy premium is for 'lost profit' because you didn't have the pre-conception payment time. I did the math a few years ago and assumed a complicated C-Section delivery, I was still cheaper to pay out of pocket than to pay for the insurance.

I'm wondering if you are eligible for any sort of public assistance without becoming a public charge? In Georgia we have 'Peach Care' for mothers who can not afford pre-natal and later preventative care for their children.

Good luck and I'm so sorry that such happy news is accompanied by such a pain in the a$$.

[Colleens 40]

Congratulations on the pregnancy!!!

private or individual insurance policies require that you pay for a maternity rider for a period of time (in my experience 12 - 18 months) before you conceive. This guarantees them minimum 21 months of super expensive premiums. I'm assuming that the crazy premium is for 'lost profit' because you didn't have the pre-conception payment time. I did the math a few years ago and assumed a complicated C-Section delivery, I was still cheaper to pay out of pocket than to pay for the insurance.

I'm wondering if you are eligible for any sort of public assistance without becoming a public charge? In Georgia we have 'Peach Care' for mothers who can not afford pre-natal and later preventative care for their children.

Good luck and I'm so sorry that such happy news is accompanied by such a pain in the a$$.

I found that most have the waiting period for maternity benefits, but since I come from a country with a national health care plan, the US considers that I had existing insurance. So it would be like if I was expecting and had group coverage at my work, but got laid off, and no longer had coverage. Under the HIPPA laws insurace companies can not deny me maternity benefits because I was previously covered. I know in Tennessee we have Tenncare, but I am not sure if it is considered a "means tested benefit". I have decided to pay out of pocket for my prenatal visits, as we can afford them. My husband is close to getting a full time position at work, so then I will be able to be added to his group plan at a fairly reasonable rate.

[toogroove 3]

Hi Colleens, you are right, if you join a group and are coming from Canada with a national health care plan you should be cool as you have 'continuous coverage' for any and all pre-existing conditions. It is worth knowing that even if you come from a country without a national health care program, pregnancy (under group policy rules) is not considered a pre-existing condition and must be covered. Where you get screwed is if you have to buy an individual policy. Individual policies can discriminate and exclude anything from their coverage.

For example, my late husband had a history of sinus infections and allergies. I had a good job where I had a group policy and covered us both. He owned a small business without any employees and it was cheaper to insure him this way. After I lost my job, we elected to get him an individual policy because he was healthy at the time and it was cheaper than COBRA. I stayed on COBRA because we were intending to get pregnant and the individual insurers would not cover maternity unless I paid the waiting period. We didn't have any gap in coverage for him but the individual policy excluded any and all issues related to his sinus issues.

2 months after he got the individual policy he was diagnosed with brain cancer. The individual insurance company (Fortis, now Assurant) DID cover all of the expenses (millions of dollars - no joke) related to his cancer treatment. The irony is that if I had not lost my job and he had stayed on my group policy we would have had less of his expenses covered.

I hope your fiance does get the full time job and get coverage for you and the little one.