Health Insurance Question

[lucyandroger]

So my brother and SIL are TTC. I would be over the moon about becoming an aunt except that they don''t currently have health insurance. My mom brought it up and tried to impress upon them how urgent it is that they get some health insurance ASAP but didn''t want to be the overbearing MIL.

So my question is: If my SIL gets pregnant before they get health insurance, will the insurance still cover the birth? Or is it considered a pre-existing condition?

I''m just wondering how HUGE of an issue this is before I call them up and offer some sisterly advice

Thanks for any responses!

 

[April20]

I''m no expert, but I think it depends on the insurance.

I got laid off last summer and picked up insurance to cover us until I found another job that would provide it. The coverage was basically major medical. The questionnaire specifically asked me if I was currently pregnant and I do believe it was a disqualifying question for coverage. It was bundled with questions regarding health history for disease that were obviously used to identify pre-existing conditions.

I would recommend they do some serious research into the insurance options available and if pregnancy is considered a pre-existing condition before they TTC. Pregnancy and delivery is NOT cheap by any means.

 

[AmberGretchen]

Ditto - depends on the insurance and also on your state. I think some states divvy it up depending on the type of insurance - i.e. the rules might be different for group insurance vs. individual insurance.

Pregnancy is NOT a time to be uninsured or underinsured - it is enormously costly, and you really can''t skimp on health care and still be responsible.

 

[lucyandroger]

Date: 4/8/2009 7:47:45 PM
Author: April20
I''m no expert, but I think it depends on the insurance.

I got laid off last summer and picked up insurance to cover us until I found another job that would provide it. The coverage was basically major medical. The questionnaire specifically asked me if I was currently pregnant and I do believe it was a disqualifying question for coverage. It was bundled with questions regarding health history for disease that were obviously used to identify pre-existing conditions.

I would recommend they do some serious research into the insurance options available and if pregnancy is considered a pre-existing condition before they TTC. Pregnancy and delivery is NOT cheap by any means.

Thanks for the response...that''s what I was afraid of.

Yep, I know that the cost of delivery alone would put them under let alone pre-natal care and care of the infant. I can''t believe they''re being so irresponsible.

Unless they think my mom and I will just pick up the tab...I just can''t believe they would even put us in that position.

 

[lucyandroger]

Date: 4/8/2009 8:46:33 PM
Author: AmberGretchen
Ditto - depends on the insurance and also on your state. I think some states divvy it up depending on the type of insurance - i.e. the rules might be different for group insurance vs. individual insurance.

Pregnancy is NOT a time to be uninsured or underinsured - it is enormously costly, and you really can''t skimp on health care and still be responsible.

Thanks, AmberGretchen.

I''m going to have to have a really serious talk with them. I just don''t know what they''re doing. I mean they''ve never really been responsible but I thought they would get their act together before bringing another life into this world. I just don''t get what they''re thinking. ugh

 

[InLuv101]

My policy also has a 30 day waiting period so I couldn''t get pregnant for 30 days after the coverage started. Not sure if this is true of all/most policies but it''s worth mentioning.

 

[MMT]

I would look into it right away. If they won''t cover it is the local health dept an option for her?

 

[Hudson_Hawk]

It may be considered a preexisting condition, however she should be able to get aid through the state to help with birth, etc.

I know when I started my job they pushed me to sign up for short term dis then as opposed to later, because if I was pregnant when I signed up for it later it would be considered a PEC and not covered. BOOO....

 

[neatfreak]

So the bad news is that it likely wouldn't be covered (except if they managed to get fabulous insurance which I doubt if they currently have none unless one of them gets a great job). BUT there are often state programs that will help with prenatal care and if their income is low enough every state has a children's health insurance program so the kid will be covered.

But it's still irresponsible IMO and many times the birth itself isn't covered even if prenatal stuff is. And the birth can be CRAZY expensive even if she has a normal delivery.

 

[diamondringlover]

I think is should be covered I work for a large insurance company in the US and we cover all pregnancies whether they are prexisting or not.

 

[neatfreak]

Date: 4/11/2009 2:01:07 PM
Author: diamondrnglover
I think is should be covered I work for a large insurance company in the US and we cover all pregnancies whether they are prexisting or not.

Your company may cover it but most won''t. In fact, many insurance companies have a rider for maternity benefits that has to be added before someone becomes pregnant even if they are already insured with that company. I would make sure the OP''s sister reads the policy extremely well before shelling out for insurance, especially if they would be purchasing it on their own. It''s more likely to be covered if they get a new job with a large company that has a good plan...but even then I wouldn''t count on it.

 

[mayachel]

Pregnancy is treated differently than most other "pre-existing" conditions, in that there is a shorter time period that it can be excluded from. Most companies will say any "illnes" that you have gotten care for in the past 12 months but pregnancy is past 10 months...So, there may be some loopholes if they get coverage prior to seeking care. Not that I''m advocating it.

Most states also have excellent WIC (women/infant/children) programs for both the uninsured and underinsured. There are no reasons NOT to get early prenatal care.

 

[Tacori E-ring]

Tell them to STOP TTC NOW! Seriously! We buy our own health insurance (BCBS) and had to add a maternity coverage rider. I obviously could NOT be preggo when we added it and we can only change our policy once a year. It was pricey. An extra $450 a month but do they have ANY idea how expensive it is to have a baby? Doctor visits, medicine, ultrasounds, my birth alone was over 20K (thankfully paid by BCBS). Cost would only compound with a c/s or any nicu time. Being a parent is the ULTIMATELY responsibility and (not to be harsh but) not having health insurance (period) is very irresponsible. Medical debt NEVER goes away. Not the best way to bring a child into this world.