Pregnancy and Insurance: Are You Covered?
Expert advice and tips for moms-to-be
Julie Kelsey, from Germantown, Maryland, was very frustrated with her insurance after the birth of her son. “I received a bill after my son was 18 months old for something that the insurance company kicked back,” Kelsey says. “The hospital blamed the insurance company—the insurance company blamed the hospital. Everyone was sure that it was my responsibility. It was horrible and very annoying.”
Insurance doesn’t have to be so confusing. The secret is knowing who to go to when you have questions and knowing what your carrier covers as soon as you know that you are pregnant.
A Preexisting Condition?
A major concern for women who are considering switching jobs while pregnant is wondering if their labor and delivery costs will be covered.
Rae Lee Olson, a spokesperson for Life and Health Insurance Foundation for Education (LIFE), a nonprofit organization that strives to educate Americans about the role personal insurance plays in proper financial planning, as well as a Principal for the Vita Benefits Group, says that pregnant women no longer have to be concerned that pregnancy will be considered a preexisting condition.
“A law called HIPAA (passed in the 1997) prohibits group insurance carriers from excluding pregnancy under a preexisting condition clause,” Olson says. “Therefore, as long as a woman has continuous coverage (without a gap of more than 63 days), then a pregnancy could not be considered a preexisting condition under a new group insurance plan.”
It is important to remember that the insurance for your new job may not kick in for up to three months. That may leave you uninsured for a period of time. Check to see how long you can keep your current insurance and see if there is any way you can extend coverage until your new insurance takes over. It may cost you extra money, but remaining covered during all of your pregnancy is vital.
Who Can Answer Your Questions?
One of the issues many women have with health insurance is where to find the answers to their questions. Olson says that many companies have a human resource department that usually has someone who specializes in health insurance and policies.
“Typically there is a contact in the Human Resources department for questions on employee benefit plans,” Olsen says. “Who you contact typically depends on the size of the company you work for. For example, in a very large company, there may be a dedicated benefits persons to assist you with questions. In a medium-sized company, your general HR representative may be the contact. In a smaller company, you may be directed to the insurance broker or agent who assisted your employer setting up the coverage. You should always feel free to ask when you have questions about your coverage.”
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