Change in Insurance with New Pregnancy

Updated on June 22, 2010
K.V. asks from Umatilla, OR
14 answers

I just found out recenly that I am pregnant with my 3rd baby and we are over the moon excited about this child, but there is one tiny black cloud that maybe you moms can help me with.
The current job my husband has is not a wonderful job, but it has excellent benefits, it paid nearly ALL of the expenses for our first 2 children. He has recenly been presented with an opportunity for a much much much better job and better paying and all the stuff we really want for our family (we should hear this week if he got it for sure or not), but their health care program isn't as good and it won't cover a pre-existing pregnancy.
So this pregnancy...although wonderful in soooo many ways....is bringing way to many new questions and decisions.
Have any of you experienced a job switch after being pregnant? Or had to get health insurance after finding out you are pregnant? I need advice. Is there any kind of insurance program out there that will cover a pregnancy already happening that we could look into if we get the new job? If you have ANY insight I would really appreciate it, I would love to have peace of mind about this so I can fully enjoy the fact that we are experiencing miracle #3 in our family!!!

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T.J.

answers from Seattle on

They can deny the birth itself but not prenatal care. But do you not have other coverage that won't end until the other begins? That determines whether a preexisting condition is covered.

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C.J.

answers from Dallas on

If I remember correctly as long as you have had continue coverage with no lapse in coverage the new insurance cannot say you have any pre-existing conditions. I believe this is part of the HIPPA laws. You will have to start over with all of your deductibles and out of pocket max, but you should be covered by the new insurance. Good luck.

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L.D.

answers from Albany on

That doesn't sound right. :-| I've had insurances change mid pregnancy twice now and all they do is bill the first insurance for the time I was under them and then bill the second insurance for the remainder and birth. If you don't have a lapse in coverage, I don't see how they can deny that. If you really can't get around it, would it work to pay for COBRA just until after the baby is born? That way your insurance stays the same. If it's better paying, that should help with the cost of COBRA and at least it would give you peace of mind PLUS make it so you don't have much to pay when the baby comes.

1 mom found this helpful

C.S.

answers from Philadelphia on

I may be wrong but I believe it is a federal law that pregnancy no longer is a pre ex. You may want to check this.

Good luck and congrats with #3. I have one of those unexpected miracle #3 babies too. She is just pure joy. ♥

(PS I just googled it. It is a federal law. They cannot deny a pregnancy)

1 mom found this helpful
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M.C.

answers from Washington DC on

I would talk to the benefits/insurance billing office at your OBG office.

At my OBG, they are very careful about insurance. As soon as you find out what the insurance will be, call them and ask if there is a way that you can determine what the pregnancy coverage will be.

A story that I was told by them was that a lady's insurance changed mid pregnancy, she went to an appointment, forgot to tell them about the change, and the bill for that visit was declined. 'Oh yeah, I have new insurance'. Well the new insurance claimed that becuase she had a visit before she called and had it cleared verified they were now claiming it was pre-existing and they wouldn't cover all of the expenses.

I'm telling you this to inform you that as soon as you may have a change, work with your OB.

Also, talk to your husband about what he wants. If the new job is a huge improvement over the current one it would be a shame to have to let it go. Especially in this job market. As for having this be a deciding factor, I would look into keeping your current insurance under COBRA. It can be expensive, but keeping it for a few months may be less expensive than having to cover the costs under the new insurance.

My hubby changed jobs while I was pregnant. He HATED his current job where he worked 6 days a week and holidays. The job change didn't affect our insurance, but it did effect our paychecks. He took a lesser paying job, but it was M-F, and he got 3 of 4 Sat. off, and all Sundays and paid holidays. It was a big adjustment, but worth the change.

Good luck
M.

1 mom found this helpful

J.S.

answers from Seattle on

K. - I would go along with the previous answers. Technically with the new Obamacare you can no longer be denied for pre-existing conditions, but most facets of the law haven't been put into practice yet.

My thought is, go to a midwife. Midwives can charge insurance if you have it, but if you don't it's the most affordable way to get complete pre- and post- natal care. Prices range from $1200 - $3000 depending on where you live and who you see, but that's from your first visit until your 6 week post-natal and everything in between. Most people have to reach a similar deductible anyway! Also, they have payment plans, which brings me to my last point -

Make your situation known right away wherever you are and ask them to work with you. Another bill might seem like a lot in your overview of finances, but it is really a big deal to pay $xx per month for a year or so to get your beautiful baby into the world? Think of it from a bigger perspective, and even if the worst would happen and you end up with a huge bill, you'll be happy to make those payments month after month when baby is laying in your arms looking up at you with those intense eyes!

J.G.

answers from San Antonio on

Call the HR guy/gal at the new job and tell them your situation. They should be able to tell you if you'd be covered. Ask them the name of the company's insurance provider. You could call them too and tell them your situation and ask if you will be covered.

It's different in every state, so wish I could help more.

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N.Z.

answers from Portland on

There are plenty of programs out there to make sure babies are born healthy and have a healthy start. You might look into COBRA. But, make sure that it is both policy on the new insurance not to take care of you and baby and that it is legal. With all the strides we've made in this country to make sure babies are healthy, I find it hard to believe you wouldn't have care.

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S.L.

answers from Portland on

K.,
Usually with employer plans, they are pooled so they cover all employees (and their families) regardless of pre-existing conditions. If you find that they really don't cover an existing pregnancy, see how much it will cost to pay the COBRA amount for just you from the old insurance. If that is too much, check with the Oregon Medical Insurance Pool (OMIP). When I was on it 4 years ago, they had a 6 month preexisting condition exclusion so I was able to get on it when I was newly pregnant and have the pregnancy coverage kick in the month I was due. Not ideal, but certainly possible! Looks like you have your research work cut out for you!

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J.D.

answers from Seattle on

My understanding is that insurance companies are not allowed to deny coverage for a pregnancy on the basis that it is a pre-existing condition. I would be very surprised if your new plan does.

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I.G.

answers from Seattle on

Insurance laws vary by state, I think it would be best to inquire with your insurance commission about the situation in OR.
In WA pre-existing conditions can only be excluded for 3 months, after that they have to be covered. Also, if there is no break in insurance the new insurer must cover pretty my anything (pre-existing cond. don't apply).
Congrats and good luck!

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J.N.

answers from Seattle on

I would check into the laws in your state. I did not think it was legal to consider pregnancy as a preexistng condition, in Washington at least. If it is a problem, you should be able to stay on COBRA until the baby is born. If not, talk to the hospital where you are having your baby and set up a payment plan. I was changing insurance due to a job change on July 1st and my son came early (on June 27th). Unfortunately for us, the old insurance was way worse than the new would have been and we ended up with a huge bill because of the length of his hospital stay. The hospital will put you on a payment plan. My son was 18 months old before he was fully "paid off," but they were good about working with us. Good luck and congrats!

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J.Y.

answers from Portland on

I have a hard time believing that the insurance company is defining pregnancy a pre-existing condition. I switched jobs while pregnant and looked up some federal laws at the time and it is not considered a pre-existing condition. I would check again.

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