Pregnancy and Changing My Deductible on Health Insurance - How Does This Work??!

Updated on January 31, 2013
S.B. asks from Kansas City, MO
11 answers

Hi, I'm currently about 4 weeks pregnant, and have only partial maternity care included in my health insurance. That means they only cover office visits and some lab work, but not delivery or doctor's fees. I was planning to pay out of pocket for that (ouch). I have private insurance through United Healthcare, and normally they wouldn't cover maternity but they are trying to change their policies before the 2014 Affordable Care Act forces them to allow pregnancy in any policy. Anyway, my question is, I would like to lower my deductible from $6000 to $2500, and this will cause the policy to be sent out to underwriting again. I'm already pregnant- can they deny coverage for it or cause any other wackiness? I'm worried I should leave well enough alone. Any insurance agents know? Thanks so much!!

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So What Happened?

Thanks everyone! To clear up a few things: My coverage is private (not through an employer, so not group insurance). Insurance company does NOT know about my pregnancy, as I haven't been to a doctor yet. If I change my deductible successfully (Ie: the policy is approved by underwriting) and they find out I was pregnant before it was started, what will happen? Can they cancel my policy? I'm concerned because it's a family policy and I wouldn't want to jeopardize their coverage too....

UPDATE #2- So I'm now thinking that alll of you who have encouraged me to be upfront are probably right (and it feels best, too). I'll call tomorrow and ask. I mean, I already have a policy with them so they can't change that! Thanks again for all the help!! It means a lot to me, and eases my anxiety to hear your stories!

Featured Answers



answers from Dallas on

what ever you do, if you call United get the name and extension number or employee number and call center location of the person that you talked to and write down the day and time you talked to them. Ask if they can send you an email or something in writing.

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answers from Portland on

Call United and ask them. They know what their policy and rules are. You don't want to do anything underhanded and so direct questions is the way to go.

The only time I've been able to change anything about my insurance has been during a specific period related to the open enrollment time.

3 moms found this helpful


answers from Miami on

I don't have an answer for your insurance questions, but either way keep in mind a hospital delivery is going to be very expensive (each of my first two normal, natural deliveries were well over $14,000 just for the hospital portion). If you are healthy enough, a birth center or homebirth will save you loads of money (my homebirth midwife I'm using this time is less that $5000 for all "office" visits, labs, ultrasound and the delivery combined).

3 moms found this helpful


answers from Los Angeles on

The only way to know for sure, is to call them directly and ask. Be honest and explain your questions and concerns nicely and completely up front. Ask for their best advice as to how to proceed.

I would think that since you already have coverage and are a paying customer there would be no 'pre-exsisting' condition since you have been with them before you got pregnant...but I am no expert and in my experience Insurance doesn't EVER seem to benefit us, it only goes in their favor, ya know?

Honesty is always the BEST policy, that way you are not trying to be sneaky or under-handed. If you go in stating the truth and are just asking how you can change things to benefit you the most, *hopefully* you will get a nice agent who answers and is willing to work with you, not against you! You are a paying customer, there is nothing wrong with trying to get the very best coverage for the very best price, you just need to be open about all of it!

~Since you have yet to see a doctor, technically your pregnancy is not official yet or could always state that you *think or hope* that you might be pregnant and inform them you haven't even seen a doctor yet, hasn't been enough time for a missed period ? Or something?? and then go from there on when and how you should proceed IF it does turn out you are actually pregnant? "I don't want to count my chickens before they hatch so-to-speak but if it is true how should I proceed to get the best coverage from you"?? Something like that maybe?!! But in your own words of course and still maintaing the truth!

Good Luck!

3 moms found this helpful


answers from Phoenix on

I'm an insurance agent in AZ. Of course they can, and likely will, deny it. You don't wait until your pregnant to either get insurance or try to get BETTER insurance. If you have a high deductible, you have lower premiums. If you choose a lower deductible, you pay a higher premium. Sorry, but you will probably have to pay the higher deductible. Good luck.

3 moms found this helpful


answers from Dallas on

I have had private insurance for about seven years. Half of that time was through United. While with them, I had to fight them on several occassions. In all instances, they saw it my way. I think that is because I often had a paper trail and I did not give up my position. So take meticulous notes and do as much online and in writing as possible.

I don't think this request in change would affect your current policy as long as you don't cancel the existing policy. My biggest fear would be what they would charge me for premiums since you are currently pregnant. They may not deny the insurance, but they may charge additional fees for your "condition".

Contact United. They will be able to tell you if this change puts you in jeopardy.

3 moms found this helpful


answers from Eau Claire on

Not sure about MO, but in WI we have a health care program specifically for pregnant women without health care. If you are pregnant, they can't deny you. If you would be income eligible for something like may be worth taking advantage of.

For both my kids I had group health insurance through my employer at the time, which paid 80%, and with each STILL ended up with about $2000+ out of pocket.

Otherwise, I agree with the others about being up front with UHC. I'm sure you are not the first person to ask this, and they will give you an honest answer.

2 moms found this helpful


answers from San Francisco on

Seems to me that to change the terms of the policy, you would have to cancel the existing policy and get a new policy. In that event, the pregnancy probably would not be covered.

I think you should stick to what you have. Like you said, any insurance is better than no insurance.

Congrats on the pregnancy!

1 mom found this helpful


answers from Kansas City on

Most of the time, with insurance changes concerning pregnancy, the change in coverage is not good on maternity benefits for 1 year. This is to insure you don't do just what you are doing. I am not sure calling United is the right thing to do either, if what I stated is wrong, you are raising the red flag on yourself and your situation.

1 mom found this helpful


answers from Washington DC on

The best person to ask is the people at United Healthcare. There should be an 800 number on the back of your card. Call it. Tell them your situation and what they would do.

There are two insurance agents on here - however - i don't know if they are auto or health agents.

My GUESS? You are already partially covered so they cannot deny you since you are covered.

Congrats on the pregnancy and good luck with the insurance!

1 mom found this helpful


answers from Los Angeles on

I'd imagine they won't let you make changes but it doesn't hurt to just call as ask as a "new" member. Doesn't hurt to just ask how much it would cost for general coverage even though you are pregnant. The reason why I think they would deny it is because it's a preexisting condition. If they know you are pregnant, you may be able to change it but it will be at a premium.

Is your insurance group? Meaning from your work? If so, they can't treat pregnancy as a pre-existing condition.

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