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Can You Get Health Insurance When Pregnant?

can-you-get-health-insurance-while-pregnant

ANSWER:

In many cases, you cannot get health insurance when pregnant.

More Info: As of this writing (2013), most insurance companies will not insure you if you are attempting to become a new subscriber and are already pregnant.  You may be eligible for your state’s high-risk pool insurance program or pre-existing conditions insurance program.  Under this program, you will purchase a plan based on each state’s premiums.

What Is the Health Insurance Portability and Accountability Act?

The Health Insurance Portability and Accountability Act of 1996 made it illegal for group insurance providers to consider pregnancy a pre-existing condition.  Unfortunately, the loopholes in this law still make it extremely difficult for a pregnant woman without health insurance to become insured.  For example, group providers are allowed to implement up to a twelve-month waiting period from the start of a job until coverage kicks in.  Women who are already pregnant when hired would not be insured at any time during their pregnancy.

What Is the Affordable Health Care Act?

Currently, only group health plans with 15 or more employees are required to cover maternity costs.  Some individual plans offer maternity benefits as a rider but it is not required. As of 2014, under the Affordable Health Care Act, maternity benefits will be included in all health plans including individual, small business, and Exchange plans.

Do I Have Any Options Now?

The government is attempting to make it easier for pregnant women to receive the health care services that they need.  There are several programs for which you may qualify.

Medicaid and the Children’s Health Insurance Program
Every state operates programs that help low-income families receive medical care.  You may qualify for one of these plans based on your individual state’s criteria.

State High/Risk Pools Pre-existing Conditions Insurance Programs
You may be eligible for your state’s high-risk pool insurance program or pre-existing conditions insurance program.  Under this program, you will purchase a plan based on each state’s premiums.

Find a Job that does not have a health insurance enrollment waiting period.
It is a long shot, but if you are looking for a job, or looking to change jobs, you may be able to find an employer that offers health insurance coverage that will cover your pregnancy.  Employers with 15 or more employees are bound by the Health Insurance Portability and Accountability Act of 1996.  If the employer does not have an enrollment waiting period, or has a very short one, you can apply for a job and for health insurance coverage.

 

Resources

“Frequently Asked Questions about Portability of Health Coverage and HIPAA.” United States Department of Labor. N.p., n.d. Web. 10 Oct. 2012. <http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html>.

“Rejected for Insurance | HealthCare.gov.” Home  | HealthCare.gov. N.p., n.d. Web. 10 Oct. 2012. <http://www.healthcare.gov/using-insurance/managing/need-rejected/index.html#pregnant>.

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