If your doctor gives you the news that your pregnant and you concieved before you got your health insurance is it considered a preexisting condition?? Or does how far along you are when you purchase the insurance affect wether or not you are covered?
2007-04-06 16:17:57 · 6 answers · asked by CalamityJane 3 in Business & Finance ➔ Insurance
Seems like everyone that has answered missed the big question - are you going on a group plan? If so, then pregnancy cannot be considered a pre-existing condition as part of the HIPAA federal laws if you or your spouse are insured on a group of 2-50 employees. If it has more than 50 employees, then pre-existing conditions on everything most likely will be waived, and covered covered from day one.
If it is an individual policy, then there usually is a waiting period before the maternity coverage begins. Also, state laws will vary from state to state regarding this. I suggest calling the state insurance commissioner's office to see what your particular state's laws are if you are on an individual plan. Either way, good luck, and congratulations.
2007-04-07 15:07:54 · answer #1 · answered by nurse ratchet 6 · 0⤊ 0⤋
Many times there's a "waiting period" for maternity benefits - like 90 days, 6 months, or even a year, before they start. Other times, they start right away - but mainly only with an employer's group plan.
Anyway, if you don't have a "waiting period", it's going to depend on how far along you are, and how much the insurance company believes you. If you're talking 4 weeks when the doctor tells you, that's plausible. If you're talking 4-6 months, it's a bit harder to sell that to the adjuster.
2007-04-07 13:00:27 · answer #2 · answered by Anonymous 7 · 0⤊ 1⤋
A lot of health insurance policies won't cover a pregnancy/delivery for the first 10 months that you are covered. If you can 'hold it in' that long you are fine.
Don't try to outsmart an insurance company. They have seen it all before.
Go talk to a licensed insurance agent in your area. You have a lot more needs than just covering the pregnancy.
2007-04-06 16:36:54 · answer #3 · answered by insuranceguytx 5 · 5⤊ 0⤋
If you're 6 weeks or less, you can probably get away with it - but after getting insurance, I would find a new ob/gyn and not transfer the records (so that the insurance company doesn't know that you know). Yes, it is pre-existing if you knew.
Of course, if you got insurance week 4, and then went to the doctor week 6 and found out, then it's not pre-existing per se, just like if you had cancer and didn't know it, it doesn't qualify as pre-existing.
2007-04-06 16:23:06 · answer #4 · answered by Anonymous · 0⤊ 3⤋
It all depends on the rules of the company and what they're allowed to exclude in your state.
In Virginia, for instance, it doesn't matter whether you knew or not; they don't cover pregnancy for individual policyholders if you conceived within the first 6 months of coverage (or before.) It some states, they may be required to do so. Ultimately, you'll have to check with your company to know for sure.
2007-04-06 19:07:42 · answer #5 · answered by ISOintelligentlife 4 · 1⤊ 2⤋
Some pre-existing conditions are there even though you don't know it.
Some "Manifest " themselves, i e, your back starts to hurt and doesn't stop. Something's wrong. That's "manifesting itself. "
Others go by treatment. on Mon your back startsto hurt, you call your dr, on Fri you see him and he says ":you;re pregnant. " That's treatment.
Don't go by us. Ask an agent.
And do it while there are no problems. Saves a lot of headaches.
2007-04-06 19:20:18 · answer #6 · answered by TedEx 7 · 0⤊ 3⤋