Pre-existing?

Question

Okay we applied for Healthy New York medical insurance. It is by Community Blue but has lower premiums for small business owners. My question is I just found out that I am about 5 weeks pregnant. The doctor will not want to see me until I am 8-9 weeks (around the end of September). My insurance will begin September 1st, however I got pregnant the last week of July when I was not covered. Since I never saw a doctor and won't until I am covered will this pregnancy be considered pre-existing?

Also, if it is considered pre-existing, will it eventually be covered after a few months- in time for my delivery?

Answer 1

I think you are OK and here is why...

I looked at the application you completed for this program (let me know if it is not the right one - I put the link under sources)

1. You did not know you were pregnant when you signed up.
2. The application did not ask any medical questions - they did ask if you were pregnant, but only so they could add another person to the policy rate.


I would call them and let them know (1-866-432-5849)

Answer 2

I don't know the specifics of the Healthy New York plan.

However, *in general*, it is possible for a plan to not cover maternity stuff at the beginning of a policy. (This is done to prevent people from waiting until they are already pregnant to obtain health insurance.) What would happen is that normal pregnancy related conditions would not be covered for 270 days from the date that the policy began. In other words, just enough of a time period to make sure that the woman wasn't pregnant when she signed up.

Generally, in a case like that, medical complications of pregnancy/delivery would still be covered. (Ex - you're in the hospital delivering your baby and end up having a stroke...the insurance policy would still cover the treatment of the stroke even though it happened during a non-covered delivery.) But the regular prenatal and delivery charges would be excluded.

The only way to know whether or not your specific policy will exclude your pregnancy is to review the policy documents once they are sent to you. If there is an exclusion for the service, it should be stated somewhere in the policy.

(And, of course, as someone mentioned...if a person were transfering from one group policy to another, pregnancy generally wouldn't be considered pre-existing. There are just exceptions and quirks that come along with purchasing your own policy rather than going through a large employer group.)

Answer 3

I do not know the correct answer, but I know that the answer about "chronic diseases that might disqualify you from getting an insurance policy" is wrong in this case. The question dealt with New York. NY does not allow persons from 19-64 (I assume no one is pregnant after the age of 64) to be excluded due to chronic diseases. By the way, this law also makes NY insurance so expensive that the seemingly "low" premiums with Healthy NY years ago were already more than I am paying now in California without being a small business owner, and roughly what a large business would have paid (per person) for a group plan in NY.

Answer 4

A pre-existing condition means you would have to be treated for it BEFORE you were covered with your new plan. If you are pregnant but never saw a doctor than it is not pre-exising. Insurance companies cannot base pre-existing standards on symptoms that you had before treatment without a diagnosis, There is no way for them to investigate the condition if you never saw a doctor for it.

Answer 5

I do not think that they will deny you medical coverage because you were already pregnant. Usually the pre-existing condition goes toward chronic diseases that might disqualify you from getting an insurance policy.

Answer 6

Yes, it will - unless you're currently covered by health insurance whcih covers pregnancy, and just SWITCHING to the new company.

Answer 7

Yes it will.