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Total Health

Switching Insurance during Pregnancy

By:
David Lack

Question :

I just found out that I'm pregnant. Meanwhile, my husband just got a great job in a different state (Maryland) starting in three months. He will receive health insurance, but I'm concerned that unless I get a new job right away, my prenatal care and delivery will not be covered because it's a pre-existing condition. I know that Maryland has progressive laws concerning women's health and maternity issues, so I'm hoping this isn't the case.

S.B.

Answer :

In a mobile society like ours, pre-existing conditions are a big concern to many people. Fortunately, those who maintain continuous insurance coverage have less to worry about than those with pre-existing conditions and no insurance.

Federal law protects the insurability of those who are covered continuously. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established new rules for group and individual insurance. For example, group insurance is now available on a guaranteed-issue basis to all employees in businesses that offer health insurance as a benefit. A person cannot be turned down for insurance due to a pre-existing condition, though separate rules govern the treatment of such conditions.

Most companies that offer insurance to employees also make it available to dependents of the employees. If an employee and/or his or her dependents have satisfied a one-time, 12-month exclusion for pre-existing conditions, they can move to new employer-provided insurance without having to satisfy another exclusionary period. This means that when you and your husband move to Maryland, it is likely that you will be covered by your husband's plan immediately. If the insurance plan includes maternity benefits, your pregnancy will be covered. There may be a charge for dependant coverage, but it is well worth it.


Good coverage and good medical care are so important during a pregnancy. Because of the protections and guarantees of the law, perhaps the only difficulty for you will be to find a new obstetrician for your continuing prenatal care. You may want to do some research on the physicians near your new home before moving.

As to other programs and laws related to women's health, call the state's health department or insurance department for more information. There may be resources that will benefit you and your baby.

 

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