Pregnancy and Health Insurance

iVillage Member
Registered: 10-15-2011
Pregnancy and Health Insurance
5
Sat, 10-15-2011 - 4:44pm

Hi! My husband and I want to start trying for our first child. As of right now my husband needs to apply for health insurance, at his new job. His workplace will be doing this in November (next month). If everything goes good our health insurance plan will be effective January 01, 2012. We know that it takes an average of three months to get pregnant and we wanted to start next month. I am wondering if I was to get pregnant before January would my health insurance cover my prenatal costs once our plan is effective in January, even if I got pregnant before the plan was effective? We would not start trying until we knew we were accepted for the health insurance plan, so I am wondering if it would be

iVillage Member
Registered: 10-15-2011
Sat, 10-15-2011 - 4:53pm

I thought I would also post this question on a board where maybe someone has already gone through this or knows a little more about this :)

iVillage Member
Registered: 06-05-2010
Mon, 10-17-2011 - 4:35pm

Hey there!

Let's say it doesn't take you 3 months to get pregnant; and you end up pregnant before the end of the year. Worst case scenario is that you would be paying for doctor's visits out of pocket until your insurance kicks in (and that can get expensive).

And unless you have some really WEIRD insurance, it should kick in and pay for the rest of the pregnancy come January.

But, to be on the safe side, just ask! They'll be upfront with you about what they will and won't cover.

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iVillage Member
Registered: 07-05-2005
Thu, 12-01-2011 - 1:21am

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iVillage Member
Registered: 09-08-2008
Tue, 12-06-2011 - 2:12pm
Staci is right, KH, as a general rule...your insurance will pay for everything you go to the dr for from January 2012 for as long as you are on the plan. I am actually in the health insurance business in Texas, and I can tell you that here group plans over 15 employees have to cover maternity automatically. They can't deny it or say that it is a pre-existing condition if you got pregnant before you joined the plan. But if you go to the doctor before January, the doctor might require payment of certain services before your insurance kicks in. That part of it is up to the doctors office and the way they bill. The common thing I see is that they bill at the end for all your prenatal stuff, except for some blood tests and misc. in the beginning.

Again, that is going from Texas insurance law, but I think most states are similar. If you go to a good OB, they will get your insurance information when you receive it, they'll run it in the system, and they will sit down with you and explain your benefits and the cost of everything. But you'll still be on the hook for any actual office visits or lab work done before January. Hope that helps!
iVillage Member
Registered: 12-15-2011
Thu, 12-15-2011 - 3:35pm
Don't know if your question was answered, but according to my cousin who works for a major insurance company you would not be covered. You best option would be joining medical which covers all medical expenses three months prior to the date you apply. You can always cancel once your husbands insurance kicks in and nothing is out of pocket. Hope that helps.
:)