Unexpected pregnancies can be very expensive if you delivery (especially prematurely) after COBRA expiries. If you already have a group health plan, read the SPD or summary plan description to verify that maternity in included. If so, try and plan a pregnancy in the first 1-9 months of your COBRA enrollment, so that your checkups, delivery and post natal / well baby visits are covered. You do not want to find out after the fact that maternity had a $5000 deductible or was not covered under the group health plan.
Pregnancy - a preexisting medical condition
There is one pre existing health condition that can by joyous but painfully expensive. Because of pregnancy, many woman are turned down for health insurance benefits. It's too bad that pregnancy is treated like an illness by many health insurance companies.
Having pregnancy as a preexisting condition which blocks access to health care
is really bad public policy for many reasons beyond the scope of this article.
Your due date and COBRA
If you already have COBRA, your group benefits will continue the same as when you were employed. But depending on your due date, your COBRA benefits may end. The standard COBRA benefits last 18 months. If you conceive anytime between 1-9 months on COBRA, (and deliver within the 18 month time limit), all your hospital and related expenses should covered, subject to the health plan limits.
If you get pregnant after 9-18 months on COBRA, it would be very doubtful that you will have coverage when you deliver your baby (assuming you're full term), as your COBRA benefits only last 18 months.
Also you can work for another employer and stay on COBRA, as long as they do not offer a group health plan to you.
Pregnancy and HIPPA
HIPPA (Health Insurance Portability and Accountability Act of 1996)
is a Federal law that bars insurance companies from considering your pregnancy as a pre existing condition, if you becomes eligible under another group plan. And only if the employer’s group plan includes pregnancy in it's coverage, for every employee. HIPPA only applies to group health plans.
HIPAA doesn't apply to someone who previously had no health coverage at all and then gets into a group health plan through a new job. So if you had no previous insurance, got pregnant, then landed a new job with insurance, your new health plan would not have to immediately cover your pregnancy. You might have to sit out a preexisting condition waiting period, a period that could be longer than your pregnancy and in the meantime pay for your visits yourself.
If you previously were on a group health plan with no lapse in coverage (over 62 days), you can get a certificate of creditable coverage that you take to your new employer's plan administrator that should offset most waiting periods, 6 months I believe is maximum.
If you plan on converting your COBRA health plan to a private health insurance plan, check with your insurance company to see if they would accept your pregnancy / pre existing condition and still pay for her prenatal care and delivery. But most individual health plans do not cover pregnancy as most if it's pre existing.
Pregnancy and Health insurance alternatives
If you are in California, You might qualify for Medi-Cal, a program designed to cover the uninsured, like low-income, pregnant women. Even if you are not in California, there are many other state high risk pools that accept pregnant women without insurance.
If your states does not have a high risk pool, or you cannot afford the high premiums, organizations such as Catholic Charities and Lutheran Social Service often have reduced cost prenatal services available.
Medicaid is a state and federal program that pays for some health services for certain low-income pregnant women, and children. Each state has differing income limits, and guidelines for who qualifies. The average income limit is around $30,000 per year.
Getting accepted by Medicaid is your hardest step. Call the human resources department or social services in your county, and explain that you are calling for a Medicaid for pregnant women application.
Once qualified you should then find a doctor who accepts Medicaid patients. Pregnant women are covered for all care related to the pregnancy, delivery and any complications that may occur during pregnancy and up to 60 days postpartum.
Craig Casey is an Writer, Coach, Blogger, Husband, and Former Health Insurance Agent helping people on the web since 1999 with their health insurance problems.
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