Basics of Health Insurance: Maternity Insurance
Health insurance can be confusing, and maternity insurance is no exception. Some health insurance companies will try to tell you that it is impossible to get maternity insurance after you become pregnant. But unplanned pregnancies happen everyday and even unplanned babies and their mothers need health coverage and prenatal care. That’s why the federal government made concessions for pregnant women under the Health Insurance Portability and Accountability Act.
HIPAA and Pregnancy
Under HIPAA, health insurance companies cannot consider pregnancy a pre-existing condition. They cannot invoke an exclusionary time period, nor can they deny payment for prenatal care and delivery costs for both mother and infant.
However, this only applies to group healthcare plans that offered maternity coverage before the pregnancy occurred. If your employer does not offer maternity coverage, you cannot change plans after becoming pregnant to obtain maternity insurance under HIPAA. However, some insurance carriers may be lenient on this issue so it doesn’t hurt to ask around if you find yourself without maternity insurance when you become pregnant.
Changing Jobs While Pregnant
If you find yourself in a situation where you must change jobs during a pregnancy, you may find yourself without maternity insurance. Insurance carriers are not required by law to waive the standard waiting period for new employees, so if your new employer requires a 90 day probationary period before health benefits take effect, you may be without coverage for those 90 days. Depending on the timing, you could be without health insurance and maternity insurance during your delivery.
The best way to avoid this problem is to opt into COBRA coverage with your previous health plan before leaving your old job. COBRA insurance is pricey, but not as expensive as paying for a labor and delivery bill out of your own pocket.
What to Do When COBRA is Not an Option
California Assembly Bill 1401 amends the federal COBRA laws to extend COBRA coverage for up to 36 months. However, if you work for the federal government, a church, or have individual health coverage, COBRA laws may not apply.
If you are ineligible for COBRA coverage, you do have other options. You can always purchase maternity insurance through a private policy or a group plan through a professional organization or trade association. However, getting coverage while pregnant through a private health plan is very expensive. You may need to weigh your options carefully. You may find that paying for a prenatal visit or two is less expensive than paying outrageously high private healthcare premiums.
Maternity Rights
Federal laws protect women from being excluded from a job or promotion based solely on her plans to become pregnant. It is illegal for an employer or potential employer to ask a woman if she plans on becoming pregnant. Even women who plan on starting a family right after obtaining a new job are not exempt from being offered healthcare if all other eligibility requirements are met.
If you are planning on becoming pregnant, it is important to know the specifics of your health insurance and maternity benefits. Knowing what to expect can help you plan ahead for covering the cost of prenatal visits and labor and delivery.