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Is Pregnancy A Pre-Existing Condition For Health Insurance?

Before the Affordable Care Act, health insurance companies treated pregnancies as a pre existing condition. Is that still the case today?

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Starting a new family is both an exciting and nerve-wracking time in your life. After the initial shock and joy begin to fade, the inevitable question arises, “Can we afford a baby?” Adding a member to your family is expensive, there’s no way to sugarcoat it, but how can anyone call your new bundle of joy a liability? Let’s dive in and find out whether or not your pregnancy is really considered a pre-existing condition.

Is Pregnancy Considered A Pre-Existing Condition?

A pre-existing condition is any health issue or chronic condition that you had before applying for coverage. Essentially, anything that requires additional medical benefits and costs is considered a pre-existing condition, and since there are a series of checkups and tests you need while you’re expecting, pregnancy would, therefore, be considered a pre-existing condition.

However, if you were already enrolled in a health insurance plan that comes with prenatal care (which most do) before you got pregnant, then you may not have to worry. Luckily, you don’t have to worry about your pregnancy being considered a pre-existing condition, or any chronic health issue you have for that matter, which we’ll touch on in just a bit. According to Healthcare.gov, pregnancy is not considered a pre-existing condition. With that being said, you would not be denied coverage or charged a higher premium due to your pregnancy at the time that you applied for a new health plan. However, pregnancy was in fact considered a pre-existing condition before the ACA (Affordable Care Act).

In most cases, health insurance will cover some of the costs associated with pregnancy. This can include prenatal care, delivery services, and postpartum care. The exact coverage will vary depending on your individual plan, so it is important to review what is included and excluded in your policy before signing up. Some plans may also provide additional benefits such as coverage for pre-existing conditions or flexible spending accounts for out-of-pocket expenses. Be sure to ask questions and do research to make sure you understand exactly what is covered by your health insurance in case of a pregnancy.

What About For Short-Term Disability Insurance

Short-term disability (STD) insurance providers do consider pregnancy a pre-existing condition. If you’re looking to get covered while you’re pregnant, then your best bet is to explore other options. If you get pregnant after you are already enrolled, your provider won’t terminate your policy, but the benefits won’t cover your prenatal expenses but will help with your income when you can’t work.

What About Travel Insurance?

Travel health insurance companies consider pregnancy a pre-existing condition, and may not cover you if you’re expecting. However, you may still be able to get enroll in a travel insurance plan even if you’re pregnant, but your prenatal care may not be one of the benefits.

Can You Be Denied Coverage While Pregnant?

You cannot be denied coverage for being pregnant if you are enrolling in health insurance coverage through the Affordable Care Act’s marketplace, but if you are looking to enroll in a private plan outside the marketplace, you can still be denied coverage.

The health insurance marketplace made it significantly easier for expecting mothers, and anyone with pre-existing or chronic conditions for that matter, to find affordable and comprehensive coverage. Prior to the Affordable Care Act, most women and families had to purchase pre-existing pregnancy insurance which was often expensive. Today, if you’re expecting, then your best bet is to get covered through the health exchange, and you may even qualify for a subsidy.

Switching Health Insurance While Pregnant

Switching health insurance while your pregnant is tricky. If you have private health insurance, then switching coverage while expecting may be either incredibly expensive or not possible. Remember, private health insurance companies can deny you coverage if you are pregnant.

On the other hand, if you are enrolled in an Obamacare marketplace plan, then you may have to wait until the Open Enrollment Period to switch coverage. So, while you’re allowed to switch coverage while pregnant, you may find yourself stuck with your current plan until November.

Prenatal Care Benefits

Woman receiving prenatal care

If you have health insurance during your pregnancy, then you may not have to worry about costs associated with your doctor visits. For most plans, the following prenatal benefits are typically covered (though you may want to confirm with your insurance provider):

  • Sexually transmitted disease (STD) testing and counseling
  • Rh incompatibility (blood condition) testing
  • Folic acid supplements
  • Anemia screening
  • Urinary tract infection screening
  • Gestational diabetes testing
  • Labor and delivery costs including C-section
  • Hospital stays
  • Counseling for breastfeeding
  • Midwife services
  • Any complications associated with your pregnancy
  • Recover
  • Neonatal care

Enrolling In Medicaid When Expecting

Medicaid does not treat pregnancy as a pre-existing condition, meaning you if you qualify for Medicaid while expecting, you cannot be denied coverage. In fact, many pregnant women turn to Medicaid or the Children’s Health Insurance Program (CHIP) for their health insurance needs.

When you are enrolled in Medicaid, you can expect the same, if not more prenatal care benefits to be covered. Medicaid is one of the most comprehensive options available, so if you’re eligible, it’s definitely worth exploring this as your pregnancy pre-existing condition insurance.

What Happens After Your Baby Is Born?

Once your baby is born you will be eligible for a Special Enrollment Period. That means you are free to switch or enroll in a plan of your choice outside the traditional Open Enrollment Period.

What Does The Future Of Healthcare Hold For Expecting Mothers?

The Affordable Care Act made sure pregnant women would not be treated as if they had a pre-existing condition. It not only guaranteed coverage for expecting mothers but created a market that offered more affordable health insurance options for everyone with pre-existing or chronic conditions. Unfortunately, the current administration has been pushing legislation that puts pregnant women in jeopardy.

While women still can’t be denied health insurance when pregnant, the GOP has definitely been pushing a different agenda and is looking to repeal the Affordable Care Act altogether. That would obviously be a major loss for anyone with a pre-existing condition, but for now, there’s nothing to worry about.

Things to Consider While Choosing the Best Health Insurance for Pregnancy

Whether you’re expecting a baby or looking ahead to the future, it’s important to consider your options when it comes to health insurance plans. With so many different plans available, it can be hard to know which one is best for you and your growing family. To help make the process easier, here are some tips on what to consider when choosing a health insurance plan for pregnancy.

Cost of Coverage
One of the most important things to consider when selecting an insurance plan is the cost of coverage. Most health insurance plans will cover essential prenatal care and delivery costs, but there may be additional fees for additional services such as ultrasounds or genetic testing. It’s important to understand exactly what is covered under each plan before making a decision so that you don’t end up paying more than necessary.

Maternity Benefits
When looking at health insurance plans, make sure that they include maternity benefits such as doctor visits, hospital stays, and any other medical expenses related to pregnancy and childbirth. Some plans also offer additional benefits such as breastfeeding support or postpartum care. Be sure to read over all plan details carefully so that you know exactly what is covered and what isn’t before making your selection.

Network Providers
Another thing to keep in mind when choosing a health insurance plan is the network of providers associated with the plan. Make sure that your preferred doctor or hospital is in-network so that you can take advantage of all available discounts and benefits associated with the plan. If not, you may have to pay out-of-pocket costs for services outside of your provider network.

Selecting a health insurance plan that covers pregnancy can be daunting but it doesn’t have to be! By understanding the costs involved, making sure there are adequate maternity benefits included in the policy, and confirming that your preferred doctors are within the provider network, you can find the perfect health insurance plan for your needs! Take into consideration all factors before making a decision on a healthcare policy so that you can rest assured knowing that both yourself and baby are well taken care of throughout your pregnancy journey!

Conclusion

When it comes to finding the best health insurance for pregnancy, there are a few key factors to consider. Many health plans offer coverage specifically tailored towards pregnant women, so be sure to review your options carefully before enrolling in one. Make sure that any plan you choose covers prenatal visits, delivery costs, and postpartum care for both mother and baby. It’s also important to look at coverage limits and plan exclusions to make sure you’ll have enough financial protection if any complications arise during pregnancy. Doing your research can help you find the best plan for your individual needs and budget. Compare health plans today at First Quote Health!

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