Nov
19
2009

  6 Month Gap In Maternity Coverage

I thought that if we were HIPAA-qualified, that we wouldn't be subject to exclusion periods for health insurance. Unfortunately, that's not exactly the case.

For maternity coverage in a non-HIPAA plan, any pregnancy conceived in the first six months would not be covered at all. No healthy pregnancy checkups, no delivery or hospital charges.

For maternity coverage in a HIPAA plan, an existing pregnancy would be covered (it would have to be existing at the time the contract was signed), but again, any pregnancy conceived in the first six months of the plan would NOT be covered at all.

If I were 20, I don't think this would be a problem, we'd just delay trying to conceived for 6 months. But I'm considerably older than that, and I'm not going to delay trying to conceive again just for some dumb health insurance policy.

Terry and I will just take our chances. If I don't get pregnant before next July, then insurance will cover everything if I get pregnant later. If I get pregnant before mid-February or so, we could get insurance to cover everything (if we go without any health insurance between 12/31 and then so we don't sign a contract too soon). But if I get pregnant during the first six months of the policy, nothing.

If we've got to cover the costs of a pregnancy, that would be fine if it was like my last. I'll have a home birth, see the midwives for prenatal care, we'll pay out of pocket. Even if we have to cover the costs of an emergency C-section, we'll just have to to suck it up and pay out of pocket.

I spoke to someone at the VA board of insurance, and it appears that if something was wrong with the baby AFTER the birth (like in William's case), then the family policy should cover it, no matter when I got pregnant. But we'd need to check with the insurer themselves, since there is no state law on this, it's just up to the insurer. As long as any emergency treatment for A BABY is covered, we're prepared to pay for the birth (even if there are complications). But if we had a preemie twins or something in the NICU for months and it was NOT covered, it could wipe us out. And that would be a problem.

As of now, our plan A is to make like bunnies in an attempt to conceive before the end of the year. My cycles have been anovulatory thus far, so unless I ovulate we won't even have a chance of success, but we'll do what we can.

Plan B will probably involve seeing a lawyer about asset protection so we won't get completely wiped out in a worst-case scenario.