Changing insurance while wife is pregnant.

I am not sure if anyone has experience in this, if you have insight into this I would appreciate it. My wife is currently pregnant (with twins) and is due in February. I was planning on looking to gain new employment in IT at that point. I have become aware that a position will be opening up this week in a company I would really like to work for. My question revolves around my wife and her care. I am nervous that things may change (hospital, doctors, etc.) if I gain new employment, but if I wait I may miss out on a good opportunity.

Any thoughts?

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Comments

leefdaddy

At most employers, around here anyways... you aren't eligible for health benefits, etc until after atleast 90 days of employment.

You might want to check into that.

cacharo

Good point, I certainly will. The company is a fortune 50 health care provider, so I hope that is not the case.

Thanks for your input.

RTmarc

You need to be extremely careful in this case. Most insurance companies will consider pregnancy a pre-existing condition and will not pay for it. You really, really need to check on that prior to swapping jobs.

cacharo

Makes sense, have you heard of that happening before?

Plantwiz

RTmarc wrote:

You need to be extremely careful in this case. Most insurance companies will consider pregnancy a pre-existing condition and will not pay for it. You really, really need to check on that prior to swapping jobs.

Check into things BEFORE any decision is made.

You will qualify for COBRA, but you'll want to avoid filing if you can as long as you can...however, it is most likely that with your exisitng coverage....any difficulty with the pregnancy or just shortly thereafter will all fall into the 'pregancy' and have a better chance of being covered.

If you switch jobs and there are complications with the delivery (and let's hope there are not...just using as a point of the discussion), you may be paying some pretty heafty bills.

Now, the kids and the wife are worth it!

HOWEVER,
A typical, healthy, single delivery in a medium sized city, with pretty good insurance ...the bills run around $5K +/- (now you won't pay that, but that is what the bills are which get covered by insurance in the 'discount' rate).

A c-section will take you to about 10K +/-

An 11-day stay in NICU for 1 baby...about $80K (and insurance many or may not cover this..depends on your plan and the plan limits...some will be covered some won't).

A 4 day ICU stay for the mom who has some complications (35K in addition to the baby).

Now add a second baby to the equation....it's pretty expensive.

****

NOW, many times, multiple births are handles NO problem by the mom and the babies go to term and everything is perfect and the fun begins at home.

***

TO keep the sanity in your marriage, and in particular with Mom caring 2 babies...she's worring about stuff already (even when she tells you she isn't), keep her stress level down and put the job change off a year or two.....unless of course you have NO choice and have to change jobs.

***

And YES it is posible the insurance company will consider pregnancy as a pre-existing condition and waive coverage of the event until after 'x' time has passed. When women fill out insurance paperwork....they'll ask you if you ARE pregnant...it changes their equations a bit.

dtlokee

I had an employee who was married and didn't have healthcare at all. Found out his wife was 2 months pregnant, applied for healthcare through my company, got coverage for him and his wife (not even family coverage), his wife gave birth 6 months later, upgraded to a family plan (had 30 days from the day the child was born to add him to the policy), no issues. I would say check into it carefully and if the job is that much better and you can qualify for COBRA like Plantwiz said but that can run 600-1000 a month.

cacharo

Thanks everyone for your insight into this. I really appreciate it.

blargoe

You would qualify for COBRA, it would be very expensive for you to carry this for the 90 day waiting period until you get on your new employer's insurance. It's something we all deal with when we change jobs, it's just part of the game. NOT carrying it when you leave the current company is not an option if your wife is pregnant, if you expect these weekly/biweekly visits to the doctor to be covered. And if she isn't going weekly yet trust me she will, she is carrying TWINS for pete's sake! That is going to be considered by her ob doctor a high risk pregnancy just by default and he will want to keep a closer eye on her (speaking from experience, being the father of twins myself).

Congrats on the twins, and good luck with the job hunt. Make sure you have your bases covered - you're probably not going to have issues with pre-existing conditions as long as you have carried your employer's group plan for a good while and carry the COBRA when you leave so the continuous coverage doesn't lapse.

fonque

RTmarc wrote:

You need to be extremely careful in this case. Most insurance companies will consider pregnancy a pre-existing condition and will not pay for it. You really, really need to check on that prior to swapping jobs.

dont scare him with this nonsense, this does not apply to medical coverage through an employer.

He just needs to find out when the health benefits start, and what network they use, and whether its a ppo or hmo. This will let him know if he can keep his same doctors.

COBRA is fine but its damn expensive.

Plantwiz

fonque wrote:

RTmarc wrote:

You need to be extremely careful in this case. Most insurance companies will consider pregnancy a pre-existing condition and will not pay for it. You really, really need to check on that prior to swapping jobs.

dont scare him with this nonsense, this does not apply to medical coverage through an employer.

...quote]

It can, and it is worth inquiring BEFORE he takes the position and the pregnancy won't be covered.

This maybe varies state-to-state, but can be a stick point.

I don't think it was stated to 'scare' anyone. It merely serves as a reminder of things to consider. Changing a job when one is young and single (and healthy) is a snap. Changing jobs when a child has a chonic aliment...a spouse with 'x'...etc...they (insurance companies) will in many cases cover you at some point, it may be an additional 6 month, it could be 2 years, or it could be a higher premium. Sometimes the employer will accept this responsibilty and PAY for it for the employee so that the coverage (costs) are paid for in the employees eyes....but those costs are still present. I worked with a young guy who had a bad tooth problem, but was 6 months away from dental coverage. His supervisor wanted him to be productive and they simply paid the costs for him. Coverage vaiers and if you can find a company who 'self-insures' you may find additional benefits....point is don't assume coverage will be there because your a nice person. Insurance goal is to pay as little as possible as slowly as possible.

blargoe

fonque wrote:

RTmarc wrote:

You need to be extremely careful in this case. Most insurance companies will consider pregnancy a pre-existing condition and will not pay for it. You really, really need to check on that prior to swapping jobs.

dont scare him with this nonsense, this does not apply to medical coverage through an employer.

He just needs to find out when the health benefits start, and what network they use, and whether its a ppo or hmo. This will let him know if he can keep his same doctors.

COBRA is fine but its damn expensive.

When I changed employers, the insurance provider with the new company had a clause that there had had to be a certain number of days (I want to say it was a year) of prior coverage thru a group plan for any pre existing conditions to be covered.

The only way to be sure is to contact the HR department of the company.

Kaminsky

Kinda bings home how lucky we are over here in the UK where we have the free national health servce where everyone gets treated no matter what with the best treatment possible within limits. Other European countries have access to these same facilities for free if they are over here at the time due to recipricol agreement between EU countries. (Although a lot of their health services are far better than ours but usually paid through national contribution)

Even though our health service is in a bit of a mess right now, these sort of questions never ever come up for us. A pregnant woman has full access to checkups, choice of delivery and even gets 6 months paid leave from work and their job held open by law. This is regardless of her financial situation.

kevozz

Kaminsky wrote:

Kinda bings home how lucky we are over here in the UK where we have the free national health servce where everyone gets treated no matter what with the best treatment possible within limits. Other European countries have access to these same facilities for free if they are over here at the time due to recipricol agreement between EU countries. (Although a lot of their health services are far better than ours but usually paid through national contribution)

Even though our health service is in a bit of a mess right now, these sort of questions never ever come up for us. A pregnant woman has full access to checkups, choice of delivery and even gets 6 months paid leave from work and their job held open by law. This is regardless of her financial situation.

LOL. It's not "Free". You pay for it in higher taxes.

kevozz

All of this may have been covered in this thread, but here is how it works from my experience.

I've had companies that started insurance coverage immediately, 1, 2, or 3 month waiting periods.

In this case, you will need to purchase/continue your insurance through COBRA until the coverage from you new company kicks in. You will have to pay the full premium for your health insurance, but it's the same insurance as before. It can be less costly if there is any medical treatment needed.

If you are on a "Group" health plan and move your coverage directly to another "Group" health plan, there can be no pre-existing conditions so long as there is not a lapse of coverage greater than 63 days. Make sure you get a "Certificate of Prior Coverage" from your previous insurance company to give to new insurance company to show coverage so there won't be any pre-existing conditions.

It won't cost you more per say, than anyone else since your wife is pregnant. That's why it's Group health coverage. The cost is spread out evenly across a group, like all the people that work for a specific company. The cost for each person in that group is the same. It the cost of insurance goes up, the entire group shares the increase equally.

The last 2 health insurance plans i have been on did not treat pregnancy as a pre-existing condition. I'm not sure is that is plan specific or law though. Those same plans waived all pre-existing conditions if you used their in-network doctors.

I've seen a few plans that don't cover pregnancy, but those were individual plans that cost less. Have not seen this for Group plans.

I have also seen a few plans that will not cover any major surgeries for a specific time period (like the first year), but that was about 15 years ago.

There is a good chance you can use the same doctors with your new insurance. Most will accept many different insurances, especially if it's a large insurance company.

blargoe

In my case, specifically I was told by my former employer that there could not be more than a 63 day gap in coverage, or the insurance company could legally not cover pre-existing conditions. I don't know if that is a state law or a federal law though.

Personally I had to take the COBRA because two of my kids had serious medical conditions that required some very expensive treatment. COBRA is quite expensive, but if you're taking another job it will only be two or three months, and it will save your butt if you have anything expensive going on medically (like a pregnancy). Particularly one with twins involved. Trust me, don't gamble on this one.

cacharo

Kaminsky wrote:

Kinda bings home how lucky we are over here in the UK where we have the free national health servce where everyone gets treated no matter what with the best treatment possible within limits.

I almost specified that I lived in the US, but then I realized I was specifying that I was living in the US.

As an update to everyone, I am going to apply for the position. I will take everyone's advice and comments into consideration if I get any further in the hiring process. I really appreciate everyone sharing their (horror) stories and knowledge.

TempGuy

This is an old thread, but was the first to come up when I searched Google. So I thought I would reply.

Base don HIPPA, it is against federal law to consider a pregnancy a pre-existing condition.

The previous poster was right that if you go less than 63 days without group coverage, they have to cover you. Here's how the company gets around it. They make you wait 90 days before you get health insurance. So if you don't get COBRA, wham, you're out of luck on pre-existing conditions, but not pregnancy.

On the other hand, during those 90 days, without COBRA, you won't coverage for all those prenatal visits. My wife is high risk, and has preexisting conditions.

I'm lucky, I work for a pharmaceutical company where we have coverage from Day 1, with all prrexisting conditions, regardless of previous coverage. However, I'm looking at a new job with a 90+ day wait period. I'm using that as my reason to decline the offer, though there are many other concerns I had the job.

Devilsbane

leefdaddy wrote: »

At most employers, around here anyways... you aren't eligible for health benefits, etc until after atleast 90 days of employment.

You might want to check into that.

COBRA is always an option. You can continue your current coverage for something like 15 months. Unfortunately you will end up paying roughly double what you did before because you now have to pay the employers part.

http://www.dol.gov/ebsa/cobra.html

RTmarc wrote: »

You need to be extremely careful in this case. Most insurance companies will consider pregnancy a pre-existing condition and will not pay for it. You really, really need to check on that prior to swapping jobs.

It is a pre-existing condition, but that doesn't matter as long as you have proof that you never had a gap in health insurrance. If you quit job A and then waited a year before taking job B, then this would be a serious issue.

EDIT: Silly me, just noticed that TempGuy bumped a 3 year old thread. Sorry for the posting.

veritas_libertas

fonque wrote: »

dont scare him with this nonsense, this does not apply to medical coverage through an employer.

He just needs to find out when the health benefits start, and what network they use, and whether its a ppo or hmo. This will let him know if he can keep his same doctors.

COBRA is fine but its damn expensive.

It's not nonsense, I was specifically asked about this when I came on to my company's health insurance plan.

MrAgent

I changed jobs while my wife was pregnant as well. Most companies in the DC area either offer you insurance on day 1, or you may have to wait 30 days. I had to wait 30 days, but I was had insurance from the old company until the end of the month... so I ended up only going a week without insurance.

Ask the company about their health benefits.

My son was in the NICU for 7 days and the total bill came out to $20,000. Thanks to my new insurance, I didnt have to pay a dime.

SteveLord

MrAgent wrote: »

My son was in the NICU for 7 days and the total bill came out to $20,000. Thanks to my new insurance, I didnt have to pay a dime.

Mine was in NICU for twice as long after transferring from another hospital. Got a $135,000 bill! After a phone call or two...TriCare/Army finally took care of it.

rfult001

I'm doing this right now...

My wife is high risk because she is pre-hypertensive and she had a c-section with the first kid. Thankfully, with some of the more recent changes in healthcare regulation, I don't think you can be denied for pre-existing conditions anymore. I am also pretty lucky that my new employer is paying COBRA until I am eligible for insurance.