Is Pregnancy a Pre-Existing Condition?
Pre-existing conditions are conditions that are already present before the insurance policy comes into effect. Medical issues are commonly considered pre-existing conditions. Some common examples of such conditions are high blood pressure and diabetes. Conditions which are considered are those that will somehow affect the insured’s claims. The insured will most probably need to ask for a higher number of claims and benefits because of the condition that he or she already has. Rather than refusing to provide coverage to applicants with pre-existing conditions, most insurance companies may issue a policy which doesn’t consider claims that are caused by the said condition. They will not consider the claims for a certain amount of given time.
If a woman gets pregnant at the time when she has no insurance coverage, it can be really difficult in terms of financial aspects. Hospital fees are already very expensive. If a complication arises, these fees can escalate even more. During pregnancy, a woman will need financial support for routine obstetrician visits, medical tests, and the hospital bill for when the delivers the baby. A woman who is insured by a policy which does not cover pregnancy claims will have to expect very high bills.
Typically, pregnancy isn’t regarded as a disability, as most women are able to continue their normal activities while pregnant. Still, there are some conditions related to pregnancy which can hurdle a woman’s lifestyle. Alternatively, childbirth and complications which may possibly occur during the process are basically covered under the maternity disability coverage.
Basically, pregnancy is not a pre-existing condition. However, loopholes exists which allow insurance companies to deny coverage to new policyholders who are pregnant at the time that they purchase their coverage. Some, but only a very small percentage of policies, do not consider pregnancy-related claims. If an insurance company does regard pregnancy as such, then the exclusion period will be at least nine months. Claims relating to the pregnancy will not be covered. Claims will only be covered for subsequent pregnancies. Additionally, group health insurances plans cannot exclude pregnancy as a pre-existing condition.
Group Health Insurances
HIPAA (Health Portability and Accountability Act of 1996) ensures that insurance policies cover pregnancy in some cases. But, this is only true for a specific type of insurance coverage, which is group health insurance. Remember, HIPAA only covers group health insurance policies. Individual policies may not consider pregnancy-related claims.
Group health insurances are required by law to accept any applicants. In addition, these plans are not allowed to exclude newborns as long as the child is enrolled within 30 days of his or her birth. This type of insurance falls under the Pregnancy Discrimination Act. This entails that claims related to pregnancy must be covered. A woman who is covered by an employer-sponsored disability insurance plan should be familiar with the terms of her coverage. Most likely, the policy will have certain exclusions, which means the insurance company will only pay for finances which fall under specific circumstances. As such, the insured must be familiar with how the policy works before she makes a claim.