Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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Pregnant woman and health insuranceYes, you can get health insurance when pregnant; however, there are many limiting factors as to the type of coverage you will be eligible for and when the coverage will become effective. Currently, about 13% of pregnant women in the country do not have any health insurance coverage.

This article outlines the legality of labeling pregnancy as a pre-existing condition, the ability for pregnant women to obtain both private and group health insurance, and other options available to help manage the high cost of pregnancy related medical care.

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Is pregnancy considered a pre-existing condition by insurance companies?

While the 1996 Health Insurance Portability and Accountability Act (HIPAA) makes it illegal for providers of group health insurance plans to view pregnancy as a pre-existing condition, there are many exclusions to this law.

Also, this law does not apply to private insurance obtained outside of work offered group health plans. So, although the law makes it sound like a pregnant woman can obtain instant coverage; that is not the case due to the exclusions listed below.

One- If you change jobs you must have had group coverage at your old job to be automatically covered by the group health insurance at your new job. If you did not have coverage then you will be subjected to a waiting period that could be a year long. Clearly, after this length of time you have already incurred all the pregnancy related cost.

Now you will need that insurance to pay for a new child! If the waiting period is only a month or so you will need to pay out of pocket for any costs in that time frame.

Two- Since HIPAA only applies to group health plans, the same scenario will exist if you attempt to switch from private insurance to the group plan at your new job. That waiting period makes the coverage worthless and you are better off holding onto your old coverage.

At the end of the day, private insurance companies do still treat pregnancy as a pre-existing condition and they will not offer you coverage if you don’t already have it. However, there are other options you can consider. These include government options, working out a deal with your facility, discount plans and charity based help.

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What government health insurance options are there for pregnant women?

Medicaid, WIC and several state sponsored government options exist to help low income women afford the costs of pregnancy that currently run from about $6,000 to $8,000 for a healthy pregnancy and birth. You can find options online for each of these programs and look at your state department of insurance for local options.

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How do hospitals help pregnant women deal with the cost of pregnancy?

Another option is to approach the administrative or billing department of your hospital to see if they offer a sliding scale or a payment plan. If they don’t you may look at another facility in your area. Also, check into local birthing centers as opposed to hospitals. The cost of having a baby at birthing centers tends to be up to $2,000 less for pre-natal care and childbirth than at a hospital. These centers are obviously focused on the needs of pregnant women and therefore more likely to offer payment plans and sliding payment scales.

Do discount plans offer health insurance to pregnant women?

Discount plans, like Ameri-plan, are not health insurance. They do not require deductibles or put limits on coverage amount. What they do pay for is quite specific; however, if you simply cannot obtain insurance you may be able to get significant discounts of as much as 50%, from these plans. They are not as comprehensive as health insurance, but another option.

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Do any charities offer financial health to pregnant women?

There are some charitable organizations that will help a pregnant woman with the costs of pregnancy, as well as offer emotional support and resources. Both Catholic Charities and Lutheran Support Services may be options for women struggling with this issue. Ask a local church, doctor’s office or social services office for recommendations.

To re-cap the situation, yes, you may be able to get health insurance when you are pregnant. However, unless you had previous coverage through a group plan and are merely transporting that to another group plan, you will be forced into a waiting period that nulls the coverage during the time period of your pregnancy. The high health insurance rates mean that looking into all options is wise.

Your other options include government programs, working out a deal with the hospital or birthing center, discount plans and charitable assistance. Don’t despair, even if health insurance does not sound like an option for you at this time. There is help out there for pregnant women.

To prevent yourself from falling into the same situation twice, you will want to secure health care now, even if it will not take effect until after your child is born. Without a doubt, the birth of a child means that you will need that coverage for the next 18 years.

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