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jenjen | Insurance and pregnancy? |
I just found out today that I am pregnant. Also today I found out that I got a new job that I had applied for. I currently work at Wal-Mart and was planning on staying there part time. I have ok insurance through my current job, but the job I will be starting has better coverage. I was planning on swiching insurances when I start the new job but will the pregnancy be considered pre-exesting? I could keep the insurance through wal-mart, but being pregnant I don't know how long I'll be able to hold down 2 jobs. Any suggestions?? Serious answers only please. |
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Michael S
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Keep the insurance you currently have, because no one will cover the pregnancy now. It's like trying to buy auto insurance after having a car wreck. No one will cover it. If you lie on your application, there's a chance the new carrier will find out when you became pregnant, (they contact your doctor, or access your medical history through a national data bank) thus they would deny the claim. Keep what you have until the child is born. |
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Suzanne: YPA
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I agree with "Deep5223," except that HIPAA requires at least 12 months (not 2 years) of "Creditable Coverage" (18 months for a late enrollee) under your present group plan and that there cannot be more than 63 days' (not 60 days') lapse; also, I'm unsure where the "25 employees" reference comes from; it's not in the Federal Code. If your new insurer's plan is subject to state insurance laws (not all are), that state may reduce the 12 month period.
If you've been covered under your present group plan for at least that long, you're fine, as long as you sign up for your replacing plan as soon as you're eligible. If you have at least 12 months of Creditable Coverage, this cannot be considered a pre-existing condition. You will have to provide a copy of your "Evidence of Creditable Coverage" form (which you'll receive in the mail) when you sign up for your new insurance.
If you were not enrolled under your current plan for at least 12 months, your present "Creditable Coverage" may not completely extinguish the pre-existing condition exclusionary period under your new plan. If this is the case, send me a message through Yahoo Answers and I'll explain what you should do.
Generally, your group-based coverage cannot have been lapsed for more than 63 days to carry over to your new group-based plan. However, under HIPAA, any "waiting period" you have does NOT count toward the lapse period.
Here's an informative bulletin on HIPAA published by the USDOL: http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
I hope this helps. |
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deep5223
 |
HIPPA law says that if you have been covered by your present insurance (group) for more than 2 years and go on new group insurance within 60 days of changing jobs, the new group can not apply a pre-existing condition to you. You WILL be covered immediately. This only applies to group plans of more than 25 employees. Check with the human resource person where you are planning to go to work and make sure they will cover you. |
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mightyart
|
Hey, for what it's worth...
I was offered a new job when I was pregnant about six years ago. I told the lady in HR that I had just discovered that I was pregnant, and I wouldn't be able to switch because I needed the insurance coverage. She said they had an Aetna HMO, and it did not have a pre existing condition limitation on pregnancy, so I most certainly would have coverage. It's worth asking, as they really frown on employers hassling pregnant women. I don't think that they could revoke their offer of employment if they find out you are pregnant. Further, you could find out they have some really crappy policy that means that you should stick with Walmart's coverage. |
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mizzzzthang
 |
If I were you, I would keep the insurance you have.......It will take 60 to 90 days for your other insurance to kick in when youstart your new job, and if it's Anthem, anything they can find to be preexisting that they don't have to pay for they will.........Take care, hun and gl with the new baby! |
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hurricane_0_8
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Suzanne gave good advice and clear facts that you can rely on.
Here is a good way to proceed:
1. Keep the Wal-Mart job and its health coverage at least initially but go ahead and switch to part-time if you are sure you can keep the health coverage as a part-timer. Ask HR. If you find you cannot keep it as a "formal part-timer" just tell them that you need to temporarily cut back on hours for "personal reasons" and ask them to keep you on as a full-time employee while you "sort things out".
2. Do not mention to the new employer that you are pregnant until you actually report for work (you are hired for sure). Then, when you are filling out the employment paperwork related to medical insurance ask for "details about pregnancy and especially about waiting periods for coverage".
3. If you like what you hear from the new employer and get IN WRITING that you are covered for pregnancy without a waiting period, then you can safely drop the Wal-Mart coverage (and maybe switch to a part-timer status).
By doing this, you will keep your options open so that you can select what is best for you.
If this works out that you move to a new job with full coverage for your pregnancy (as I expect) be sure to take the time to thank Wal-Mart and its HR department for being so understanding. It is always best to leave each of your employers with a good final impression and an expression of thanks will help.
Best wishes. |
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Paulette
 |
I would say absolutely it will be pre existing.
See if you can continue your Walmart Ins. or keep that job till the baby comes.
After a while it will definitely be too hard to keep up with two jobs.
Good Luck with the New Baby and New Job.
Talk to the public relations person to help you with the ins. technicalities |
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Loollea
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for sure, that's pre-existing, you'd be better off staying where you are until after the baby |
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mbrcatz
 |
How did you find out about the pregnancy? If a doctor told you, it's pre-existing. If you took a home pregnancy kit, it's not, or rather, you can claim you didn't know you were pregnant when you started the job, and there's no medical record diagnosing you as pregnant.
Seriously compare the maternity benefits of both plans - a 20% copay on a pregnancy is THOUSANDS of dollars. |
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