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Pregnant? Here’s Some Helpful Information Regarding Health Insurance

First a little history lesson: prior to the Affordable Care Act a pregnant woman would have found it nearly impossible to purchase an insurance policy. Indeed, even group employee health plans were not required to include maternity benefits.

Under the pre-existing conditions section of the Affordable Care Act, insurance companies may no longer deny a pregnant woman insurance because she is pregnant.

Many other options for pregnant women also exist to help provide prenatal care and a healthy mother and baby.

  • Individual health plans are available through your state’s marketplace and it does not require that you disclose your pregnancy at the time you sign up. The open enrollment period currently begins November 1st for coverage beginning January 1 of the following year.
  • Husbands who wish to add coverage for their wife need not disclose the pregnancy when making the change 
  • Men who acknowledge parenthood can add a child they fathered  to a family policy in some cases
  • CHIP and Medicaid programs are available to cover pregnancy until the child is born and provide postpartum care for the mother and child.

Occasionally there are unique situations that raise questions of coverage and pregnancy. For example, let’s say that you have coverage through an employer based insurance plan and you lose or change jobs. In the event of a job loss an expectant mother should immediately look into CHIP and Medicaid benefits in her state. A job change that results in a lapse of coverage because of a wait until coverage begins may necessitate using COBRA benefits to cover until the new employer’s insurance is in force.

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Perhaps it is a good time to define some of the terms and acronyms that have been used in this article. Government programs mentioned are:
  • Affordable Care Act- Formally the Patient Protection and Affordable Care Act enacted in 2010 also known as Obamacare it’s major features were to afford people coverage for previous conditions which included pregnancy as well as providing for other women’s health issues
  • CHIP- Children’s Health Insurance Program, a jointly funded federal/state program administered by states to federal standards it provides for children’s health care through both Medicaid and separate CHIP programs
  • Medicaid- A state administered program for low income individuals and families that operates under broad federal standards. Funded jointly by federal and state government, coverage differs from state to state.
  • COBRA- Consolidated Omnibus Budget and Reconciliation Act allows employees to continue their health insurance benefits from an employer after termination, job loss or loss of eligibility due to hours reduction for a limited length of time.

The current availability of insurance and other benefits both private and public can assist pregnant women in many ways that were not available in the past. If you are looking for assistance in choosing the best insurance plan for you and your unborn child consider contacting ConsumerCoverage, a trusted source for insurance for many. We have many options, companies, and helpful customer service to assist you in your decision-making process. As with all things regarding you and your child’s health it is wise to seek help and advice as you plan for the birth of your child.

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Nov. 1st each year begins the open enrollment period for coverage beginning in January, it closes currently on Dec 15th. There are also certain other periods based on life events, check the ACA website.
No, and she does not have to disclose her pregnancy when applying for coverage. Thanks to the Affordable Care Act coverage cannot be denied.
Medicaid or CHIP coverage lasts through the pregnancy and up to 60 days after the birth of the child. Evaluation of mother and child for further eligibility takes place at that time.

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