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Subsequent high-risk pregnancy and insurance

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Subsequent high-risk pregnancy and insurance

Postby sam10 » Sun Aug 01, 2010 00:26 am

by sam10 (1436 Posts), Sun Aug 01, 2010 00:26 am

How does it work with health insurance and a subsequent high-risk pregnancy? Has anybody had issues with health insurance coverage during/after a subsequent high-risk pregnancy? For instance, if additional monitoring/treatment is needed if PE shows her ugly face again, and all the costs for having a preemie?

My insurance was great the first time around, but now I know I am at higher risk and my insurance knows that too!
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Re : Subsequent high-risk pregnancy and insurance

Postby jamilyn » Sun Aug 01, 2010 01:27 am

by jamilyn (430 Posts), Sun Aug 01, 2010 01:27 am

As long as you arent trying to get new insurance they cant not cover it. If its Drs orders that you have more U/S and tests and visits then they cover it. So unless you no longer have maternity coverage or have changed insurance carriers/plans then you should be totally safe. If you switch then they could have a pre-existing clause where you have 12-18 months with no coverage for it. I wasn't able to get individual insurance that had maternity coverage because of my history though so we stayed on my husbands work insurance instead of switching.
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Re : Subsequent high-risk pregnancy and insurance

Postby kellikbock » Sun Aug 01, 2010 08:50 am

by kellikbock (387 Posts), Sun Aug 01, 2010 08:50 am

I never even thought of the possiblility of it being a pre-existing condition. Thanks for bringing that to light.
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Re : Subsequent high-risk pregnancy and insurance

Postby sam10 » Sun Aug 01, 2010 10:36 am

by sam10 (1436 Posts), Sun Aug 01, 2010 10:36 am

I am not planning to switch, but this is good to know!
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Re : Subsequent high-risk pregnancy and insurance

Postby jamilyn » Sun Aug 01, 2010 11:51 am

by jamilyn (430 Posts), Sun Aug 01, 2010 11:51 am

Def don't switch. Even some Insurance thru work have Pre-existing clauses that dont allow you to get pregnant for so long once you start and no Individual Insurance will take you once youve had PE or HELLP unless you are wanting insurance that doesn't cover pregnancy and even then they may still not accept you.
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Re : Subsequent high-risk pregnancy and insurance

Postby brianned5 » Tue Aug 03, 2010 12:35 am

by brianned5 (567 Posts), Tue Aug 03, 2010 12:35 am

I carry our insurance through my employer and have never had any problems. I was monitored very closely my second pregnancy. I wanted to be a SAHM and I was told I couldn't get my own maternity coverage because I'd had a c-section. So, that's why I'm still working.
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Re : Subsequent high-risk pregnancy and insurance

Postby missgamecock » Tue Aug 03, 2010 10:13 pm

by missgamecock (6064 Posts), Tue Aug 03, 2010 10:13 pm

I have federal health insurance as I am a federal employee. They paid everything from the transnuchal scans to repeated beta draws with Cate because of my anxiety to early USs to weekly NST and BPPs. I think after everything with Cate, they paid out close to 30k? She wasn't a nicu baby. If she had been (she would have been if I had allowed them to deliver her at 34 weeks), they would pay for that. They also paid for extra dr visits after she was born. Same with Sara.
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Re : Subsequent high-risk pregnancy and insurance

Postby saiyanna » Thu Aug 26, 2010 05:49 pm

by saiyanna (2 Posts), Thu Aug 26, 2010 05:49 pm

Good Day, I am new here to this forum, and am very thankful to have found this foundation online and forum where I can speak to others about H.E.L.L.P syndrome and my experience with it in the past.

I have a question related to insurance that I did not quite see answered in this thread. I was diagnosed with H.E.L.L.P. in September 2000, 39 weeks into my pregnancy. My son did not survive. I currently do not have health insurance, would like to try again to have a child within the next year or so, however I want to acquire health insurance and get myself healthy before embarking upon that.

Because I had H.E.L.L.P in the past, yet do not plan to get pregnant anytime soon, would insurance companies consider that a pre-existing condition? I was told that I would be considered high risk if I ever did get pregnant again, so if i acquire insurance and then later down the line get pregnant, could they deny me coverage?

Thanks for any opinions or assistance from experience that can be offered.
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Re : Subsequent high-risk pregnancy and insurance

Postby angieb » Thu Aug 26, 2010 06:30 pm

by angieb (1192 Posts), Thu Aug 26, 2010 06:30 pm

I've switched insurances 3 times since my pregnancy ended last Sept. (lots of job changes between DH and I.) All group work plans, from Cigna, to United Healthcare, to Anthem-MO, and now Anthem-VA. I'm also going through fertility treatments.

The only company I've had issues with so far is Anthem-VA, and that's because they've had trouble tracking all of my insurances last year (even though I gave them all of the information and have supporting documents, they are being a PITA and saying I have a "pre-existing condition exclusion for any treatment I received in the 6 months prior to the enrollment date, even though I've been covered by Anthem-MO even now and all 6 months prior.) Anyway, even though they are being a pain, in the letter they even acknowledge that pregnancy is not an allowable pre-existing condition.

So I think it generally should be okay, as long as you have been covered long enough (about 18 months) and haven't had a break in insurance for more than 63 days.

Now dealing with them may be a pain. Insurances suck.
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Re : Subsequent high-risk pregnancy and insurance

Postby jamilyn » Tue Aug 31, 2010 01:47 am

by jamilyn (430 Posts), Tue Aug 31, 2010 01:47 am

Individual insurance is very different then insurance from work even if its the same company (ex aetna, cigna, blue cross, etc). I havent heard of one individual insurance plan covering pregnancy if you have had any kind of complications. Most group insurances will cover it all they will cover it from the start or will have like a year waiting period for it. That is def something to ask before you start the process when you talk to an insurance company, you can call and talk to an Underwriter and ask them but I used to be an agent and since I stopped I have heard things have even got more strict and they will exclude more. So you could get insurance but ALL pregnancy related claims would not be covered at all. I hope you are able to find a company that will cover you.
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