COBRA is Expiring, My Wife is Pregnant

[Sveiks]

Full disclosure: I messed up big time here. Some of it was being naive, and some of it was being afraid of getting bad news, so not asking the right questions. But what's done is done.

My wife is pregnant, due in September.
My COBRA benefits run out before that.
It never occurred to me that pregnancy was considered a pre-existing condition until a few days ago.

What are my options? My current provider is United Health Care -- can/will they extend my existing insurance through the pregnancy? If there is any chance that they would, how do I approach that? What do I say and who do I talk to?

What other options are there -- is there anything I can say to other providers?

Can our doctor's office push us in the right direction here?

I'm in DC, in case that matters. We are otherwise healthy -- neither of us are rail thin, but we're not huge or anything either. Both don't smoke and haven't had any medical issues.

 

[Dave020]

Should be able to get a plan under HIPAA. I don't know how it works or what they offer in your area but check with an agent who knows that market. There may also be other plans/programs available specifically for pregnant women.

On this forum we have the following agents who work the DC market:

http://www.insurance-forums.net/forum/dgoldenz-3683/
dgoldenz (David Goldenzweig)
703-753-3376
[email protected]
High Risk Life Insurance Quotes | Insurance Experts in Virginia
Life/Disability/Health/LTC/Fixed annuities
Specialize in high-risk cases. Health insurance in VA/MD/DC, other lines of business in 25+ states.

 

[Mash]

The company who was the "company of record" at the time of inception would be the one providing coverage.
In my opinion you and your wife are still covered under the old plan since that was the one providing coverage when the inception occurred. Check with the insurance commissioner of your jurisdiction to be sure.

 

[GreenSky]

The company who was the "company of record" at the time of inception would be the one providing coverage.
In my opinion you and your wife are still covered under the old plan since that was the one providing coverage when the inception occurred. Check with the insurance commissioner of your jurisdiction to be sure.

Your opinion would be wrong.

Rick

 

[Sveiks]

So what's the answer then?

 

[Bruce]

Full disclosure: I messed up big time here. Some of it was being naive, and some of it was being afraid of getting bad news, so not asking the right questions. But what's done is done.

My wife is pregnant, due in September.
My COBRA benefits run out before that.
It never occurred to me that pregnancy was considered a pre-existing condition until a few days ago.

What are my options? My current provider is United Health Care -- can/will they extend my existing insurance through the pregnancy? If there is any chance that they would, how do I approach that? What do I say and who do I talk to?

What other options are there -- is there anything I can say to other providers?

Can our doctor's office push us in the right direction here?

I'm in DC, in case that matters. We are otherwise healthy -- neither of us are rail thin, but we're not huge or anything either. Both don't smoke and haven't had any medical issues.

Comments:

1. Your doctor's office cannot help.

2. You may have a right to conversion to a UHC Individual Policy after Cobra expires. However, not all plans are required to provide conversion. Some states require it; others do not. Generally, if conversion is available to active employees, it is available to Cobra Beneficiaries. To find out more, you can:

- Search for the term 'Conversion' in your plan booklet and Cobra related materials you have received. Read and understand that provision.
- Call UHC (and/or their Cobra Administration vendor) and ask them if Conversion is available.
- Call the DC Department of Insurance.
- Call the Dept of Labor - Employee Benefit Security Administration. They can be helpful.
- Your best option is to follow the advice given previously and contact a local agent specializing in Employee Benefits. That agent should be able to guide you as well as identify any potential non-UHC options.

3. If you do have a right to conversion, take special note of the time frames regarding notification and reuired premium payments. Generally, the required notifications of any eligibility to Conversion are very short related to the expiration of Cobra benefits; 15 days is the norm, I believe.

4. If you are eligible to convert and decide to do so, make sure your acceptance and first premium payments are done via registered mail.

5. Whatever option(s) are available to you, it's advisable to calibrate your cost expectations toward the expensive side.

Good luck.

 

[sissymary]

There is none! You should have bought an individual plan when you knew you were going to leave or get fired from your old job! This would have saved you money every month also? I can not tell you how many times I have talked to someone in your situation, only to be told, well I don't want to give up the bennies like low cost co-pays and such. Then they have a heart attack, or get some other pre-existing condition, and can not get an individual plan ever again. They never listened! Your wifes condition is considered pre-ex because the child could be a pre-me, or have other issues, (I hope not), and since all health plans have to include future children, and they can not exclude your child, they don't want this exposure, and the pay out $ of the birth. Go or call some local hospitals, tell them of your situation. Most have plans where you can pre-pay at a discount for the delivery cost. This is your only choice as I can see it. Live and let learn.

 

[IndividualHealthGuy]

There is none! You should have bought an individual plan when you knew you were going to leave or get fired from your old job! This would have saved you money every month also? I can not tell you how many times I have talked to someone in your situation, only to be told, well I don't want to give up the bennies like low cost co-pays and such. Then they have a heart attack, or get some other pre-existing condition, and can not get an individual plan ever again. They never listened! Your wifes condition is considered pre-ex because the child could be a pre-me, or have other issues, (I hope not), and since all health plans have to include future children, and they can not exclude your child, they don't want this exposure, and the pay out $ of the birth. Go or call some local hospitals, tell them of your situation. Most have plans where you can pre-pay at a discount for the delivery cost. This is your only choice as I can see it. Live and let learn.

Do the individual plans cover maternity where you are? Because in most parts of the country you can't buy plans with maternity on them. I don't see how your response was in any way helpful. I hope you don't talk to your clients like that.

Perhaps this wasn't a planned pregnancy? That does happen sometimes....

To the OP... A conversion plan is about the best you can do right now, or find a job that gives you benefits day one so you can put her on that plan.

 

[taterpeeler]

Cant comment on the exact regs in your state however if you were here in Texas you are screwed. No maternity coverage on indy policies and there is also no conversion. Risk pool is no go on matenity.

I have recomended the pre pay prego idea to several client. We have a hospital that offers a discount on prego and you get i think a new doctor that is in residency or some such.

if you talk to TXInsurance he has the default answer of Medicaid....

 

[djs]

Are you currently working? I'm assuming not, since you have a cobra plan, but I could be wrong.

If not, are there any state(?) sponsored programs available for you? Chances are pretty good that there is. I know here in California there is obviously Medical (medicaid in other parts of the country) but there is also AIM, or Aid to Infants and Mothers, which is actually a great program, if you can get it. DC probably has something similar.

Outside of that, I'd go with the conversion plan.

Dan