Need to Place Individual with Insured Pregnant Spouse

rechdxs

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Client has pregnant spouse. Spouse is already covered with maternity, but client cannot join same plan. Having trouble placing client in individual plan, getting denied due to spouse's pregnancy. California. Any suggestions on where I can place him?

Thanks,

Ryan
 
That's what I was thinking, but would love to figure out a solution, even if it's short-term or slightly more expensive than market.
 
Having trouble placing client in individual plan, getting denied due to spouse's pregnancy.

Now I've heard everything. There's a thread on here about being denied for conditions they don't have. This is the ultimate condition the man doesn't have.

How does his spouse being pregnant and insured make him a poor risk for health insurance?

What will it be next? - "I have a client who is breathing and has a heartbeat....having trouble getting him insurance due to these two preexisting conditions."


 
I assume you are talking the male spouse needing insurance? It makes a HUGE difference. Women can get insured when they are pregnant, men can't. Explain that to me....

If you happen to be talking about the wife, look to AIM (related to healthy families). It's Aid for Infants and Mothers, and provides EXTREMELY affordable coverage for mom and baby. You will not get paid, but, it is a good service to point impossible situations to.

Of course, standard California only disclosures apply.

Dan
 
BINGO....we have a winner.....no one wants to take a roll of the dice on this one....been that way for years....


....because the husband can claim the baby as a dependent which means the baby's on the policy non-underwritten.
 
Women can get insured when they are pregnant, men can't. Explain that to me....

Maybe in CA, but not in most states. You have to buy insurance BEFORE the event.

In GA, and several (most?) states mom can get Medicaid retroactively.
 
In California - you can put him on any of the individual-only PPO plans like RightPlan 40 PPO and such that only cover individuals.

He is only uninsurable because the carriers don't want him to be able to add the baby onto his plan (in first 30 days no underwriting) in case there are expensive issues with the baby. He is eligible for plans that only cover individuals where he cannot add on any other family members.
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DJS - not sure what you mean about women can get coverage when pregnant. In CA, any pregnant woman currently uninsured is a decline with all carriers until after the birth. AIM is income-dependent and most don't qualify. MRMIP has a 6-month waiting list.
 
Yes, it is the man I am talking about and agreed, it's crazy.

Dave020- thanks for the explanation.

I will check out the RightPlan 40. Any other carrier suggestions for individual only plans that will not consider his spouse's pregnancy?
 
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