My unique situation: I am under my dad's insurance (his employer's group insurance) because I am under 26years old. So although I'm not a dependent of his but I get to stay. My husband doesn't have insurance and is a business owner. His office doesn't have a group policy yet but will get one by the end of fall. I'm due at the beginning of fall. . . Baby needs insurance. I can't add him to my dads plan and DH can't give him a plan of his own and DH can't get a private plan because the upcoming baby is considered a big time pre existing condition (baby won't be a PEC under the office's group plan:once it get enstated). Any advice at all? We make too much to be considered for any low income insurances nor will they take us for the short time we will need it (between baby's birth and DH group policy enstatment)
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Well I do know that the baby will covered by your insurance for the 1st 31 days after the baby is born, if that helps at all.
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@TurtleDoves: Why can't the baby go on your dad's plan with you? That really surprises me that the child of a plan member isn't automatically allowed to be added. For example, what about teen moms... can they not add their baby on to their parents plan? Its not like they would have a plan of their own!
I guess I would call around to major providers and see if they do individual plans for infants. When I was between jobs I had an individual plan for myself through United Health Care and it was pretty cheap with very good coverage.
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Do you work? If so, can you get your own plan through your work?
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They can't refuse a baby as a pre-existing condition under the Affordable Care Act. Pre-existing condition is no longer a valid exclusion for children and soon to be for adults. Yay ACA!
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The child isn't automatically on the policy for the first 31 days because the policy isn't under you or your spouse. You are a dep on the policy so there is a high likelihood that your dep won't be considered as eligible. There are some plans that don't cover dep pregnancy related costs unless it's the Spouse of the policy holder.
As far as the baby being considered a pre ex ,that isn't legal ( I work in the industry) so you may need to do some homework on that topic and do not just assume. Also, you do need to contact your local Job and Family Services in your area and explain that the baby won't have coverage for X amount of time and they can/will assist you in finding a program specifically for the baby. They can NOT turn a child away from health coverage. They can refuse you but not a child. There are plans specifically for that.
I would seriously suggest doing some more research as it sounds like you've gotten some incorrect info.
Good Luck. -
@Mrsbells: they will only cover him for that period if I then add him to that plan (which I can't do) @MamaMoose: Unless the grandchild was a dependent of my dads then no, he can't claim him. He claims my grandpa as a dependent because my grandpa is disabled and my parents are his full time caretakers.
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@yoursilverlining: No I don't work:/ @Mrs. Jacks: they can refuse a pregnancy under private insurance. That rule only applies to employer groups. @Crisark: Unfortunately all my info is straight from the horses mouth. They can reject baby because they are a private insurance:( either way I'll contact job & family services and see what they can do for me. Thanks ladies:) this is so so stressful:/
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@TurtleDoves: like crisark stated check with the state programs available in your area, a child can not be turned away from health care. There is so much info out right there now when all the pending changes -it gets confusing fast!
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@TurtleDoves: Actually, private insurance can give your child a high deductible but not refuse anymore under ACA. They can refuse you as a pregnant woman because your pregnancy is a pre existing condition... but once the child is born private insurance can no longer refuse for the child.
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@Mrs. Jacks: Your information is correct except for the mother being considered to have a Pre Ex because she's pregnant. It's actually against the law to discriminate against a pregnant woman.
Still, I would check and double check the info you were given and get answers from someone else if you were told straight from a health insurance rep that the baby can be denied. -
@TurtleDoves: NY State has a public health insurance program call Child Health Plus. We qualify for it, in fact most people unless you're Donald Trump qualify for it. For JUST the child.
Perhaps look on Michigan's site to see if there is something similar?
ETA: This sounds very similar
http://www.michigan.gov/mdch/0,1607,7-132-2943_4845_4931---,00.html -
@Crisark: Hmm... for my insurance I was told pregnancy was a pre-existing condition too, but there are so many moving parts to this that maybe I had it wrong.
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@Mrs. Jacks: The only reason I say I 'know' is with my job we handle Cobra insurance so people are often concerned their pregnant spouses will be refused the continuation coverage. It simply is not the case with group policies.
Now I'm sure there are loopholes but on a federal governed HIPAA regulated plan it is not legally allowed. -
@Crisark: And I defer to you because I know the pediatric side of things from work... so tons of experience, but the OB stuff I only have an N=1 from my own experience.
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@Mrs. Jacks: Hey no problem. This stuff is so confusing, if I hadn't been dealing with all spectrum's of the health insurance world for the past 5+ years I'd have no clue, and sometimes still feel lost lol
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@Crisark: That's why I pay such close attention to all the provisions of ACA and when they phase in. It's important stuff!
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@Mrs. Jacks: Absolutely. It's all a very big deal.
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@Mrs. Jacks: @Crisark: I hope you ladies are on to something! I will def get 2nd and 3rd opinions on what my insurance broker told me and DH this week. I've been in tears ever since.
It's just ONE month that he will be without insurance as we wait for our next insurance to kick in. And our insurance won't be retroactive so once we get it, it won't go back and pay for that one month. It stinks....
Anyone know anything about COBRA? I think i'm going to spend tonight researching that and find out what goes into it. -
@TurtleDoves: COBRA is what I deal with at my current job. If you are eligible for COBRA you would be able to add your newborn.
Also as a side note, you can't have Pre Ex held against you with a new insurance carrier unless you went uncovered for more than 61 days. You would still be out of pocket for the costs during that month but you can't have PreEx put at you once you do get the coverage. -
In Texas they have CHIP for uninsured children...can you just apply for something like that? My SIL was in an almost identical situation to you--my MIL carried her, she was a single mom, but got pregnant and then had our nephew, but couldn't add him to their policy. I guess there are probably income requirements, but it was the only option at the time to have him covered.
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@regberadaisy: Thank you! I don't know how I missed your link. Unfortunately, once you pull up the online application, it says one must be 133% below the poverty line to qualify! It does provide phone #s of case specialists I could call that may be able to point me in the right direction though.
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I've been going thru something kind of similar, except I carried the insurance and when I quit my job, the cobra coverage was so expensive (like 1800/month) that we started looking for individual plans. Any child under the age of 18 has to be covered...but if your baby is healthly, it shouldnt be difficult or expensive to get an individual policy for him from a private carrier (and it wouldnt be that expensive to get your husband some insurance too, if hes healthy...like $100 a month...at least thats what my husband was quoted). They can set the insurance up to be retroactive, too, so the baby is never without coverage (at least, thats what I was told...but it could be different in other states).
I would contact an insurance broker and ask them their thoughts-they can quote premiums and direct you to the best option for your family. With the new healthcare law, all plans have to cover well baby visits-which is a plus!!
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UPDATE!!!! I am excited...this is a good thing that's happening.
My husband just told me that the "terms and conditions" of his new insurance will cover whatever happens from "date of application" to "in-statement period"
So, they will be done applying for insurance within he next 2 weeks as a small business.....then they will wait until November for it to kick in.
However: From the date they apply to November, all claims will be retroactive. So, basically, we will be reimbursed for any of baby's medical needs from mid-Aug to November.
I am due the 2nd week of Oct. So this is all good news!
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