Planning a Pregnancy or Adoption?
What You Need to Know About Health Insurance

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Pregnancy cannot be considered a pre-existing condition under a federal law known as HIPAA, the Health Insurance Portability and Accountability Act of 1996. And for those interested in adopting a child, since 1993, health insurance companies are prohibited from discriminating adopted children of any background in most situations. It also has special stipulations that prohibit discrimination for any pre-existing conditions the adopted child might have. And prior to 1993, the insuring of adopted children was quite unpredictable.

Because federal law prohibits pregnancy to be a pre-existing condition, it tends to cast a false impression because there are situations in which pregnancy can and will be considered a pre-existing condition. If you are pregnant and have had no coverage at all beforehand, this does not apply. If this situation does apply and you found a new job during the middle of your pregnancy, you might still have to wait out a pre-existing period or exclusion which could be longer than your actual pregnancy. This would leave you responsible for all the doctor and hospital bills. Remember, it is illegal for any employer to inquire about your familial plans.

HIPAA usually only applies to group health plans. So if you have an individual insurance plan and are pregnant and then buy a plan through group insurance, you would be subject to the pre-existing waiting period. So it seems that HIPAA does not apply to everyone, but it does help. Coverage options for already pregnant women are very slim because insurance companies are already well aware of the costs that come along with a pregnancy. Medicaid and WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) are alternative options for those that meet the low-income requirements.

What is should couples in planning a pregnancy or an adoption do to better insure their family coverage? Plan and plan well. Make sure you already have insurance and it has maternity coverage or dependent availability on the plan. Discuss your work options. Will you remain at your job or leave near the end of your pregnancy? All new parents should be prepared. Planning your health coverage ahead of time is essential to your family’s medical needs.


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