Is Pregnancy a Pre-Existing Condition
As any expectant parent knows, the appropriate prenatal, labor, delivery, and postpartum care comes at a substantial financial cost. For those who had maternity coverage included on their policy prior to becoming pregnant, that makes one less thing to worry about. This is no small matter, considering that there is a seemingly innumerable array of potential problems and preparations that must be handled to navigate even the smoothest pregnancy and childbirth.
But for a mother-to-be who had not been planning to have a child, or for a woman who lacked the means or opportunity to secure any sort of health insurance, the cost of care is a giant hurdle to overcome. A lack of proper prenatal treatment can lead to complications in delivery and may endanger the health of both the mother and child, in addition to greatly increasing the risk of birth injury.
The issue of whether pregnancy constitutes a pre-existing condition in insurance phrasing is a tricky one and it provides a source of confusion for families who wish to amend an existing policy or to seek new coverage to help cover pregnancy and birth expenses. Obviously, this is an urgent question to resolve because the cost can grow exponentially in the event of a birth injury and the subsequent necessary treatment and care.
How Am I Covered?
One thing that is immediately clear is that an expectant mother will be unable to purchase individual health care if she is already pregnant. It is a guaranteed financial loss for the insurance company, and they will have no objections to rejecting your application for a new policy. For this reason, it is highly advisable to obtain a health insurance plan with maternity coverage before you become pregnant, if the pregnancy is planned.
If you are already covered under one group insurance plan and are transferring to a different group policy due to a new job or similar circumstantial change, then your pregnancy cannot be excluded as a pre-existing condition. So, if your new group policy has maternity coverage, your claims will be paid, as mandated by law. This legal protection is aimed almost exclusively at group insurance rather than individual policies, so it may be difficult or too expensive to undertake the matter on your own.
Contact Us
A Philadelphia birth injury lawyer of Lowenthal & Abrams, P.C., can answer many questions you may have about how the costs of care associated with a birth injury may be covered, either through your insurance policy or a civil action. Contact us at 215-238-1130 for more information.