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almostmarried · Feb 13, 2009, 11:17 AM

My fiancé and I are getting married in a couple months, at which point, I plan to switch to his health insurance. (We both have anthem through our jobs, but his company pays more in.) I am a pre-school teacher, and am not planning to go back to my job after the summer, so I will no longer have health benefits through them. I recently found out that I am pregnant, and am wondering if I will have to stay at my current job to keep health insurance, or if I will be able to be covered under my soon to be husband's insurance. I'm worried about the whole pre-existing condition thing. However, his open enrollment for insurance will be after our wedding and before my insurance lapses. I don't know if that makes a difference. Any help would be greatly appreciated.

jkh · Feb 20, 2009, 01:50 PM

Oh I am doing this now. I am switching to my husbands insurance in April and am also pregnant. Now I am not a 100% sure on this but I think as long as you do not have a lapse in coverage you can get on your husbands.

I am in the process of trying to get my cobra in line until my husbands insurance starts. Call the insurance company they should be able to tell you, my husbands company was very helpful. Oh and congrats on the baby!

sunny1ib · Mar 9, 2009, 09:15 PM

Originally Posted by almostmarried

My fiance and I are getting married in a couple months, at which point, I plan to switch to his health insurance. (We both have anthem through our jobs, but his company pays more in.) I am a pre-school teacher, and am not planning to go back to my job after the summer, so I will no longer have health benefits through them. I recently found out that I am pregnant, and am wondering if I will have to stay at my current job to keep health insurance, or if I will be able to be covered under my soon to be husband's insurance. I'm worried about the whole pre-existing condition thing. However, his open enrollment for insurance will be after our wedding and before my insurance lapses. I don't know if that makes a difference. Any help would be greatly appreciated.

Congrats on your wedding and your soon to be arriving new addition!

There are some considerations to be made with your questions but I would need a bit more info.

Generally speaking: From what info you provided, you have insurance now. Your pregnancy was "diagnosed" (assuming) recently. You will be keeping your job until May/June. If you terminate your employment prior to your wedding date, you will DEFINTITELY need to consider COBRA benefits. Depending on the state, size of the group (employer) you are currently employed with, you should contact the HR Dept and find out what will be available for you upon termination AND the cost to maintain the coverage. Regardless of the open enrollment period at your finace's work, you can expect to have 30 days to advise his plan of your marriage and be enrolled in his plan. You DO NOT want to show an interruption of coverage in-between the termination (your) date AND the date you will enroll under his plan.

Also, depending upon the plans that you both have, you may qualify for a "transition of care" relating to your pregnancy. Transition of care usually takes place on or about the 32nd week of gestation (for pregnancy) OR depending the circumstances of the pregnancy.

I hope this has been helpful to you.

I am not an attorney and the information contained in this post is not to be construed as legal advice.

almostmarried · May 1, 2009, 10:17 AM

I am paid up for my insurance with my work through the middle of August. Our wedding is in June. There would be no lapse in my insurance coverage from my plan to his... However, when my fiancé called the insurance company, we were told he needed to talk to his employer. I don't understand this, as they are the ones that will have to cover me, not his employer. Upon talking to his HR department, they said I cannot be covered under his insurance because the pregnancy occurred before marriage. (still not understanding why they are the ones who determine this) Looks like I'll be going back to my job in the fall to be able to keep my insurance. Moral of the story, use more than the nuvaring to prevent pregnancy before marriage!

jef1056 · May 1, 2009, 11:03 AM

You may still want to get on your future husbands plan. It could be less expensive with one family plan in the place of a separate couple/family and a single.

First, fully insured group health insurance is governed by the state it is written in. Many large plans are self funded plans and governed by state and federal regs. Most plans can be "purchased" with different benefits and apply some of them differently. The carrier may only be the administrator with a self funded and are not fully aware of what would be covered. That's why they tell you to ask HR.

Under a federal law known as HIPAA, group health plans cannot consider pregnancy a pre-existing condition and cannot exclude coverage for prenatal care or your baby's delivery, regardless of your employment or health insurance history, but only if the plan already includes maternity coverage. This holds true whether you are the primary insured or a dependent. So, health plans can't deny you coverage when you go from one job to another and switch employer-sponsored group health plans.

As long as the new plan offers maternity coverage they can not claim a pre existing condition.