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Conference moira::parenting_v3

Title:Parenting
Notice:READ 1.27 BEFORE WRITING
Moderator:CSC32::DUBOIS
Created:Wed May 30 1990
Last Modified:Tue May 27 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:1364
Total number of notes:23848

1287.0. "Pregnant before marriage - Insurance question" by ODIXIE::FINK (Son of the New South) Sun Jan 26 1992 00:55

    
    	If this has been asked elsewhere, please point me in the right
    	 direction.  Otherwise.... :-)
    
    	As I wrote in my introduction, we just found out a few days
    	 ago that my girlfriend is expecting our first in September. (:-))
    	 While we both view this as great news, we have one problem.  Ok,
    	 several, (like telling my folks), but this is the biggie.
    
    	She is currently unemployed, and therefore has no insurance.  We
    	 had been planning on getting married in the next year anyway, now
    	 we're just going to move it up several months.  But what I'm
    	 wondering is if my insurance (John Hancock, 80%), will cover
    	 the costs of the pregnancy???  I've called personnel about how
    	 to cover her, and they just said fill out the form within 31
    	 days of the wedding, and that's it.  But I'm wondering if they'll
    	 consider this a "pre-existing condition" and not cover it.  I'm
    	 not trying to get the company to cover anything they shouldn't,
    	 but I'm just wondering what the proper procedure is.  Has anyone
    	 gone through this yet??
    
    
    
    
    				Wondering in Atlanta,
    
    					-Rich
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1287.1set limit?SCAACT::COXIf you have too much to do, get your nap first!Sun Jan 26 1992 23:136
    I think they have a set limit ($1000?) on a pre-existing condition but
    the 800 number should know.  Regardless, they should pay all costs of
    your newborn, whether you marry or not!
    
    Good luck,
    Kristen
1287.2GIVE IT YOUR BEST SHOT- IT CAN BE A BITCH !NEMAIL::FLAHERTYLMon Jan 27 1992 11:4515
    I don't think that they will cover you...I think that you would have
    to have your girlfriend on your plan for a least 6 months in order
    for John Hancock to pay. But I'm not sure...that's how it is for
    my husband plan (Blue Cross Blue Shield Master Medical) and they
    pay for EVERYTHING but I wasn't on his plan for 6 months so I
    had to go thru John Hancock. 
    You should also try to change the coverage to 100%, 80% really doesn't
    do much. I was able to change..and it made a difference they paid for
    everything, cause the cost having a baby (normal) is $3589 more or
    less mostly more...
    
    Good Luck
    and Congrats !!
    
    Linda
1287.3PEACHS::MITCHAMAndy in Alpharetta (near Atlanta)Mon Jan 27 1992 11:4810
Do definitely call the (800) number to get the answer.  

I looked in the 1991 edition of "Your Benefits Book" and didn't see anything
which covers your question.  Personally, I am skeptical that John Hancock 
will cover this (they will likely view it as a pre-existing condition) but 
I am hopeful they will.

Good luck and congratulations...

-Andy
1287.4We were covered.....DPDMAI::CAMPAGNAMon Jan 27 1992 13:213
    For What It's Worth, when I joined Digital in 1986, I was 7 months
    pregnant, and delivered a premature baby about 7 weeks after my hire
    date. Everything was covered. 
1287.5They may cover itMARX::FLEURYMon Jan 27 1992 13:2517
    I asked my personnel rep a similar question regarding pre-existing
conditions last month.

    If I were to get pregnant in the fall, say September.  And then switch
health plans during open enrollment in December, say from John Hancock to
Harvard Health.  Would the new health plan cover the costs of delivering my 
baby?  Her answer was "Yes definitely".  

    My experience to date is that Digital carries alot of clout and the
insurance companies are willing to comply in some cases where they might not
otherwise.  Especially John Hancock - since all they do is administer DEC's
money.

    Good luck.  Let us know what you find out.

- Carol
1287.6I think it will be coveredTLE::RANDALLliberal feminist redneck pacifistMon Jan 27 1992 14:4416
    
    When I re-started at Digital after taking some time away from the
    company (kids and alternate career development), I was able to
    sign up for long-term disability that includes coverage of an eye
    condition that caused me to be denied LTD when I applied for it
    separately.  
    
    A friend of mine started at Digital a couple of years ago when his
    wife was 5 months pregnant, and all the birth and prenatal
    expenses that were incurred after his start date were covered.  
    
    I think that  basically if you sign up within the 31-day grace
    period, everything is covered.  Digital is much more generous in
    this area than a lot of other plans.
    
    --bonnie 
1287.7change in family statusVERGA::STEWARTCaryn....Perspective is Everything!Mon Jan 27 1992 15:1723
As previous notes suggest, contact your PSA or check with JH (I'd go with
Personnel myself....)

I think what you'll find is:

The catch here is the "change in family status" that your marriage creates
and therefore there is no problem with the pre-existing condition stuff.

That's why they told you to add her on after your wedding.  In order to
make those kinds of changes in your coverage outside an open enrollment,
you need either a change in family or employment status.

There may be some way to cover an unrelated dependent though. I recall reading
where Digitial was looking into changing its personnel policies in some
areas to treat unrelated dependents the same as related.  I don't know if
anything has come of that, but it may be worth asking about.  Then
too, some states have commonlaw marriage laws that may apply as well.

Some food for thought....

Good luck and congratulations!

~Caryn
1287.8IRONIC::BRINDISITue Jan 28 1992 16:1110
    I was 5 months pregnant during open enrollment time and I "enrolled" in
    an HMO.  No questions were asked re: pre-existing condition.  And it
    wasn't that I switched from one carrier to another.  Previous to open
    enrollement I was uninsured through Digital.
    
    I hope you don't run into problems.  Those doctor and lab bills can be
    pretty expensive.
    
    Good luck.
    Joyce
1287.9VMSSG::KILLORANWed Jan 29 1992 13:1520
    
    I don't know how your fiancee's OB/GYN does the billing,
    but mine worked like this.  They first gave me a form
    to sign that listed what a normal vaginal birth would
    cost and what was included.  I told them I had JH, but
    did not show them any proof.   They estimated that it
    would cost $1800.00 and that my cost 20% would be $360.00.
    This $360.00 could be paid at $60.00 for six months. 
    After the delivery they then billed JH for the total amount
    of their services.  Ultrasounds were not included or
    any lab work. 
    
    I did find that once we met the deductable to JH that
    the OB/GYN group and the lab did submit bills to JH for
    the lab work and ultrasounds.
    
    So all your Fiancee has to do is tell them she has JH.
    
    Jeanne
    
1287.10I think you're ok on this oneMIVC::MTAGWed Jan 29 1992 18:5511
    I used to work with a man who was planning on getting married, then
    found out she was pregnant.  He did all the same checking and I believe
    Hancock would cover the complete cost of the pregnancy, even though she
    was pregnant when they got married.  Unfortunately, she ended up
    miscarrying so the insurance never became an issue.
    
    I think you should have no problem, but do contact the 800 number as
    suggested.  
    
    Mary
    
1287.11It was JH!MVDS02::BELFORTITime to get a new Timmy!Thu Jan 30 1992 12:106
    If you plan on getting married anyway, why not go in and put her on
    your insurance now... as common-law!  Oppp, I forget, MA. does not
    recognize common-law! (if this is in MA.)
    
    I had my husband on my insurance for 6 months before we got married! 
    This was in Colorado!
1287.12Rich lives in GA -- it recognizes common-law-marriagePEACHS::MITCHAMAndy in Alpharetta (near Atlanta)Thu Jan 30 1992 13:010
1287.13Good news from personnel!ODIXIE::FINKSon of the New SouthFri Jan 31 1992 02:0019
    
    	Thanks for all the replies!  I called my PSA today, and she
    	 told me that DEC does *not* have a "pre-existing condition"
    	 clause.  So all we have to do is get married, and everything
    	 is covered!! :-)
    
    	This is really a load off our minds, as we weren't really sure
    	 how we were gonna pull this off.  Now we can spend our time
    	 *enjoying* impending parenthood, and not worrying about it
    	 as much. :-)
    
    	Thanks for all the congrats, too.  It's nice to feel so welcome
    	 in this file.  You can be sure y'all will be seeing me around
    	 more often from now on. :)
    
    
    
    
    				-Rich (and Becky)
1287.14WMOIS::BARR_LI'm the mother, that's why!Fri Jan 31 1992 12:365
    Yah Hoo Rich, GREAT news!!!
    
    Lori B.
    
    P.S. It was great talking to you on the phone the other night!!!