Trying to Get Health Insurance When You or Your Partner Is Pregnant.
Summary: Attention men, make sure you have health insurance BEFORE your wife or partner gets pregnant otherwise you will be denied coverage for the term of the pregnancy. Women, you MUST get health insurance BEFORE you get pregnant. Pregnancy is considered a “pre-existing condition” and you will be denied coverage. Sad but true.
Through a series of events that included being forced off the job due to a repetitive injury disability, and my subsequent transition to self employment, I was without health insurance for a couple of years. It’s not that I liked to tempt fate; it’s just that money was tight and buying health insurance as an individual was phenomenally expensive.
We were going to start a family soon, so after my partner got pregnant we decided it would be best if I also got health insurance. She was insured by Blue Cross through her employer and had planned to add our baby to her policy once she was born.
She was relatively satisfied with her policy so I figured I might as well go with the same company. I called up Blue Cross and they sent me an application packet to fill out. It contained all the usual questions involving your medical history, pre-existing conditions, age and so one. However there was one question that struck me as odd; are you or your partner pregnant or are planning to get pregnant? The question sounded like a trap. It was such anomaly I knew the question must have some consequences attached to it. However, I also knew that insurance companies were notorious for combing through you application during a health crisis to try and discover any reason to deny coverage. So I answered it honestly and checked yes.
A couple of weeks later I get a notification in the mail saying I had been denied coverage because I’m expecting a baby. Confused, I called them up and ask for an explanation. I told the representative that I think they misunderstood as I’m not the one who’s pregnant, it’s my partner.
“Are you the father?”
“Yes”
“Are you sure?”
“Yes, I’m quite sure.”
“Then we can’t insure you.”
“But I’m not the one who’s pregnant” I said again, as if she didn’t understand me the first time.
The insurance representative went on to explain that under state law, if I was insured with them, they would be required to also ensure my baby, after she was born, if I chose to do so. The tone of her voice implied that somehow this would be an outrageous imposition to put them in or perhaps an underhanded trick.
I explained that my partner was already ensured with Blue Cross and she’s going to put our baby on her policy.
“Yes, but you could also choose to put her on your policy and there would be nothing we could do under California state law to stop it” she replied.
“Why would I do that? It would make no sense. If we’re both insured by Blue Cross and she’s already planning to put our baby on her policy, why would I bother putting the baby on mine instead? It would be pointless.”
“Yes, but you could still choose to add to your baby to the policy and we couldn’t stop you.”
“But you’re still going to be insuring our baby one way or another anyway…either through her policy or my policy.”
“We don’t know that. Maybe you’ll pick another company.”
It was evident that I was stuck in an Orwellian feedback loop with this representative and this was clearly not going anywhere productive. Disgusted, I hung up the phone. After a few minutes of reflection I just had to chuckle. Not only at the absurdity of the situation but also at the countless misguided Americans who proudly and defiantly declare that they don’t want some bureaucrat in Washington telling them what doctor they can and can’t go to, and therefore they are against any form of government mandated universal health care. I just wish I could explain to them that we already live under a system where bureaucrats coldly and routinely deny and restrict our health coverage. And it’s all done in the name of profit and increasing shareholder value. Personally, I think I’d feel safer with a faceless public servant making these decisions. A government bureaucrat, at least on a theoretical level, works for the taxpayers and can be held accountable to them. My Blue Cross representative, however, seems to be completely unaccountable to anyone.
In reality, health insurance companies aren’t really health care providers at all. They’re investment companies. They collect money from people in the hopes of investing it and returning a hefty profit. End of story. The promise of health care is a ruse used to collect the money in the first place. So it’s little wonder these same companies do everything in their power to restrict or deny you the coverage they promised. Every dollar paid to you is one less dollar in their pocket or the pocket of their shareholders. It’s almost as if they think they are the ones getting shafted! This is why when their investment portfolio takes a hit, you get an increase in your premiums. The money needs to be made up somewhere and it’s certainly not coming out of the CEO’s pocket.
So what did I ultimately do? Just crossed my fingers and hoped I didn’t get sick or injured over the next eight months. After our daughter was born I had no problem getting insurance, however, I went with Blue Shield instead. I wish I could say I picked them because of some high minded principle over how I was treated, but the truth is Blue Shield just offered me a better policy than Blue Cross.
I don’t trust insurance companies. I don’t anyone who does. So for me health insurance is just a commodity. It’s all about the best benefits, at the best price, with a company that has the best chance of actually honoring their policy during a health crisis.
So it’s five years later and we still have the same setup. My partner and my daughter each have their own policies with Blue Cross. Why separate policies? Believe it or not it’s cheaper than getting a family plan. On the other hand, I’m still ensured with Blue Shield. We’ve been trying to consolidate our plans into one unified family policy with just one company but it’s been tough to find one that improves upon the current situation; and we’re paying about $600 a month for the three of us!
You know, it’s downright retarded that in the richest country in the world I have to deal with this nonsense.
That’s it for now.
File Under: Getting Health Insurance, Pregnancy and Health Insurance, Fatherhood and Health Insurance, Health Insurance Policy Pregnant
February 1st, 2010 at 5:56 pm
All I can say is thank God Medicaid came through for us, no one in our household had any insurance at all except of course, for the kids, who are covered through Medicaid. Just one of the wonderful benifits of working in the food and retail industry!
[Reply]
August 31st, 2010 at 9:21 am
Yeah, people who have never run into these types of problems think that there is nothing in the industry that needs fixed. Usually, by the time they realize otherwise, it’s too late.
.-= Mark´s lastest blog ..Car Insurance Estimates =-.
[Reply]
August 3rd, 2011 at 2:47 pm
I´m from the EU, a British citizen and now live in Sweden. I really feel for all US citizens, even the loonies who talk of death panels as your all in the same boat and it´s just plain unfair. 600 US? That´s a fortune, I´m not making light of it.
Give you an example of how it SHOULD work : Our daughter was born 6 weeks premature, 100 miles from our home ( visiting friends, she´s doing fine btw, fit,healthy, strong, and HUNGRY )and was born at an amazing hospital, more like a 4 star hotel,with brilliant, friendly, relaxed staff, our own spacious room, wide screen tv, bed for me (the dad) in same room with my girls. She was then flown to a hospital closer to our city – same story, for some more evaluation – almost two weeks of being in a hospital plus plane ride just for her. How much did we pay? NADA. We´re all covered by the state. I don’t say that to rub it in, but there´s so much misinformation in the US, I want people to hear it from the source unfiltered. If access to healthcare was taken away here in the EU, well – it would never happen as we regard it a privilege and our right.
The US needs a left wing equivalent of the Tea Party. I like your country, I intend to move there one day with my family, but right now, things are looking shady.
[Reply]
September 19th, 2011 at 11:00 pm
I was just trying to find insurance for myself with a pregnant wife and kept getting hitting the pregnancy question denial with no explanation. Thanks for writing this up. We have an absolutely horrid health insurance system in this country. The only thing worse might be the politicians!
[Reply]
October 30th, 2011 at 8:09 pm
My husband faced the same thing with getting health insurance here in the US after we moved back from England and I was pregnant – I had gotten a policy months earlier in anticipation of being pregnant. Tying health insurance to employment is insane and this needs to be fixed. However, in my experience, government run insurance is no way to go. I went through an absolute nightmare in England trying to get some simple medical tests. Sure, it’s great to have coverage but you are completely at their mercy and I was told I would have to wait 4 months to get the results back of a simple blood test. You are told where you can go to the doctor and if you need to see a specialist, they choose one for you and send you a letter months later with an appointment date (usually months after that)which is nearly impossible to change. I was told I had to go to a doctor near my home even though I worked in London right next door to a huge hospital and doctor’s offices. It was crazy and I wanted to scream every time I had to deal with the NHS.
[Reply]
April 26th, 2012 at 11:01 am
I just went through the same ridiculous conversation. Plus, they require a bank account for direct debit. A credit card wasn’t acceptable (really? In America?). So now what? Do I lie to my pregnant wife so she doesn’t worry? Unreal. Being self employed sure does make for some interesting encounters…
BTW, love the blog.
[Reply]
May 4th, 2012 at 12:36 pm
I am currently in the exact situation. I left my last job in January and started my own graphic design business. I was not aware of this absurd law that men can’t be insured if their wife is expecting, so I didn’t opt for the Cobra coverage from my last employer and instead pursued an individual plan. My wife was a month pregnant when I left my last job and it took me about a month or two before I got around to applying for new coverage. Then, I discovered this BS law. My wife has full coverage with maternity and I am still being told that I am uninsurable until a month after the baby is born. How does that make sense? I’m 28 and in perfect health with no pre-existing conditions and no medical record. I’ve been to the doc like 1 time in the past 6 years and I’ve never been to the hospital. I am amazed at how insurance companies are allowed to deny coverage to expecting fathers even when the mother has full coveerage maternity insurance. How is this allowed? I just hope nothing happens to me this year in the only time period of my life that I’ve been uninsured.
[Reply]
May 13th, 2013 at 2:38 pm
You must have applied for an individual policy, while you should have applied to add yourself to your wife’s policy. That way, the pregnancy is not an issue (they are already obligated to cover the child via her policy). I just did that with my wife’s policy (applied to join her policy; wouldn’t have been possible to get insurance if I tried for an individual policy).
[Reply]
Straight Dope Dad Reply:
May 13th, 2013 at 3:10 pm
It wasn’t possible for her to add me. We’re not married (she’s not my wife) and her insurance was supplied by her employer.
[Reply]
May 16th, 2013 at 5:57 am
I have also faced many problems with insurance. The laws keep on changing and there is no proper guidance regarding the same. I am glad I read this article, because I and my partner are planning for a kid this year:)
[Reply]