Googling has brought up conflicting answers, so I’m hoping I can get some straight dope on this:
We just found out my fiancee is pregnant! She is currently unemployed and uninsured. However our wedding is next week and after we are married I’d like to add her to my plan through my work. I have read that pregnancy by law can’t be treated as a pre-existing condition when adding a new spouse on a group plan- is this the case? Is there typically a waiting period before coverage can begin? If it matters, I live in Texas and the plan is UHC. I’d prefer not to have to ask these questions to my employer or insurance company yet, at least until I have some idea what the facts are. Thanks!
Some plans have specific enrollment periods. If open enrollment is in December your wife wouldn’t be able to join until December. Some plans might make exceptions to their open enrollment got a number of reasons including marriage.
Asking your employer or insurance company is usually how you’d find out. You could also read your employee handbook or your insurance policy.
I’d be very surprised if you’re not able to add your new wife to your insurance immediately. Normally, marriage, divorce, childbirth, adoption, etc are all qualifying life events allowing you to change your coverage even if it’s not an open enrollment period. But your company’s HR department will know for sure.
Yes, I’m pretty sure the marriage is a life event that allows us to add her immediately after the wedding. I just want to make sure they are indeed required to allow me to add her to my group, even though she is pregnant. And also, what the waiting period would likely be before she is allowed to get use benefits.
The term you’re looking for is “Life Changing Event”, marrige usually counts as one.
As far as the pre-existing condition I can only tell you anecdotally that is is possible to add a wife who was pregnant before you were married and added her to your insurance because I did it (at least it was possible under certain conditions 16 years ago).
It wasn’t easy. There was a lot of letter writing and I got my boss involved with HR.
I used to work in the benefits outsourcing industry with lots of companies as clients including some in Texas with UHC and what you say is true. A marriage is a qualifying event and almost always immediately applicable outside of the open enrollment period.
To the OP, I wouldn’t worry about it much. You do have to ask your employer just to make sure this applies to your case and it should but they have to submit the right documentation to the insurance company to have it take effect when you need it to. You need to tell them on Monday if you are getting married in a week. You will have to change insurance plans from single coverage to family coverage or something similar and it will likely cost you much more than your existing plan deducted from your paycheck but your employer will typically cover about 2/3rds of that.
Even if your company has a open enrollment when something changes in your life you can add a new dependant outside the opeenrollment period. Things like a marrage, birth of a child, adoption, dependant loosing coverage.
Check with you HR or insurance company. Some companies will cover from first da of coverage some will consider it a pre condition. I have had both.
Under Obamacare, mandatory pregnancy coverage is one of the goodies that start in 2014.
That being said, I’d think it would be rare for an employer-sponsored plan not to cover pregnancy. But yeah, check with your company’s HR or benefits coordinator for a definitive answer. And mazel tov!
I was added immediately to my husband’s insurance after our marriage and I had finished my radiation treatment for cancer about two weeks before that. I think that if you add immediately you are fine, but if you try to add later they can deny you or not cover some things. What does your company say when you ask?