Blue Cross Blue Shield, Aetna: Sorry, Your Pregnancy Is A Pre-Existing Condition

Katlyn is having trouble getting health insurance because she just graduated from college and is 15 weeks pregnant. She’s found herself in an expensive situation.

First and foremost, I am 15 weeks pregnant, unmarried, and I just graduated from college. This should be an exciting time for me, as I’m starting two new chapters in my life; unfortunately, enrolling for health insurance has become a burden.

Pregnancy is considered to be a “pre-existing condition” much like diabetes, cancer, or any other kind of health malfunction that would label me as less than perfect. I am a non-smoker, was a varsity athlete in college, and am of average height and weight. I have no other pre-existing medical conditions at all: I have no allergies, no asthma, and I’ve never had any major surgery. When I called Blue Cross Blue Shield, they denied me coverage due to my “condition”. When I asked if this would be a common concern for other health insurance companies, they said, “Yes, you will find this with all health insurance companies.”

So I called other companies. Aetna and Assurant both denied me as well. Every company told me I was more than welcome to enroll AFTER I had my baby. Being 15 weeks pregnant, it would be tough to me to find a job since I am beginning to show, so any hopes of long-term employment with health benefits would be a long shot.

However! There is a glimmer of hope! I can stay on my father’s health insurance for $400 a month through COBRA. Had I not been pregnant, I would have qualified for a health insurance plan for about $175 with BCBS. My boyfriend has health insurance through his company, but since we’re not married, I don’t qualify. I also looked into state health plans, but with my current jobs (all part-time, do not offer insurance) I make too much money to qualify. Fantastic.

Who says health care in the US doesn’t need to be fixed?

Thank you,

Unfortunately HIPAA, the Health Insurance Portability and Accountability Act of 1996, says that group health insurers cannot consider pregnancy a preexisting condition, but doesn’t have the same requirement for individual plans. That’s why they’re able to deny coverage in your case. Also, you try to should avoid any coverage gaps because according to iVillage:

HIPAA doesn’t apply to someone who previously had no health coverage at all and then gets into a group health plan through a new job. So if you had no insurance, got pregnant, then landed a new job with insurance, your new health plan would not have to immediately cover your pregnancy. You might have to sit out a preexisting condition waiting period, a period that could be longer than your pregnancy and in the meantime pay for your visits yourself.

We don’t want that to happen to you, even if $400 a month sounds like a lot to pay for health insurance.

Have any of our readers been in a similar situation? How did you get through it? Do you have any advice for Katlyn?

Pregnant without health coverage [iVillage]
(Photo: Jonathan Harford )