Dependent Not Covered for Routine Maternity Care, What are My Options?
Hi. I have a question regarding health insurance that I can’t seem to get confirmation from anyone. My health plan at work doesn’t cover routine maternity care for my dependents. My daughter got married a month ago and is currently covered under my plan. She and her spouse don’t have health coverage from their employers. They don’t qualify for Medicaid either.
If my daughter gets pregnant after open enrollment ends will she qualify for a special enrollment period and be allowed to sign up for a policy in the heath exchange?
This way she can remain on my policy until she becomes pregnant and can be dropped because it wouldn’t cover her maternity expenses.
Answer
Generally speaking a dependent can remain on your plan until they become pregnant, at that time they will qualify for a Special Enrollment Period. However, in this situation it may not make sense to claim her as a dependent. If they claim themselves they may end up with cheaper coverage and avoid any complications with her technically having affordable employer based coverage which would bar her from getting cost assistance.
When in doubt contact the Marketplace call center at 1-800-318-2596 (TTY: 1-855-889-4325).
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My daughter is 24 and married. She is on my husband’s insurance policy that will not cover pregnancy. We need to get her insurance. I understand she will be eligible under the Special Enrollment Period. My question is “Will we have to drop her from our insurance before she can apply?”
I am a dependent on my father’s employer provided health care plan. I was informed that they are not covering my prenatal care, are they legally allowed to do that?
As far as I know no, although if it is through a specific type of employer that has a grandfathered plan then maybe. You should check with your insurer to get details. The laws are complex and simple answered can be hard.
I am in the same situation. I just found out I am pregnant and thought I would be covered under my dad’s insurance and I am not. My husband has affordable single coverage insurance but the family coverage is outrageous and we wouldn’t be able to pay our other bills with the added expense. What are my options as far as coverage? My dad’s policy covers everything else except my pregnancy. Can they legally do that?