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Ask the Health Insurance Expert

I married my wife and four weeks later found out we were expecting a baby. Since we are newlyweds, she hasn't been processed onto my insurance yet. Once she is added, will the pregnancy be considered a pre-existing condition due to the time of conception being around the week of our honeymoon? Also, my wife had no health insurance before we were married.

I'm assuming you have health insurance through an employer-sponsored group plan that provides coverage for eligible dependents as well as employees.

Usually you and your dependents would sign up for health insurance during your employer's open enrollment period. But because you were recently married, your wife is entitled to sign up now. Under the federal Health Insurance Portability and Accountability Act (HIPAA), you have 30 days from the time of marriage to request your wife's enrollment in the plan.

Also under HIPAA, as long as the health plan covers maternity care, pregnancy cannot be excluded as a pre-existing condition. Most employer-sponsored group health plans cover maternity care, and many states require them to cover pregnancy, although you should check the benefits to make sure.

Although the health plan cannot exclude pregnancy as a pre-existing condition, it can impose a pre-existing exclusion period for up to a year for other types of conditions if your wife did not have continual health insurance coverage for the last 12 months without significant breaks in coverage.

For more, see pregnancy complicates health insurance options and HIPAA: Your rights to health insurance portability.




Last updated: May. 24, 2011