It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....

Health Insurance - SSDI Issues Message Board

Pre-existing condition waived under new Health Care Reform (News + Experiences)

Post New Thread   Closed Thread
LinkBack Thread Tools Search this Thread
Old 04-07-2010, 11:17 AM   #1
Join Date: Apr 2010
Posts: 2
23kiddo HB User
Pre-existing condition waived under new Health Care Reform (News + Experiences)

I'm new here and have been doing a considerable amount of research on Maternal Health Coverage, as I am also new to the US.

We have never had health coverage in the US. My wife is a US citizen though. Initially when I called a few insurance companies, I was surprised to find out that insurance companies will not take on pregnant women, as they are too high risk. So, when the Health Care Reform Bill was passed into law, you could only imagine how excited I was.

The grey area since the bill passing on March 21, has been the developing story of the pre-existing condition waiver, and the high-risk pool.

This, according to many articles i've read recently is supposed to be in effect 90 days after the bill was passed. I spoke with Blue Cross, and they confirmed that they could not offer us any coverage now, but in the coming months (specifically after June 21) us not having insurance now in the US for more than 6 months and my wife's pre-existing pregnancy condition would potentially qualify us to be put into the new High-Risk Pool, that would get us maternity insurance under the new Health Care Reform law. This could not be confirmed though, as many of the details are yet to be ironed out.

What I am looking to do with this post, is get people's insight (read: not political stance) on their experiences or any breaking news on this topic, to help pregnant mothers in similar situations as ours, get maternal coverage with a pre-existing pregnancy condition.

Last edited by 23kiddo; 04-07-2010 at 12:18 PM.

Sponsors Lightbulb
Old 04-08-2010, 05:15 AM   #2
Senior Member
Join Date: Aug 2003
Location: Grand Forks, ND, USA
Posts: 291
kewlgirl HB User
Re: Pre-existing condition waived under new Health Care Reform (News + Experiences)

Most pregnant women that don't currently have health insurance coverage can quality for Medicaid.

Medicaid is insurance that is paid for by the government. To qualify, you have to meet certain criteria, such as being low income or being pregnant. It is very difficult for a pregnant woman to be denied if she doesn't already have insurance.

Here is some information on Medicaid.

Good health is important to everyone. If you can't afford to pay for medical care right now, Medicaid can make it possible for you to get the care that you need so that you can get healthy – and stay healthy.

Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services.

Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. Read more about your state Medicaid program.

Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.

Your child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if you are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child.

In general, you should apply for Medicaid if your income is low and you match one of the descriptions of the Eligibility Groups. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)

Screening Tools

To help you see if you may be eligible for a variety of governmental programs, you may access the GovBenefits and BenefitsCheckUp websites.

When Eligibility Starts

Coverage may start retroactive to any or all of the 3 months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change. Most States have additional "State-only" programs to provide medical assistance for specified poor persons who do not qualify for the Medicaid program. No Federal funds are provided for State-only programs.

What is Not Covered

Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups. Low income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the TANF program or from the SSI program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses.

Old 04-09-2010, 06:43 AM   #3
Join Date: Apr 2010
Posts: 2
23kiddo HB User
Re: Pre-existing condition waived under new Health Care Reform (News + Experiences)

Medicaid is an option for some, but for people that are working or have an average amount of income, there isn't (wasn't I should say) an option for maternal coverage.

Shame you can't post links here, but there are stories circulating on the internet, and hopefully some progress is made with this law and the waiving of the pre-exisiting condtion for pregnancy by the stated deadline of June 21, 2010. Here is an excerpt from a story PBS ran:

"In one of the first moves the Obama administration has taken under the new health care reform law, Health and Human Services Secretary Kathleen Sebelius on Friday sent a letter to state governors and insurance commissioners intended to gauge interest in a new insurance high-risk pool program. The health care reform bill provides $5 billion in funding to create a network of insurance pools for people with pre-existing medical conditions who do not have insurance. The pools are intended to open within 90 days, and are a stopgap measure that will last until 2014, when insurance companies will no longer be able to deny coverage to anyone based on pre-existing conditions"

Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Testicle ache after pre-ejaculate kizza2208 Sexual Health - Teens 2 09-02-2009 10:49 AM
Not being able to get erection during intercourse due to pre-***? Benny1991 Sexual Health - Men 0 11-23-2008 03:25 PM
Will have pre-operation hysterectomy on April 1, 2008, advice on any question to ask? perfectlove3952 Hysterectomy 0 03-17-2008 10:29 AM
i had the leep will more pre cancer come back? mrk2007 Human Papillomavirus (HPV) 3 12-18-2007 02:16 PM
do all guys pre-ejaculate? Emme203 Sexual Health - General 11 12-03-2007 07:59 AM
Pre-Ejaculate (Facts for Teens) _mystictiger_ Pregnancy-Teen 12 01-02-2007 05:46 PM
Diagnosed Pre-Diabetic Help Please cfoxj Diabetes 34 01-06-2006 10:42 PM
Pre-menopause in pre-teen? anxious and confused Menopause 7 12-16-2004 03:03 PM
pre-ejaculate pre-*** bayou12 Pregnancy 1 12-19-2003 06:57 AM
Does anyone know... (pre-*** question) cottonblossom Pregnancy 4 11-09-2003 08:16 PM

Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off

Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 12:52 PM.

Site owned and operated by™
© 1998-2018™ All rights reserved.
Do not copy or redistribute in any form!