Can a pregnant person get health insurance if her employer goes bankrupt?
January 19, 2011 9:38 AM   Subscribe

What do we do for health insurance if my employer goes bankrupt? I'm pregnant.

I'm worried the company I work for is going to go bankrupt. My understanding in case of bankruptcy, or if a company otherwise ceases to offer health insurance at all, COBRA goes away too.

The US Department of Labor's fact sheet on employer bankruptcy mentions "Other coverage may be available by converting your employer’s group health coverage to an individual policy."

Which would be fine (if expensive) except that I'm pregnant, so I'm pretty sure no individual policy will touch me with a 10 foot pole.

I'd like to avoid talking to our company's insurance broker. Mainly because he's given bad info in the past (more likely due to incompetence than malice) but also because I don't want to advertise my concerns about the company.

Other potentially relevant factors:
-We live in California, the San Francisco Bay Area.
-If things things do hit the fan, I think it'll be in a couple of months, so I have a little time.
-I'm due in July.
-Coverage through my spouse is not an option.
-We have some assets, so I doubt we'd be eligible for any state programs. On the plus side, we would be able to cover even fairly expensive private insurance for a while, if it were available.
-After the baby is born, I think it's realistic to start interviewing 2-3 months after the baby is born. (Based on prior experience, any earlier and I'll be a sleep-deprived drooling zombie.) So we should have access to group coverage again eventually.
-"Rack rate" at the maternity ward is insane, and climbs to catastrophic in case of complications. (Apparently they charged almost $50k for delivery of our first child, which apart from induction and a c-section was an "uncomplicated" delivery. WTF?!?!)

Is there any way to get individual insurance when one is pregnant? Should I urgently start looking for another job?
posted by anonymous to Work & Money (13 answers total)
HIPAA prevents health insurance from considering pregnancy a pre-existing condition. So you may not be as screwed a you think you are.
posted by zsazsa at 9:44 AM on January 19, 2011

You'll qualify for Medicaid.

Your husband may not. But if you need it to cover you, it will.

And the baby will be covered by Medicaid when it's born.
posted by zizzle at 9:48 AM on January 19, 2011

Or, I should rephrase, that in most states, you'll almost certainly qualify for Medicaid as a pregnant woman.
posted by zizzle at 9:50 AM on January 19, 2011

"HIPAA prevents health insurance from considering pregnancy a pre-existing condition. So you may not be as screwed a you think you are."

That particular HIPAA provision does not apply to individual plans, only employer group sponsored plans, sort of...

It's really going to depend on the laws in your state when it comes to getting individual coverage. In Minnesota, for example, pregnant women can't be denied coverage, but the coverage can exclude coverage for maternity for the first 18 months of coverage.

Go find an independent insurance agent in your area. They should be familiar with the options available to you.
posted by thatguyjeff at 9:55 AM on January 19, 2011

You can get a HIPAA conversion plan. It may be very pricey, but probably better than being uninsured and pregnant.
posted by ClaudiaCenter at 9:55 AM on January 19, 2011

I forgot to add...

States/plans that offer a conversion privilege very often don't require any sort of health history. Meaning, if you are allowed to convert your coverage into individual coverage, your pregnancy would be covered.

Again, check with an agent and ask about the conversion privilege.
posted by thatguyjeff at 9:59 AM on January 19, 2011

HIPAA may come into play here, but only if certain conditions are met (must have had 18 months of creditable coverage [most group plans are "creditable"] previously and not had a gap in coverage of more than 63 days). If you are HIPAA-eligible you have the right, as zsazsa wrote, to buy a "portability" (HIPAA-enabled) plan from any insurer, and it may not exclude preexisting conditions.

Under something called a "conversion" policy, you have the right to buy a plan from the same company that covered you in your employer's group plan, and the plan cannot exclude preexisting conditions. Under "conversion," you need only to have been covered under the group plan for 3 months, not 18 months.

Great guides to all this are here, here, and here.

These pages are the work of Georgetown University's Health Policy Institute.
posted by celilo at 10:01 AM on January 19, 2011

Like several other people said, you're going to want to go with a HIPAA conversion plan. It'll be expensive, just like pretty much all health insurance in this stupid country, but probably less than an individual policy and possibly less than COBRA.
posted by infinitywaltz at 10:12 AM on January 19, 2011

In addition to celilo's resources, has a "Find Health Insurance Options" tool that might help.

There is also this brochure on finding coverage in California from public (e.g. Medi-Cal) and private insurers.

And if you live in San Francisco there is the Healthy San Francisco program:

Good luck!
posted by Allez at 10:13 AM on January 19, 2011

I just read through my individual policy update document (from BCBS of NC, FWIW). I'm not 100% sure, but I *think* that they allow pregnant women to enroll in the "maternity rider" IFF they were covered within the past 60 (or something) days.

What I'm saying is: don't give up on getting an individual policy. Ask.
posted by amtho at 10:24 AM on January 19, 2011

Depending on your state, uninsured and pregnant may not be the end of the world. Many states cover these women (and their children).
posted by fifilaru at 11:08 AM on January 19, 2011

I know many women in NC who have had babies on Medicaid (thinking about doing it myself!) Really, it's completely awesome and they cover home births, midwives, and hospital births depending on what route you take. I've even had people with insurance say they wish they'd gone through Medicaid with their birthday because the insurance is so good.
posted by Rocket26 at 12:12 PM on January 19, 2011

EXCUSE ME "with their births" not "with their birthday"
posted by Rocket26 at 12:13 PM on January 19, 2011

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