Who Will Pay When You Have Pre-existing Conditions

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Author: Alexander Calvin

Author: Alexander Calvin

I moved to Florida over the Memorial Day weekend in 1987 with my boyfriend and our son and immediately started looking for a job in an office. I was very fortunate and found a job about three weeks later with a well-known company that was very close to my new apartment. On my first day on the job I had to choose health insurance coverage, and there were two plans to choose from. One plan was a conventional plan like I was used to up north where you could use your current doctor and go to your hospital of choice should you need to. The other plan was new to me; it was an HMO.

The HR representative explained what an HMO was and the benefits of choosing one plan over the other. Coverage was similar and the cost of the package I would need for myself and child basically was the same amount. With the HMO I would need to use their doctors and only certain hospitals in my area. I looked at the list of doctors the HR rep gave me, and I found several close to my home. There were also two hospitals nearby as well. Being new to the area, I didn't have a doctor for my child or myself yet. I thought choosing doctors from this list would be very convenient. So I chose the HMO plan for health insurance coverage.

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Little did I know at that time how much grief I would save by choosing the HMO plan. I started getting sick and my clothes werent fitting me right. I thought that I was putting on weight because I was eating lunch a couple of times a week in the company cafeteria. Some things happened and other things didnt, and I suspected I might be pregnant.

When I took a pregnancy test, it came out positive. My primary care doctor referred me to an OB/GYN from the HMO plan. The obstetrician told me I was about seven weeks pregnant. I expected this situation to be a huge problem. I had only been working at my new job for less than a month, so my pregnancy was a pre-existing condition. With the health insurance coverage I had at my old job, my pregnancy wouldnt have been covered.

A co-worker suggested I talk to an HR rep to find out what my options were with my health insurance coverage. I was sure the pregnancy wouldnt be covered. I had no idea how this pregnancy and the delivery would be paid for, and I couldnt begin to imagine the cost. The lady in HR asked me which insurance I had. She told me I got lucky when I chose the HMO because the HMO didnt exclude pre-existing conditions. The HMO covered my pregnancy, but the other insurance plan would not have covered it.

To my surprised I was told at the doctors office I didnt have to pay a co-payment for my pre-natal visits. There wasnt a co-pay either when I went into the hospital to deliver the baby. My whole experience with the HMO doctors and the hospital staff helped to make my pregnancy and delivery very pleasant. After that each time I got a new job, if I had a choice between an HMO and another type of insurance plan, I chose the HMO.

About the Author:

Everyone needs incredible individual health insurance to get them safely through life. You will find that nice medical insurance will be one of the greatest things that you can have.

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