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Is pregnancy considered a pre existing condition in short term disabil


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Guest MotherJ
Posted

I am an expectant mother. My company doesn't have maternity leave, and I just recently found out that I won't be able to be covered under the short term disability because it is considered a pre existing condition. I found out I was pregnant August 31,2002 and my effective date was September 1,2002. I would like to know if this is true because I was also told that pregnancy was the only thing that wasn't considered a pre existing. Also when I signed the papers electing to get the insurance that date was August 12,2002 and at that point I was unaware that I was pregnant. Any information is helpful :confused:

Posted

Pregnancy cannot be subject to a pre-existing limitation in a group health plan; however, this does not hold true for a short term or long term disability policy. The summary plan description for your short term disability policy should spell out the pre-existing condition limitations. In most policies there is a period of time prior to the effective date of the coverage which will be reviewed to determine if the person was given medical care (consulted a physician or was treated for a specific condition)during that period.

Posted

The provisions of the contract are going to determine whether or not your pregnancy is going to be considered pre-existing. Pregnancies are usually subject to the same rules as any other injury or illness, so whoever informed you that pregnancies wouldn't be considered a pre-existing condition probably misinformed you.

Since you are just signing up for insurance is it safe to assume that you were a new employee back in August? If you were covered under a different short-term disability plan through another employer or via an individual policy prior to signing up for this policy, the carrier may view the coverage as continuous, and thus your pregnancy would not be considered pre-existing.

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