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  1. #1
    justice76 is offline Junior Member
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    Adding my Pregnant Fiancee to my Health Insurance? Please help!

    What is the name of your state (only U.S. law)? Texas

    Well It was a surprise but a blessing. We have found out we are going to have a baby in Aug. We both have health insurance, both with blue cross mine is the FED. Blue.

    Well lets say I am basically the bread winner. I have the feeling she will not be able to work much longer. I am afraid to call my provider in fear they will black list me if I tell them we are not married and expecting.

    Will I be able to add her without getting married? I just want her to stay at home and relax. What would be my best course of action in this situation?

    I hope this makes sense I am a bit scattered brained.

    Thank you for your time.
  2. #2
    CourtClerk is offline Senior Member
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    I can't think of any instance where you would be allowed to make your employer responsible for your friend's medical care...

    Once your CHILD is born, you can add the child, but most insurance policies don't allow you to insure friends. Now, if you decide to marry her and make her your WIFE... that's a whole different story.
  3. #3
    ecmst12 is offline Senior Member
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    Many plans allow you to add domestic partners, same or opposite sex, but only within 30 days of a change in status. Getting pregnant is not a chance in status. Some plans will require you to actually register as domestic partners, if allowed in your state. If she is allowed to be covered, then her quitting or losing her job WOULD be a change in status.

    If you have to get married in order for her to be covered, which is perfectly legal and also common for plans to require, then it's a simple thing to go to the courthouse and get married on paper. You can still have a proper ceremony later.
  4. #4
    cbg
    cbg is offline Senior Member
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    The bottom line is that whether or not you can add her to the policy without getting married is ENTIRELY a matter of your specific insurance policy. If opposite sex domestic partners are not considered eligible dependents in your state or under your policy, then you cannot. Period. It's marriage or nothing.

    If opposite sex domestic partners are considered eligible dependents in your state AND under your policy, then you can - assuming that you have had a qualifying event as defined by your specific policy within the past 30 days. In 30 years of administering employer sponsored benefits, I have yet to see a policy where pregnancy is considered a qualifying event. (Marriage, however, would be.)

    It is POSSIBLE, assuming that opposite sex domestic partners are considered eligible dependents on your policy, that you can complete an affidavit declaring yourself "spousal equivalents" and add her to the plan that way. It is NOT required by law that your employer permit this and they can only do so if the insurance policy so states.

    The only way you are going to know your options is by asking your HR. There is no law that is going to force your employer to accept your fiancee, pregnant or not, on your insurance unless YOUR POLICY says so.
  5. #5
    cyjeff is offline Senior Member
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    Of course, you could always just go ahead and get married.
  6. #6
    RRevak is offline Senior Member
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    Have you spoken directly to your insurance company about whether or not they have a Domestic Partner Clause? I was under my ex's plan for 2 yrs under such clause and the only thing they required was that we proved that we had been residing in the same vicinity for a year or more. We had Blue Cross Blue Shield. I can tell you though, that its VERY expensive! We paid something along the lines of about $250 more than the average family plan per month and that was just for the two of us! It skyrocketed even more when we added our daughter. If you choose to add her as a Domestic and then the child once he or she is born then talk to your insurance provider and if you meet their terms (which even currently shouldnt be much) then you should be alright, but be prepared to pay for it. Before my husband and I got married a short while ago, we also looked into the same clause and as long as it was during their normal enrollment period, since we were living together for 2 yrs, they had no problem with myself and my daughter being added. The problem was that it was going to cost us just over $500 per month! (per the advice of a few on here hehe, we later bypassed the whole issue and married via civil ceremony at our county court house) Might want to look into that yourself
  7. #7
    RRevak is offline Senior Member
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    Here is the def. of Domestic Partner as far as insurance companies go. Please pay attention though to the bottom regarding the wait period for coverage. Hope this helps


    Definition of a
    domestic partner

    If your employer offers health insurance coverage for domestic partners, you’ll probably first be asked to sign an affidavit that you:

    -Have lived together at least six months.
    -Are both age 18 or older.
    -Share a close personal relationship and are responsible for each other’s common welfare.
    -Are exclusive.
    -Are not married to anyone else.
    -Are not related by blood closer than would bar marriage in the state.
    -Share the same regular and permanent residence, with the current intent to continue doing so indefinitely.
    -Are jointly financially responsible for "basic living expenses," defined as the cost of basic food, shelter and any other expenses of a domestic partner because of the domestic partnership. (Domestic partners need not contribute equally or jointly to the cost of these expenses as long as they agree that both are responsible for the cost.)
    -Were mentally competent to consent to the contract when the domestic partnership began.

    Some employers impose waiting periods that vary from six months to a year before insurance coverage begins.


    [url]http://www.insure.com/articles/healthinsurance/domestic-partner.html[/url]

    Also, be aware that since your GF is already pregnant, you might have a devil of a time getting her added as they may see it as a "Pre-existing condition" and therefore not cover the pregnancy and birth. But again, you need to talk to HR. But as i've come to know these things, they generally dont want one to come into a policy already costing them money..i.e adding someone who is pregnant, but that will depend solely on your insurance company :-)
    Last edited by RRevak; 01-19-2009 at 02:39 PM. Reason: clarification :-)
  8. #8
    cbg
    cbg is offline Senior Member
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    FYI, Federal law (i.e. HIPAA) prohibits employer-sponsored group insurance from considering pregnancy a pre-existing condition under any circumstances.
  9. #9
    Indiana Filer is offline Senior Member
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    Quote Originally Posted by justice76 View Post
    I just want her to stay at home and relax. What would be my best course of action in this situation?
    FEP insurance polices do not cover friends, domestic partners, fiancees, or other non-dependents. If you want her covered by your insurance, you need to marry her. Even though she is pregnant at the time of marriage, she will be covered by FEP Blue as of the date of the marriage.

    I've got FEP Blue, Basic plan, coverage. It's great coverage.

    Under FEP coverage, DD cost a total of $5 when she was born 18 years ago. She's made up for the low cost since.
    Last edited by Indiana Filer; 01-19-2009 at 06:02 PM.
  10. #10
    Zigner is offline Senior Member
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    RRevak - this is NOT a legal definition...it is not even one that insurance companies have to adhere to.

    Quote Originally Posted by RRevak View Post
    Here is the def. of Domestic Partner as far as insurance companies go. Please pay attention though to the bottom regarding the wait period for coverage. Hope this helps


    Definition of a
    domestic partner

    If your employer offers health insurance coverage for domestic partners, youíll probably first be asked to sign an affidavit that you:

    -Have lived together at least six months.
    -Are both age 18 or older.
    -Share a close personal relationship and are responsible for each otherís common welfare.
    -Are exclusive.
    -Are not married to anyone else.
    -Are not related by blood closer than would bar marriage in the state.
    -Share the same regular and permanent residence, with the current intent to continue doing so indefinitely.
    -Are jointly financially responsible for "basic living expenses," defined as the cost of basic food, shelter and any other expenses of a domestic partner because of the domestic partnership. (Domestic partners need not contribute equally or jointly to the cost of these expenses as long as they agree that both are responsible for the cost.)
    -Were mentally competent to consent to the contract when the domestic partnership began.

    Some employers impose waiting periods that vary from six months to a year before insurance coverage begins.


    [url=http://www.insure.com/articles/healthinsurance/domestic-partner.html]Insure.com - Health insurance benefits for domestic partners[/url]

    Also, be aware that since your GF is already pregnant, you might have a devil of a time getting her added as they may see it as a "Pre-existing condition" and therefore not cover the pregnancy and birth. But again, you need to talk to HR. But as i've come to know these things, they generally dont want one to come into a policy already costing them money..i.e adding someone who is pregnant, but that will depend solely on your insurance company :-)
  11. #11
    ecmst12 is offline Senior Member
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    The definition of a domestic partner, if it is possible for them to be covered dependents, will vary depending on the company and the state and the plan. There is not one universal definition that will apply in all situations. And it looks like a domestic partner is not a covered dependent on this plan anyway.

    If you do decide to get married to get her on your insurance, just make sure you complete the enrollment process within 30 days of the wedding if you want her covered as of that date.
  12. #12
    nextwife is offline Senior Member
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    Quote Originally Posted by justice76 View Post
    What is the name of your state (only U.S. law)? Texas
    I have the feeling she will not be able to work much longer.
    Why? Is she needing bed rest? She will also be eligible for COBRA, which, though expensive, would be way cheaper than an uncovered pregnancy. She should work as long as possible, to keep her health insurance until the delivery. Even if you marry her, most plans will not cover a pre existing pregnancy-
  13. #13
    CourtClerk is offline Senior Member
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    Quote Originally Posted by nextwife View Post
    Even if you marry her, most plans will not cover a pre existing pregnancy-
    Not true for employer sponsored plans.....
  14. #14
    cbg
    cbg is offline Senior Member
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    Even if you marry her, most plans will not cover a pre existing pregnancy-

    As I said above, Federal law specifically prohibits employer-sponsored group plans from considering pregnancy as pre-ex. An individual play may; an employer sponsored group plan cannot.
  15. #15
    Indiana Filer is offline Senior Member
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    Quote Originally Posted by nextwife View Post
    Why? Is she needing bed rest? She will also be eligible for COBRA, which, though expensive, would be way cheaper than an uncovered pregnancy. She should work as long as possible, to keep her health insurance until the delivery. Even if you marry her, most plans will not cover a pre existing pregnancy-
    But this is Federal Emplyee Program Health Insurance. It will cover the pregnancy from the date they marry (if he reports a marriage w/in 30 days of the marriage) through delivery.

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