Pre-Existing Conditions And What They Can Mean To Your Health Insurance

Over the Memorial Day weekend in 1987 I moved to Florida in with my boyfriend and our son. Right away I started looking for an office job. Only three weeks after moving here, I got a job with a well-known company that wasn't too far from my new apartment. As with any new job, I had to choose health insurance coverage, if I wanted it. There were two plans to choose from. One plan was similar to the insurance coverage at my previous job up north where I could use my current doctor and go to any hospital. The other plan was new to me; it was an HMO.

The HR rep explained the HMO plan to me and told me what the benefits of choosing one plan over the other were. Actually, coverage and cost of the package were pretty much the same. It seemed the only difference was that with the HMO I could only use doctors and hospitals on their plan. The HR rep gave me a list of doctors and hospitals, and I found several close to my home. I didn't have a doctor for my child or myself yet, so that list of doctors would be very helpful. For that reason, I chose the HMO plan for health insurance coverage.

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.

I took a pregnancy test, and it came out positive. My primary care doctor referred me to an OB/GYN from the HMO plan. It turned out I was about seven weeks pregnant, which I thought would be a big problem. I had only been working at my new job for about three weeks, so my pregnancy was a pre-existing condition. None of the health insurance plans I ever had covered pre-existing conditions.

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.