Question: My daughter who is 23 and is a covered dependent on my husband’s insurance policy is pregnant and Maternity is excluded on the policy. My question is that in California Maternity Benefits are now mandatory as of July 1, 2012. Would this apply to her as well? If so, who do I contact to get her covered? Thanks so much!
Answer: Yes. Maternity coverage is a mandated benefit in California on new plans issued after July 1, 2012. However, your husband’s coverage was issued prior to that date. It does not automatically include maternity coverage now. If his coverage is part of an employer sponsored group health insurance plan, maternity coverage will be included at open enrollment, when the entire group renews or moves to a new plan. If your husband’s coverage is an individual plan, he would have to reapply for a new plan effective July 1 or later and go through the underwriting process. Your daughter’s pregnancy is a preexisting condition that will result in the application being rejected. I’m afraid there is no way your daughter’s prenatal and normal delivery expenses can be covered now. However, her current policy will cover medical complications during pregnancy and delivery should that occur.