Hospital Indemnity Coverage California

[cbg]

Is it a short term policy? I can't find anything excluding gap coverage, per se, from the regulations but some short term policies can be.

[Betty3]

It seems from what I have read several places that at least some health gap policies are generally short term coverage with limited benefits, do not cover pre-existing conditions, are not ACA compliant & are not guaranteed issue.

You will need to read your policy provisions.

[hga]

It is a Colonial Life policy. I had the same thought initially, but I was told because it is a "gap coverage" and not a primary health insurance, it didn't fall under the same laws protecting against pre-existing clauses. Was I misdirected with this information?

[cbg]

Someone's missed the boat somewhere. Insurance carriers are no longer allowed to deny claims on the basis of pre-existing conditions, and LONG before that was made law (two years ago) pregnancy was excluded from any pre-ex clauses.

Where did you get this coverage from?

[hga]

This might not be the right place to ask this question, but it's worth a shot.

We have a high deductible Kaiser health care plan. On July 1, 2015 we started a separate hospital indemnity gap coverage policy because we knew we were hoping to have another child and it would help with labor and delivery costs. The policy has a pre-existing pregnancy clause that won't cover any full-term deliveries within 9 months of the policy start date. This date would be April 1, 2016.

I was not pregnant when the policy started, however, I am now, and my due date is March 31, 2016. A pregnancy is counted back two weeks from conception to the last menstrual period. Also, a baby can be considered "full-term" at only 37 weeks. Therefore, I am pregnant now, due to give birth within the 9 month exclusion period, yet this pregnancy is NOT pre-existing.

Obviously, I am hoping just to go overdue a few days and give birth outside the 9 month exclusion period. However, if I give birth between March 10, 2016 and March 31, 2016, what are the chances I will be able to claim the birth and receive payment from the hospital indemnity policy?

If someone can suggest a better place to ask this question, I'm all ears. Thank you.