My employer is switching health insurance May 1st. I've already paid my out of pocket max. I'm pregnant!

Question

Will I have to pay a second out of pocket max when I deliver in a few months with the new plan? We live in Texas, in case it is state specific, and they are swtiching to BlueCross.

Answer 1

Blue Cross/Blue Shield will cover it since the old insurance did.  They are required to.  When the new plan takes effect, if it is on the anniversary date, you will be required to start over.  If not, you may or may not have to.

Answer 2

It's not state specific, it depends on how your employer sets the plan up with the new carrier.  

So no one here can give you an accurate answer, only your HR department can.  Sorry.

Answer 3

Most companies give you credit for deductible and out of pocket met on a prior group health plan.  Just save your last EOB that shows what you have met and submit it to the new carrier for deductible credit.  I am assuming that your deductible goes calendar year to calendar year and not policy period to policy period.  If it would happen to be policy period, then you would start over, but it would have started over with your old plan too.

Answer 4

I wish I had my study materials here...I just got my health insurance license. I am 99% positive that when we talked about group plans that they were required to credit the deductible if the group decided to switch plans. I'd say you're safe.

Answer 5

The new plan will have a new deductible and new out of pocket max, you will have to start over. The good news is if the plan is a group plan your pregnancy will be covered. Make sure the new plan is a group plan and not an individual health insurance plan. Individual health insurance will not cover an existing pregnancy.