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TJ, Esq.
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Experience:  Licensed to Practice Law
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What is the laws in Texas involving insurance coverage for

Resolved Question:

What is the laws in Texas involving insurance coverage for a spouse that is already pregnant when you start a job with a new company? If you go to work for a company and your spouse is 7 months pregnant, can they deny insurance coverage for the pregnancy or the newborn baby coverage due to a pre-existing condition?

Thanks,
Brad
Submitted: 11 months ago.
Category: Employment Law
Expert:  TJ, Esq. replied 11 months ago.
Hello and thank you for allowing me the opportunity to assist you.

Did your spouse have health insurance prior to the new job and new insurance?
Customer: replied 11 months ago.
Actually it is my son and daughter-in-law, and yes she is covered under my son's insurance plan at the company that he is working for now. He is considering leaving his company and going to work at another company. She is 7 months pregnant, so he is concerned about making sure that there would not be any issues with insurance coverage for the baby delivery and the newborn coverage.
Expert:  TJ, Esq. replied 11 months ago.
Hi again.

So long as they maintain their coverage now, then the pregnancy will not be considered a pre-existing condition if/when he switches jobs and insurance plans. This is based upon the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). The ability to switch health plans without penalty is one of the primary purposes of HIPAA (though most people only seem to think about the privacy protections in HIPAA).

So, there shouldn't be any problem for your son and daughter-in-law. But it is important that they not have a break in coverage. If there is a break in coverage, then the HIPAA protections may not apply.

Does that answer your question? Please let me know if you need clarification, as I am happy to continue helping you until you are satisfied. Also, your positive feedback is much appreciated. Thank you for using our service!

If you would like to direct additional legal questions to me in the future, then please type "To VAMD" in the subject line of your question.
TJ, Esq., Attorney
Category: Employment Law
Satisfied Customers: 9587
Experience: Licensed to Practice Law
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