HIPAA Defined

• In 1996, the U.S. Congress passed the Health Insurance Portability and Accountability Act (HIPAA). This law consists of two parts. The first protects the health insurance of employees who change or lose their jobs. A worker, for example, who is diagnosed with cancer and changes jobs--and with it enters a new group insurance plan--cannot have their cancer defined as a "pre-existing condition" under the HIPAA act and therefore be excluded from coverage.
  
  

Pregnancy Not Pre-existing Condition

• Group health plans, under HIPAA, cannot label pregnancy as a "pre-existing condition," thereby denying coverage. When switching from one employer to the next--as the primary insured or the dependent--you cannot be denied coverage by a new employee-sponsored group health plan. This new plan must also cover maternity.
  
  

Group Vs. Individual plans

• HIPAA applies predominately to group health plans. Changing from one individual plan to another is not protected under HIPAA.
  
  

Considerations

• The federal government does not have a law forcing health insurance companies to automatically provide maternity coverage. Some states impose this law, however. Health Maintenance Organizations (HMO's), under state law, must provide coverage unlike Preferred Provider Organizations (PPO's) that have the option of inclusion.
  
  

Possible Waiting Periods

• Switching from an individual health plan into a job with a group health plan, which covers maternity, does not automatically guarantee instant maternity coverage. The new plan might impose a waiting period before coverage is allowed. In addition, many employers withhold insurance availability until a specific time of employment has elapsed, such as 30 days.