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Is pregnancy a pre-existing condition?

TD | September 8, 2008

Q: Is pregnancy a pre-existing condition? I read on Wiki that it is never a pre-existing condition.

A: The Web page on Wiki that you referenced is filled with so many errors that we could not begin to address them. Remember that Wiki is just people's opinions; some people who think of themselves as authorities can cause harm by publishing in this format. The term "pre-existing condition" is a specific term with a legal definition that varies in different jurisdictions and for different types of insurance policies. The term is NEVER the controlling factor in determining coverage for pregnancy in a health insurance policy, regardless of whether the term "pre-existing condition" is applicable or not. In other words, the question you pose is not meaningful in legal terms or useful from a consumer's perspective.

The real question you are likely asking is "Is my pregnancy covered?" This is controlled by policy issues other than the definition of pre-existing condition. Some policies exclude pregnancies. Employer-sponsored group coverage takes over coverage for a pregnancy IF the covered person had continuous prior insurance coverage. So if your intent is to determine coverage, you will need to look a bit harder at the details. We may be able to assist if you provide more information.


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