Short term disability insurance - already pregnant

**gretch6364** · 01-02-2015, 11:12 AM

My wife's company does not offer any paid maternity leave. We understood this before getting pregnant (she is about 6 weeks along), and figured we would just have to take the hit while she was on leave. In talking with some friends, they mentioned applying for short term disability to cover some of the lost wages, or if god forbid, there were complications. In doing some research, looks like we should of thought if this before and done it prior.

It sounds like their are some applications that don't ask if you are pregnant already, but seems like most have a 9 month birth window where it is not allowed. Does anyone have any experience with this? Any suggestions of a Company we could use? If we can't get coverage for a normal birth, do you have nay good suggestions of something that would at least cover complications that could cause her to miss more work?

Thank you for any help.

**Cruiser** · 01-02-2015, 11:23 AM

I have nothing helpful to contribute but congrats on the impending birth. Hopefully everything goes smoothly for her in the coming months.

**gretch6364** · 01-02-2015, 11:26 AM

Thanks. Much appreciated.

**irul&ublo** · 01-02-2015, 11:33 AM

Disability insurance will not cover complications themselves (as opposed to lost income arising from the time off), that's medical insurance. Also, I'd check to see if a normal pregnancy counts as a disability. Talk to an independent insurance agent about coverage.

**Adolf Allerbush** · 01-02-2015, 11:34 AM

Most of the women I work with apply for short term disability once the birth occurs. First, during open enrollment (e.g., in November) they elect for the short-term disability coverage. Where I work I think it costs like $20/month for the coverage so just about everyone ops in, dudes included. Then what happens is that they are required to deplete whatever PTO they have accrued and then the short term disability coverage kicks in. The coverage provides 60% of their normal pay, for a while, but I don't think it covers the entire 3-months of FMLA leave...maybe 6-8 weeks or so. As far as I know it doesn't matter if the health reason for using the coverage was pre-existing or not.

**strawjack** · 01-02-2015, 11:36 AM

If my controller was in today I could probably get an answer on this one. Not too sure that pregnancy qualifies for 'short term disability'. If it does I think I would be surprised if they let you pull off what you're trying to do. Insurance companies always cover their asses, so they don't lose. There must be an insurance guy in here to answer this one.

Congrats on the little one!

**gretch6364** · 01-02-2015, 12:03 PM

10-4 on the medical coverage. I understand that part of it...I meant if she had to be off work longer due to the complications...covering lost wages. Using short term disability for normal maternity leave is pretty common from what I have read, the issue is, you usually have to apply prior to being pregnant and most have a 9 month window where nothing is covered. I was hoping for worse case scenario if something happens. We have the money saved for the regular leave. Also, it would need to be a private policy. Her employer does not offer it, and I am self employed. Lastly, her job does not fall under the FMLA rules due to the number of employees. She kicks ass at her job, so hopefully they would work with her on it, but we are tempted to say fuck it and she searches for a new job while on leave then give notice when she finds one. Her job is really stressful and she is high up in the Company. Combined with my job, not much time or energy left, so we have to make some sort of change. Thanks

**mcsquared** · 01-02-2015, 12:12 PM

Unless your wife has a C-section short term disability doesn't apply. My wife got something like 60% of her pay for 6 weeks or something because she had a non-elective c-section. And you have to exhaust your PTO before you can start collecting if I am not mistaken. It has been a few years and it was all a blur for me.

**Adolf Allerbush** · 01-02-2015, 12:13 PM

Originally Posted by gretch6364

10-4 on the medical coverage. I understand that part of it...I meant if she had to be off work longer due to the complications...covering lost wages. Using short term disability for normal maternity leave is pretty common from what I have read, the issue is, you usually have to apply prior to being pregnant and most have a 9 month window where nothing is covered. I was hoping for worse case scenario if something happens. We have the money saved for the regular leave. Also, it would need to be a private policy. Her employer does not offer it, and I am self employed. Lastly, her job does not fall under the FMLA rules due to the number of employees. She kicks ass at her job, so hopefully they would work with her on it, but we are tempted to say fuck it and she searches for a new job while on leave then give notice when she finds one. Her job is really stressful and she is high up in the Company. Combined with my job, not much time or energy left, so we have to make some sort of change. Thanks

Gotcha, sorry for my misunderstanding. Good luck with everything, wish I had something useful to add here. Personally my wife had a moderately stressful job, probably nothing like what your wife is experiencing, and she ended up just quitting two weeks before our first son's birth and ended up not going back after leave...which, like your guys' situation, didn't hit the thresholds of # of employees for FMLA or the Oregon equivalent (e.g. 25 employees) so she was going to have to be back at work 3-weeks after the birth. Anyhow, that forced our hand so to speak, and it's worked out better, although loss of her income was a major shitter. Good luck man.

**hutash** · 01-03-2015, 12:51 PM

Depends on the state, but California pays 6 weeks maternity disability, longer if any issues, which are easy to get if your OB says. Not what you are asking, but at least in CA you and she can take 6 months off and still keep your present job, or equivalent.

**Danno** · 01-03-2015, 01:06 PM

Just because fmla doesn't apply doesn't mean they won't honor it. She just needs to ask, many good employers will still honor it.

**Cruiser** · 01-03-2015, 01:36 PM

Danno's right for sure. Mrs. Cruiser has taken 4 mat leaves over the years and while only 1 employer was large enough to guarantee FMLA benefits they all accommodated her very generously. I assume your lady has already spoken with her employer about it but if she hasn't then she might be surprised by their willingness to take care of her.

**AK47bp** · 01-03-2015, 05:50 PM

pregnancy is considered a disability. STD won't payout on a pre existing condition, being pregnant is a pre existing condition. If she bought the coverage before being pregnant it would of paid out. This is how most STD plans are designed. Even if she bought it during a guaranteed issue window like being a new hire or during open enrollment there is usually still a look back clause of about 3 months to a year depending on plan design. Basically if you file a claim they look back 3 months to see if you were treated or diagnosed with whatever it is causing your disability and can deny the claim based on that.

You can't buy car insurance After the accident and have it cover the damages. The insurance coverage has to be in place before shite happens. Same deal its STD.

**gretch6364** · 01-06-2015, 09:50 AM

Originally Posted by AK47bp

You can't buy car insurance After the accident and have it cover the damages. The insurance coverage has to be in place before shite happens. Same deal its STD.

I got that. I was wondering if there was anything out there possibly for a young healthy pregnant women that would cover unexpected complications. I figured there wasn't, but also knew if there was, the maggots would have the details. Thanks

**AK47bp** · 01-06-2015, 10:11 AM

Originally Posted by gretch6364

I got that. I was wondering if there was anything out there possibly for a young healthy pregnant women that would cover unexpected complications. I figured there wasn't, but also knew if there was, the maggots would have the details. Thanks

The only idea I have would be to get her some Obamacare coverage. Open enrollment ends Feb 15th.

Once the baby is born you can then cancel the Obamacare coverage as a qualified life event (assuming you wanted it as a "just in case" type of thing for the birth). That shits expensive.

**Sagamoron** · 01-06-2015, 10:55 AM

Hmm, let me ask Mrs Moron. We just had our first this fall and she has been on short term disability since birth (I think). Her job didn't offer her maternity leave either, but she did get 60% of her pay for the last few months. It was pretty straightforward after getting some help with from the HR Department. This is in Mass so your state might be different, but I have no clue

Good Luck with the baby!

**Adolf Allerbush** · 01-06-2015, 11:34 AM

Originally Posted by AK47bp

You can't buy car insurance After the accident and have it cover the damages. The insurance coverage has to be in place before shite happens. Same deal its STD.

Seems like you know more about this than me....just out of curiosity what if a woman didn't know she was prego during open enrollment, then by Jan 1 she realizes she was prego when she enrolled in her STD plan. What then? In other words, what makes it a preexisting condition, getting knocked up or having a doctor confirm being knocked up.

**AK47bp** · 01-06-2015, 12:27 PM

Originally Posted by Adolf Allerbush

Seems like you know more about this than me....just out of curiosity what if a woman didn't know she was prego during open enrollment, then by Jan 1 she realizes she was prego when she enrolled in her STD plan. What then? In other words, what makes it a preexisting condition, getting knocked up or having a doctor confirm being knocked up.

The effective date of the coverage would be jan 1 in your example. When the claim is filed it requires the physician to complete a section asking date symptoms first appeared and estimate due date. If that info proves the condition existed prior to jan 1 then it would be a pre existing condition. This is generally how disability insurance works.

**DeepHelmet** · 01-06-2015, 12:33 PM

Originally Posted by AK47bp

You can't buy car insurance After the accident and have it cover the damages. The insurance coverage has to be in place before shite happens. Same deal its STD.

Not true, at least not in all states. My bro blew his knee out a couple years ago. He was told by a large insurance company if he hasn't been seen by a doctor yet, it's not a pre existing condition. They signed him up and paid for his surgery.

I'll edit this to say I'm referring to health insurance. My guess is STD would be the same, but not sure. It would be worth looking into.

**AK47bp** · 01-06-2015, 12:43 PM

Originally Posted by DeepHelmet

Not true, at least not in all states. My bro blew his knee out a couple years ago. He was told by a large insurance company if he hasn't been seen by a doctor yet, it's not a pre existing condition. They signed him up and paid for his surgery.

I'll edit this to say I'm referring to health insurance. My guess is STD would be the same, but not sure. It would be worth looking into.

Health insurance and disability are entirely different things. Disability insurance is income replacement and health insurance pays medical bills.

Obamacare removed the pre existing conditions clauses for health insurance making It illegal to be denied medical insurance based on pre existing conditions.

Disability insurance is essentially an income supplement. Paying a flat % of your income to you for a set period of time until you return to work or the time period expires.

**Adolf Allerbush** · 01-06-2015, 01:25 PM

Originally Posted by AK47bp

Health insurance and disability are entirely different things. Disability insurance is income replacement and health insurance pays medical bills.

Obamacare removed the pre existing conditions clauses for health insurance making It illegal to be denied medical insurance based on pre existing conditions.

Disability insurance is essentially an income supplement. Paying a flat % of your income to you for a set period of time until you return to work or the time period expires.

I think DeepHelmet's example is from before the ACA.

**AK47bp** · 01-06-2015, 01:39 PM

Originally Posted by Adolf Allerbush

I think DeepHelmet's example is from before the ACA.

Probably right. Also some older grandfathered employer plans and some private individual coverage plans aren't required to cover pre existing conditions but speaking in general most do now.

**Conundrum** · 01-06-2015, 01:48 PM

There are some plans that still pre-ex but no new plans under ACA can. If your wife is already pregnant, it's going to be tough to place short term dis coverage. You may want to try to up your FSA contributions now if you have that option. Tough to insure the house when it's on fire.

**jfost** · 01-06-2015, 04:22 PM

We thought we were going to get rich on a Geico Short Term Disability plan, but they had a "waiting period" and you had to pay in for 10 months or something like that. We ended up breaking even on the deal, which was kind of a bummer. Just stuff whatever premiums you were going to pay under a mattress and you will be fine in 4 years when you turn the mattress over and find all that forgotten cash.

**m4b095** · 01-10-2020, 05:23 AM

The powerful date of the inclusion would be jan 1 in your model. At the point when the case is documented it requires the doctor to finish an area asking date manifestations originally showed up and gauge due date. On the off chance that that data demonstrates the condition existed preceding jan 1, at that point it would be a prior condition. This is by and large how handicap protection functions.