Pregnancy and health insurance?

Our employers cancelled our health insurance and we are applying for individual coverage. I have been told that if I am planning on getting pregnant I have to have a maternity rider for an extra 100 dollars a month. If I become pregnant without it they will not cover my pregnancy. United Healthcare is the only insurance in Texas to offer maternity coverage. Does this sound correct? What if I wasn't planning on it and just became pregnant? I wouldn't be covered. I feel like I am being lied to. Let me know if you have had any experience with this. Thanks for your feedback.
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Hi. I'm 34 weeks pregnant and have worked in the health insurance industry for 12 years and recently left that field for a different job. I currently have an individual insurance policy since my employer does not offer health insurance. If you are planning on getting pregnant you will need the maternity rider on your individual health policy. This will cost you more due to the added cost of services the insurance company will have to pay for as a result of you being pregnant. In addition, make sure that the insurance company will cover you when you are pregnant and that the plan does not have a "Maternity Waiting Period" on it. Some individual health insurance policies have a 12 month waiting period where they will not pay for any maternity related services until after you are insured with that company for a full 12 months after your effective date. If you are pregnant when you take the policy, there is a chance your insurance company will consider this a pre-existing condition and will not cover your pregnancy. They have a right to request medical office notes from your physician to determine the date you conceived if they receive a claim from your doctor's office for maternity/pregnancy related services and then deny the claim as pre-existing if you were pregnant before your policy's effective date. It is frustrating since the time when you need insurance the most, if you have or want to get an individual plan that covers maternity services, you have to make sure the plan doesn't have a maternity waiting period and that you are not pregnant before the plan's effective date. Some states have state-sponsored health plans that will pay for maternity coverage even if you are already pregnant, however, there are eligibility requirements and limitations. My recommendation is this: if you are thinking about getting pregnant (and are not pregnant already) then I would get the health insurance plan with the maternity rider and verify that it does not have a 12 month Maternity waiting period and that it will cover maternity services should you become pregnant in the months following your effective date. Good luck!
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