Can I Get Short-Term Disability for Maternity if Already Pregnant?

Short-term disability insurance provides a portion of your income when you are temporarily unable to work due to illness, injury, or maternity. This insurance aims to replace lost wages during approved leave, helping to maintain financial stability. Its primary purpose is to offer income protection, ensuring a temporary inability to work does not lead to financial hardship.

How Short-Term Disability Insurance Typically Covers Maternity

Short-term disability insurance policies often consider maternity a qualifying event, treating childbirth and recovery as a temporary disability. Coverage typically includes specific terms defining the payout structure. These terms include an “elimination period,” a waiting period before benefits begin, commonly ranging from 7 to 14 days. During this period, employees may use accrued sick days or paid time off.

Following the elimination period, the “benefit period” dictates the duration for which payments are received. For uncomplicated vaginal deliveries, this period is usually around six weeks, extending to eight weeks for a C-section. If complications arise, the benefit period can be longer, depending on medical necessity and policy terms. The “benefit amount” generally replaces 50% to 70% of your gross weekly salary, ensuring partial income replacement, as benefits are often tax-free.

Impact of Pre-Existing Pregnancy on Coverage Eligibility

A challenge arises when attempting to secure new short-term disability insurance coverage while already pregnant. Insurance policies cover unforeseen events, not conditions existing at the time of purchase. Therefore, pregnancy is almost universally classified as a “pre-existing condition” by insurance providers. If you are already pregnant when applying for a new individual short-term disability policy, coverage for that specific pregnancy will likely be excluded.

Many policies deny benefits for conditions existing before the policy’s effective date or within a specified waiting period after enrollment. For maternity coverage, this waiting period is typically between 9 and 12 months from the policy’s effective date. Even if an insurer issues a policy, any claims related to the current pregnancy will be denied if the waiting period is not met. This protects the insurer from covering an event already in progress or highly probable.

Some policies may require proof of conception dates to verify eligibility if delivery occurs within nine or ten months of the policy’s effective date. While you might still purchase a policy when pregnant, it will generally not provide benefits for the current pregnancy. It could, however, cover unrelated illnesses, accidents, or future pregnancies after the waiting period.

Alternative Avenues for Income During Maternity Leave

Given the limitations of obtaining new short-term disability insurance when already pregnant, exploring alternative income replacement options is important. One resource is the Family and Medical Leave Act (FMLA), a federal law providing eligible employees up to 12 weeks of unpaid, job-protected leave for specific family and medical reasons, including childbirth. To qualify, an employee must work for a covered employer (typically 50 or more employees within a 75-mile radius) for at least 12 months and have completed at least 1,250 hours of service. While FMLA guarantees job protection, it does not mandate paid leave.

Many states offer paid family leave programs, providing partial wage replacement during maternity leave. These state-specific programs vary in duration, benefit amounts, and eligibility, often funded through employee payroll contributions. Such programs allow workers to receive a portion of their salary for a set number of weeks, typically 6 to 12 weeks for bonding or medical recovery. These state benefits are distinct from private short-term disability insurance.

Employer-sponsored benefits can also provide financial support. Some companies offer their own paid maternity leave policies, which can supplement or replace private short-term disability. Employees can also use accrued paid time off (PTO) or sick leave to cover absences. Finally, personal savings serve as a financial bridge during maternity leave, helping cover living expenses when other income sources are limited.

Reviewing Existing Policies and Future Planning

For individuals who already possess short-term disability insurance, such as through their employer or a previously purchased individual plan, a thorough review of the policy terms is advised. Confirm that maternity is a covered event and understand the specific elimination periods, benefit amounts, and maximum duration of benefits for childbirth and recovery. Contacting human resources or the insurance provider can clarify how to initiate a claim and what documentation is required.

For those considering future pregnancies, securing short-term disability coverage well in advance of conception is important. Obtaining a policy before pregnancy helps avoid pre-existing condition exclusions that apply to new enrollments. The ideal timing for enrollment is at least 9 to 12 months prior to when you anticipate needing maternity benefits, ensuring the policy’s waiting period for childbirth coverage is met. This proactive approach helps ensure income replacement benefits are available.