Disability Insurance: Maternity & Pregnancy Leave | Guardian (2023)


If you’re having a baby or thinking of getting pregnant, congratulations! As you ponder the big questions about how pregnancy will change your life, you may also have some more pragmatic questions about how your job and income can be affected. For example:

  • How long can I take off, and will I get paid?
  • Does disability insurance cover pregnancy and maternity?
  • How should I prepare financially?

These are all good questions to ask, but a lot of the answers depend on your individual situation, the company you work for, and even the state you live in. Here are some basic details you should know.

Yes, you can get time off for maternity and pregnancy – but you may not get paid for it.

FMLA protects your job while you take leave, but not your income

While there’s no national standard for maternity leave length, the Federal FamilyMedical Leave Act (FMLA) protects your job for up to 12 weeks if you need to take time off to care for a newborn or adopted child, or an ailing family member. But while employers are required to hold your job for you, they arenotrequired to pay you during a medical leave. It’s also important to note that not every employee is eligible – here’s what’s needed to qualify for FMLA protection:

  • Your employer has at least 50 employees in a 75-mile radius
  • You have worked there at least 12 months
  • You have worked at least 1,250 hours in the past year

States with paid family leave (PFL) laws

Recognizing the importance of parental leave, more and more states are enacting PFL laws that go a step beyond FMLA by providing paid leave for employees who need to take off. Those states (plus one district) are:

  • California
  • Connecticut (starting 1/1/22)
  • Massachusetts (starting 1/1/21)
  • New Jersey
  • New York
  • Oregon (starting 1/1/23)
  • Rhode Island
  • Washington
  • The District of Columbia

Each state sets its own rules about which employees and situations qualify for paid leave, how long paid leave lasts, how contributions to the paid leave fund are made, and the benefit amount. If you live in one of those states, go to the state government website and search for “Paid Family Leave” to find out the specific rules and benefits for where you live.

Some employers offer paid family leave

Even if your state doesn’tguaranteepaid maternity leave, your employer can providePFL (paid family leave) benefits if they choose.While employees often expect companies to provide paid sick days and vacation days, they don’t always ask about maternity leave. However,a recent study by the Society for Human Resource Management(SHRM) found that 60% of employers give 12 weeks of maternity leave; 33% give more than 12 weeks.1It should be noted that these numbers include paid and unpaid leave.

Does your company offer these benefits? How long do they last? How do you qualify? How much will you get? Like state PFL rules, it varies from company to company – but there’s an easy way to find out: just contact your human resources department or manager. Finally, if you are starting a new job, you can inquire about having paid family leave benefits included as part of your compensation package. It never hurts to ask.

Disability insurance may provide benefits – but it depends on your policy.

Your short term disability plan may cover pregnancy

Do you have short term disability (STD) coverage through your workplace? Some people think thatdisability insuranceis for on-the-job accidents. While it may cover those things, short term disability also provides replacement income if you are unable to work due to all sorts of illnesses and injuries, whether they occurred on the job or outside of the workplace – anddisability insurance for pregnancyis standardly included.

Maternity would qualify for benefits under short term disability plans, if you are unable to work due to the pregnancy, childbirth, and recovery, with the certification of a physician. When you have short term disability through an employer, you may qualify to receive 50-70% of your income, typically for six to eight weeks after you give birth, depending on the type of delivery. A pregnancy with complications can be covered, because (depending on the issue) a complication can be more like an illness and the benefit period could well be longer. Policies have different requirements, so it’s important to find out what’s covered before you go out on leave.2Also, talk to your human resources manager about the correct ways to submit claims for private or state disability insurance plans.

Long term disability coverage (LTD) can provide further protection

If you have long term disability insurance that you purchased through the workplace or as an individual from an insurance company, it typically won’t cover a typical pregnancy and recovery, due to the longer elimination period required under an LTD plan. However – as with STD coverage – complications are another matter, and if an issue renders you unable to work, it will generally be covered if the disability satisfies the benefit waiting period for the LTD. Also, pregnancy can worsen other conditions that may have been dormant or under control, such as diabetes or multiple sclerosis. Post-partum depression can be issue for people who have never experienced mental health issues, and if it causes you to miss work it could be covered by your LTD policy.

One thing to remember about LTD coverage: compared to short term disability, there’s typically a much longer waiting or elimination period until benefit payments start. The typical STD plan has a 2-week waiting period; with an LTD plan, the elimination period commonly lasts 60-90 days, but it can be as long as a year.

Applying for disability coverage during pregnancy

If you just started a job that offers disability insurance, you should be able to sign up for coverage and receive any benefits available without issue. Employer plans (also known as “group” plans) buy coverage for many employees at once and don’t typically require medical underwriting – you don’t have to answer health questions or undergo a medical exam. Pre-existing condition limitations may apply – review your policy or check with HR for additional details.

It’s different when you buy disability insurance on your own. Individual policies, or voluntary group policies – whether STD or LTD – typically require medical underwriting, and pre-existing conditions are typically excluded. If you apply during your pregnancy, it will be considered a pre-existing condition. While the insurance company may write the policy, any disability or claim relating to pregnancy will probably be excluded.

Consider other ways to get financially prepared for maternity

There’s no getting around it: having a baby is a big financial commitment. But a little planning can go a long way toward helping relieve any financial stress you may be feeling. Jeannie Jackson, a Guardian financial representative recently sat down with Gaby Dunn of the Scary Mommy video series for amaternity leave interview.

If you’re not already saving, start

Start a maternity leave savings fund, ideally before you become pregnant. Actually, it’s a good idea to get in the habit of saving beginning with your first paycheck from your first job. Pay into a couple buckets: one for short-term needs, the other for long-term. Maternity leave is a good example of the kind of short-term savings need every prospective parent should be preparing for.

Find out about your benefits at work

In addition to any short- or long-term disability benefits you may be eligible for, see if there are other types of useful insurance benefits available through work. For example, hospitalization indemnity insurance is a popular, low-cost workplace benefit that can help cover hospital stays due to delivery or complications from the pregnancy. However, items covered, and reimbursement amounts, vary greatly from plan to plan, so make sure you’re familiar with your employer’s specific benefits before signing up.

Bank your paid-time-off (PTO) days

Avoid using sick days, personal days, and time off as much as possible in order to build up a store of paid days off. If you can squirrel away 20 PTO days by the time you take maternity leave, that will give you a month of full salary before you have to dip into savings or start relying on benefits.

Pay into your Health Savings Account (HSA) or Flexible Spending Account (FSA)

What are HSAs and FSAs? They’re special accounts you fund with pre-tax money that you can use to pay for out-of-pocket health care costs (FSAs give you the added flexibility to use your saved funds for things like childcare). These can help you save on taxes while helping to pay for maternity expenses such as breastfeeding supplies (breast pads, nipple guards, nursing bras, breast pump), prenatalvitamins,and so on. Note that there is one key difference between HSAs and FSAs: You can roll over unused HSA money to the next year, but unused FSA money is lost. So, you shouldn’t fund an FSA with more than you think you’ll need that year, but you don’t have to worry about overfunding an HSA.

There’s nothing more important than bringing a new child into the world. With a little financial planning ahead of time, you’ll be able to focus more on your baby – and make the most of a special time in your life.

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Frequently asked questions about disability insurance and maternity leave

Can you get short term disability if you are already pregnant?

If you just started a job that offers short term disability insurance – or you have an open enrollment period at work – you should be able to sign up for STD coverage without any problems. That’s because employers offer group insurance plans that don’t require medical underwriting – you don’t have to answer health questions or undergo a medical exam. Pre-existing condition limitations may apply. Please review your Group policy for details.

Individual STD policies require medical underwriting, and pre-existing conditions are typically excluded. If you apply during your pregnancy, it will be considered a pre-existing condition. While the insurance company may write the policy, any disability or claim relating to pregnancy will likely be excluded.

Can you get disability insurance benefits if you are pregnant?

Many short term disability policies through an employer offer pregnancy and maternal benefits which give you 50-70% of your income, typically for six to eight weeks after you give birth, depending on the type of delivery. If you have a complication during pregnancy that keeps you from working, that should also be covered – and the benefit period could well be longer. Policies have different benefits and requirements, so it’s important to look at your STD policy to find out what the exact terms are.

How does short term disability insurance work for pregnancy?

If you can’t work due to injury or illness, short-term disability insurance pays a weekly benefit that replaces a portion of your lost income – typically between 50% and 70% if you receive coverage through your employer. The amount of the benefit, the length of time you receive benefits (i.e., the benefit period), and whether or not a pregnancy is coveredwill depend on the specific terms of your policy. If you have STD coverage through work, talk to your human resources manager about what benefits are available and the correct way to submit a claim.

Find more answers aboutpregnancy and short term disability insuranceat Guardian.com.

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