Insurance Companies Find New Way to Victimize Pregnant Women

21

nicuHave you tried to put your unborn baby on your health insurance yet? Here's where we say good luck ... and don't hold your breath. The average health insurance company in America won't let you add a baby onto a family health plan until they actually have a Social Security number, and that can take as much as 12 weeks.

When I called my company during my pregnancy, an operator assured me "the baby will be covered under your insurance for awhile Mom." Apparently she was lying, or at least hedging her bets that I'd have an uneventful birth. Because a new look at premature birth in America by the Washington Post shows the medical bills for preemies are skyrocketing. And the people picking up the bills are often parents who have health insurance.

The companies consider the costs "not their problem." But before you write this off as "not your problem" if you don't have a preemie, here's another monkey wrench to throw in there: some of these same parents are turning to the only option they have. They're signing their "uninsured kids" up for Medicaid to help cover the crippling costs. In other words, health insurance companies have simultaneously found a way to screw pregnant women and screw the American public ... yet again.

Of all the stories of health care gone awry, this one stands out as a particular catch 22. You cannot seek health insurance for your child that will adequately cover care in a neonatal intensive care unit because the child is not yet born. Not to mention, until your child comes out, there's often no way of knowing they will be premature. Every mother's goal is to keep the child inside the womb as long as possible -- even those who are high risk.

Fixing this should be simple: require health insurance companies to cover care for premature babies that come out of a mother who was insured during her pregnancy, including out-of-network care that wouldn't normally apply to an adult woman (and therefore wouldn't traditionally be covered by her plan, but might be by the plan she would otherwise buy for her child). But the bigger issue is why it should be done.

Very simply? Because this isn't the issue of experimental care for an aged cancer patient that can be pulled into a Republican/Democrat health care debate. And yet boiling it all down to dollars and cents is what seems to work best for Americans these days. So here goes.

Babies, even those from well-to-do families, go on to cost taxpayers money over at least 18 years of early intervention and educational services. If, upon reaching 18, they can't live on their own, those costs could extend for the rest of their lives. By providing optimum care during those precarious days in the NICU, much of that can be avoided, thus protecting taxpayer dollars for 18 years or more.

Should this really be so hard?


Image via Dave Q/Flickr

complications, labor & delivery

21 Comments

To add a comment, please log in with

Use Your CafeMom Profile

Join CafeMom or Log in to your CafeMom account. CafeMom members can keep track of their comments.

Join CafeMom or Log in to your CafeMom account. CafeMom members can keep track of their comments.

Comment As a Guest

Guest comments are moderated and will not appear immediately.

momto... momtothemax2910

It really shouldn't. It was a battle getting my son on my insurance (6 month+ process) and we had no complications. Classic scenario of us submitting everything properly and it not getting processed properly. And the pediatrician's office knowing there was a problem but not letting us know for months - which was beyond the 90 day window at the insurance company so they denied him. Even though they had records confirming they received the original documents on time. So we had to appeal. It was a freaking joke. My father always said it's important to have insurance, it's a great resource - until you need to use it. Then it's your enemy.

JessL... JessLogansMommy

My insurance gives us 30 days after birth to officially add the baby.  The ss# wasn't the problem, we got that right away, but we had to call the hospital for the birth certificate.  We were fortunate because we did have a preemie and the bill was well into the hundreds of thousands.  I can't imagine if we had gotten that bill to pay ourselves.  

RanaA... RanaAurora

The military at least does well in this aspect. What a horrible thing for people to have to deal with.

nonmember avatar Allboys

This is ridiculous. New parents shouldn't have to battle their insurance companies like this. We had thirty days to get the birth certificate to the insurance office and then a full six months to verify the social security number. Our children were covered at birth and almost all of my maternity care was covered. Of course that is only if I went with an OB. They actually recently changed the policies with our insurance provider raising the life time max pay outs to five million due to a child who was born premature and reached the life time max at just 2 or 3.

Javi0... Javi05Eli07

We didn't have any problems with the insurance, thankfully.  We were not expecting for me to be on hospital bed rest for a week and then have a 5 week NICU stay.  Baby was strong and very healthy for a 29 weeker and had almost no problems.  Even with him healthy our total bill for those 6 weeks came out to around $150,000.  I think total the entire pregnancy was billed somewhere around $175,000.


Since we are pretty darn sure any other children we have would be born early and require a NICU stay, we are happy with our 3 boys.  Our insurance now covers birth control, but will not cover voluntary sterilization (thank you catholic church).  We want to fight it, but apparently no doctor will say that it is in our best interest not to have anymore.

nonmember avatar nonmember

It should not be a problem and yet it apparently is so one more reason why health inurance, as well as the medical industry in the form of hospital and doctor's offices, needs a big overhaul. As for the parent's getting their kids on Medicaid due to medical bills, doesn't really sound above board. You get on Medicaid because you're poor and need help, not brcause you had an unexpected medical expense. How "well to do parents" are getting their babies on there is beyond me. Not even close to what it's there for.

jeann... jeannesager

nonmember -- Just to clarify, there's a special dispensation with Medicaid, so no one is actually doing anything illegal. Premature babies can be considered "disabled," opening them up for benefits even though their parents aren't low income. It's similar to getting financial help from the government to cover special services for your autistic child or a child who needs early inervention for say, a speech issue.

nonmember avatar Anon

But, even with a delay in getting officially on the rolls, wouldn't it be retroactive to the birth date? ... I could see the point, because I always thought it would be pretty easy to defraud the ins. co. and use the benefits for someone who's not your kid/dependent. When I adopted my kids, my insurance company didn't ask for any documentation. I did it over the phone. ... As for the trouble - it would be a lot easier if we used insurance as insurance and not a subsidy. We could pay for our own routine doc visits and such, saving the ins. co. administrative costs / waits for the big stuff. Money would be saved overall (since my regular doc wouldn't have to charge me for the extra admin crap). I really wish that was a viable option for most people.

Rory McFatridge Richardson

My daughter is 15 months old and we're still having trouble with the insurance company... she was 2 weeks early and sent to the NICU after her white blood cell count indicated infection. She was there 2 full days before being discharged-- the insurance company first paid the bill, but 9 months later they actually took the money back and said it was my responsibility. It's been a nightmare... had no idea others had the same problem!

Amy Knoch

@RanaAurora - I just said the same thing to my husband.  They may have the worlds most crap-tastic hospitals and worthless doctors - but at least the health insurance is covered from day 1 no matter when day 1 happens to happen.

1-10 of 21 comments 123 Last