Denied Health Insurance Because You’re Pregnant

Well yeah, duh, its a lose/lose situation for the company!

RT
http://www.anonymouse.net.tc

It’s one thing for someone who can’t afford insurance but it’s a whole other animal if someone chooses to not carry insurance and then gets burned because of it. If she’s willing to pay for health insurance now why not before she was pregnant? It’s hardly the health insurers fault if she chose to be uninsured.

The point of insurance is to get it before you need it. Obviously an insurance company can’t break even if they accept $20k in expenses in order to get a few hundred dollars in premiums. This isn’t the insurance company being bad or evil — it’s common sense. Clearly it’s an unfortunate situation. And I am a big believer that health care costs are out of control and unreasonable — but this story has nothing to do with insurance companies doing something wrong. The point of insurance is for people to pool their risk so that an extraordinary, unexpected cost is shared among everyone participating. You can’t avoid insurance until after you have a costly condition and then be shocked when you can’t sign up afterwards. Would you be as outraged by someone being turned down for full coverage car insurance after having an accident that totaled their vehicle?

Why the heck would we even carry insurance then if we only need to get on it once we have a condition? Hell, I’ll drop my insurance now, and if I get in a car wreck, I’ll just call up Blue Cross on the way and get a cheap insurance plan! Why pay all those premiums inbetween? I don’t need to see the doctor again for another six months. I should drop now, and then just re-join just prior to my appointment! Brilliant!

This woman was absolutely and unequivocally looking for a handout. How else can you possibly interpret it?

She pays the insurance company a pittance and in a couple of months she’ll need tens of thousands from them to pay for her care.

That isn’t insurance, that’s charity, which these companies aren’t into.

As for ab’s point about health care costs - the whole point of a publicly funded system is that someone does know what it costs. Someone with a lot of muscle to protest if the costs run away. Namely, the government. They then get to balance tax income vs health care outlay and see to that the health care providers don’t overcharge egregiously.

The way our system is set up, it is reasonable for the insurance company to deny her coverage. I think the whole idea that “insurance companies are evil” misses the point. Procedures can be very expensive. If they gave her the policy without question, it would encourage people to wait until they had a large medical expense to have insurance.

This is why the idea of everyone having to have health insurance is extremely important. There is no other way to get out of our current mess. This way, everyone pays into the system, and the services are there when we need them. If we think we only have to buy insurance when we need it, it is not insurance. What would prevent this woman from stopping her coverage after giving birth?

On another note, does anyone know what happens if you give birth at a public hospital? My friend gave birth at our public hospital by choice, because there was a particular midwife there she wanted. She told me that most of the women giving birth there were immigrants and poor. I’m sure they could not pay $20K.

Don’t you think the point is that pregnant women (and babies, for that matter) should not be denied health care? I think for many women it is not a matter of looking for handouts but wanting to be protected in the event that something goes dreadfully wrong (a catastrophic accident, major complications, etc.). The problem is that pregnant women are unequivocally rejected for insurance.

In addition, if the mother cannot be insured, the baby cannot be insured. Everyone (my doctors and the insurance company) told me “babies are automatically covered for the first month of their lives,” but that turns out to not exactly be true. They are only covered from birth IF the mother has insurance and adds them to her policy. In the unfortunate event that a baby is born premature, with complications or a disease, they they can be denied independent coverage because of that condition. The doctors simply were under the impression that uninsured babies were magically covered and the insurance company representative really meant that babies were automatically covered for the first month of their life IF they had insurance (and they can’t get insurance unless their mother is insured).

I learned that pregnancy was a preexisting condition and automatic denial when I found out I was pregnant two years ago. I moved to a state where I could purchase special coverage (pricey) and after the six-month probationary period, I got coverage 13 days before my baby was born. Luckily, I had a non-complicated birth with no meds and so the insurance coverage was a wash (i.e., I paid no less for everything than if I had not had insurance at all). What I really wanted was catastrophic coverage in the event that there was a complication (yet there was no such option). Once my preexisting condition was born, I switched both of us back to ‘normal’ person’s coverage.

The point is not that pregnant women are denied health care. The point is that ALL AMERICANS are denied health care if they don’t take out insurance to pay for unexpected illness (or aren’t absolutely destitute.)

That doesn’t happen in any other civilized nation on a routine basis.

Croft — i’m not talking about the cost of a given procedure. I’m making the point that the healthcare provider and patient are specifically the ones making the choice of which procedure(s) to actually try. They have to be empowered to make decisions if there is any hope in bringing overall costs down. Not an insurance company and certainly not a government agency. Both can certainly exert force to bring the per-procedure price down. But, then can’t ultimately make the decision of which procedures to use and/or avoid. For that, we have to have a system where intelligent decisions, with difficult trade-offs, are being weighed by the people who have to live with the results.

Emily - I guess one issue is that a certain percentage of home births (I think around 15%?) get transferred to a hospital, so there is always a chance that you would end up having to pay more anyway. At least you would have a decent chance of a less expensive birth, though.

Sharon - a few points of fact. She is Irish, not Iranian, and rather than trying to “scam” an insurance company, she was trying to legally BUY health insurance.

She never complained that it wasn’t free for her, she complained that she couldn’t even ACCESS it.

And then, again, willing to pay but without insurance, she had to face a bill of up to $20,000? For what, exactly? Regardless of where she was born, there’s no reason for such an excessive bill for a basic life necessity. Health care is not something we can just do without, like cable or a cell phone. It’s not a bill you can opt out on.

ab: I absolutely agree that health care decisions should be made by the patient and doctor. However, that is not how it works now and it would stand a greater chance of being so with a single payer option. Providing, of course, that someone rode herd on the health care providers to make sure they didn’t go out of their way to prescribe procedures that are unnecessary. Many physicians have their compensation based on just how much they can actually sell in the form of treatment, if I understand things correctly, so not only do people with insurance get to fight with the insurance companies about compensation, they get to pay through the nose for needless procedures if they don’t have insurance. So no, I have no argument with a system where patients and doctors decide between them what to try. I have serious issues with a system where the doctor or patient have to consider how much a given procedure cost as a factor as to whether or not it should be done - the deciding factor should always be “will it help?”. I don’t think that is impossible to achieve. I don’t even think it’s very difficult to figure out how it would work, just difficult to implement in the current political climate.

Aaaaarrrgh. NO ONE is denied needed medical attention in the US, not this woman, not anyone else. You just have to pay for it. If she had paid 90 days of premiums before becoming pregnant, this woman would have paid for her medical care that way. Instead, she paid the hospital and midwife directly, which I have done myself. If she had been unemployed, or living at up to 200% of the poverty level, she would have been covered by Medicaid. I defy anyone here to find a state in this union that sends laboring or otherwise distressed pregnant women out into the streets if they don’t show up at the hospital with an insurance card or cash in hand. In fact, the worst place to be pregnant in the US is an Indian Reservation, which operate on a socialized system–you don’t pay a dime, but you better not get sick or pregnant after June.

I am still wondering why women, the majority in this country, allow this to happen. How do we allow insurance companies to pay for Viagra for men with erectile dysfunction (it is needed sometimes for heart conditions though) but they wont pay for birth control pills for women. Women dont raise enough hell about it thats why. We are too busy fighting with each other about breastfeeding or epdidurals or worrying about everyone else.

NO CO-OP’S! A Little History Lesson

Young People. America needs your help.

More than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 77% of all Americans want a strong government-run public option on day one (86% of democrats, 75% of independents, and 72% republicans). Basically everyone.

Our last great economic catastrophe was called the Great Depression. Then as now it was caused by a reckless, and corrupt Republican administration and republican congress. FDR a Democrat, was then elected to save the nation and the American people from the unbridled GREED and profiteering, of the unregulated predatory self-interest of the banking industry and Wallstreet. Just like now.

FDR proposed a Government-run health insurance plan to go with Social Security. To assure all Americans high quality, easily accessible, affordable, National Healthcare security. Regardless of where you lived, worked, or your ability to pay. But the AMA riled against it. Using all manor of scare tactics, like Calling it SOCIALIZED MEDICINE!! :-0

So FDR established thousands of co-op’s around the country in rural America. And all of them failed. The biggest of these co-op organizations would become the grandfather of the predatory monster that all of you know today as the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry. And the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry.

This former co-op would grow so powerful that it would corrupt every aspect of healthcare delivery in America. Even corrupting the Government of the United States.

This former co-op’s name is BLUE CROSS/BLUE SHIELD.

Do you see now why even the suggestion of co-op’s is ridiculous. It makes me so ANGRY! Co-op’s are not a substitute for a government-run public option.

They are trying to pull the wool over our eye’s again. Senators, if you don’t have the votes now, GET THEM! Or turn them over to us. WE WILL! DEAL WITH THEM. Why do you think we gave your party Control of the House, Control of the Senate, Control of the Whitehouse. The only option on the table that has any chance of fixing our healthcare crisis is a STRONG GOVERNMENT-RUN PUBLIC OPTION.

An insurance mandate and subsidies without a strong government-run public option choice available on day one, would be worse than the healthcare catastrophe we have now. The insurance, and healthcare industry have been very successful at exploiting the good hearts of the American people. But Congress and the president must not let that happen this time. House Progressives and members of the Tri-caucus must continue to hold firm on their demand for a strong Government-run public option.

A healthcare reform bill with mandates and subsidies but without a STRONG government-run public option choice on day one, would be much worse than NO healthcare reform at all. So you must be strong and KILL IT! if you have too. And let the chips fall where they may. You can do insurance reform without mandates, subsidies, or taxpayer expense.

Actually, no tax payer funds should be use to subsidize any private for profit insurance plans. So, NO TAX PAYER SUBSIDIZES TO PRIVATE FOR PROFIT PLANS. Tax payer funds should only be used to subsidize the public plans. Healthcare reform should be 100% for the American people. Not another taxpayer bailout of the private for profit insurance industry, disguised as healthcare reform for the people.

God Bless You

Jacksmith — Working Class

Twitter search #welovetheNHS #NHS Check it out

(http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/)

(http://www.youtube.com/watch?v=IbWw23XwO5o) CYBER WARRIORS!! - TAKE THIS VIRAL

I’m self-employed and bought a policy with a $3000 ded. and a maternity rider, and no, the waiting period is not 90 days, like didi said, it’s ONE YEAR from time of activation. Also, my premiums for me and my child are more than my mortgage. Tell me again how this is fair? I’m willing to pay for my health insurance, but I don’t think it’s unreasonable to not want to be held over a barrel. Also, despite the almost $10,000 I pay in premiums every years, I’m still responsible for a large portion of any bills I incur, and this is with a major carrier. Health insurance is a complete and utter rip off. I really can’t afford it, but I also can’t afford not to have it. Also, premiums go up about $1,000 every year, so just how much should I be expected to pay. $1,000/month, $2,000 a month? At some point I’m going to have to cancel it. I wouldn’t have any clients if I put up my prices 25% every year, so why are insurance companies any different?

Ali, that’s because we vote for men.

To chime in on the some similar notes, insurance is just that, insurance. We don’t crash our car then go buy insurance to cover it, or even lose our cell phone then go buy insurance. Rather than the public option, we need deregulation of insurance policy so each person can customize an option that they personally need, and be able to buy insurance from whomever we want. With our current system, geographically I can only buy high deductible insurance from TWO providers, I cannot buy insurance from other states, and my policy, by state laws MUST provide me with services I will never personally use. Imagine if car insurance worked more this way, we’d all be up in arms.

Comments
Why is it that everyone feels they’re entitled to have someone else pay for their needs?? Perhaps before the woman got pregnant, she should have thought about the cost of delivery a baby. (She’ll probably expect tuition, food and diapers from someone else too, right?) The government cannot provide everything needed by everyone. People need to begin to be accountable for themselves, their actions and their expenses. For those who really have no means, there’s Medicade. Nobody in this country is denied medical attention. Ever.

I’m 38 weeks pregnant and just had to get a new policy as my policy through my husband is ending ( he’s a student and is graduating). I called BCBS to get and imdependent policy ( we live in MA), and there was no hesitation at all. Maybe it’s because I had continuing coverage?

c - your insurance that didn’t cover maternity was much cheaper than the insurance with maternity coverage, correct? So you were saving money by having a cheap plan until you needed coverage, and then you decided to try to get your pregnancy covered under a new plan that you didn’t have to pay for until you needed. That, too, is asking for a handout. And it’s why we need a public option.

I didn’t know pregnancy would result in denial of coverage - I thought that was only for folks like me, with chronic conditions like diabetes! Wow.

Some people don’t realize that some states do not offer coverage (or good coverage) to pregnant women. In the state of Kentucky, there are only two carriers that offer maternity coverage. I applied with both companies and I was denied by one because I had had a c-section with my first child. The second company accepted me, but their maximum payout for maternity care is $2500. That is not the deductbile…that is the maximum amount that they will pay. The will try to “talk down” your bills but regardless, my next child will wind up costing me over $10,000 any way you slice it. I’m very healthy, not overweight, almost never sick and can afford insurance but still can’t afford to have another baby.