Thursday, November 18, 2010

How Insurers are Still Pulling Maternity Coverage from Pregnant Women’s Plans

by Melissa Garvey, ACNM Writer and Editor

As of 2014, maternity care coverage in the United States will take a step up. Under the Patient Protection and Affordable Care Act of 2010, health insurance plans will no longer be able to turn away applicants based on the “preexisting condition” of pregnancy. Maternity care coverage will also be mandatory for individual and small-group insurance plans as well as policies sold through state-based insurance exchanges. This is good news.

But until 2014, women will continue to get pregnant. About half will become pregnant unexpectedly and may have the added stress of no maternity care coverage. Plus, more women will try to conceive and discover in the second, maybe even the third trimester, that their maternity benefits have been cut considerably or have become significantly more expensive.

That’s exactly what happened to The Feminist Breeder—a blogger and birth advocate planning a home birth with a certified nurse-midwife under the coverage of Blue Cross Blue Shield. Here’s what happened to her after months of planning to conceive her third child:
…we found out that coverage we signed up for last year isn’t the coverage we actually have now because they keep decreasing it every year, and it’s going to get even worse in 2011. Starting in January, almost NONE of our homebirth expenses will be covered because of a massive deductible increase, and what is covered will cost us a ton more than we anticipated when we made the decision to start trying to conceive last January.
Even more women are blindsided by expenses they never knew to expect. My cousin is staring down the barrel of inflated health care bills because her maternity care will stretch across two calendar years, two deductibles, and two out-of-pocket costs. A recent Washington Post article features a woman paying $400 per month for an individual health plan who thought “it must be a mistake” when she discovered her plan required a special maternity rider in advance of the pregnancy in order to be eligible for childbirth-related coverage.

Where does this leave mothers until 2014? It doesn’t look good.


Anonymous said...

I have a client whose baby is due on December 28th. Her insurance plan changes on December 31st which will not cover her in the system that she is now enrolled. On December 31st, if she has not had her baby, she will have to change providers and give birth in a completely different facility. Otherwise, she will have to pay the difference in cost. Do insurance companies care about more than the bottomline?

Melissa Garvey said...

How horrible. I've been hearing way too many of these scenarios lately.

Rosie said...
This comment has been removed by the author.
Anonymous said...

@Rosie: I would love to relocate to your perfect world, because the world I live in, most pregnancies are unplanned, therefore, unprepared for. Admire your unrealistic, optimism though.