This 24-year-old mistakenly thought her health insurance covered her pregnancy—and 4.2 million other

[scagnt83]

Wow, these comments are a great example of exactly why the general public hates the health insurance industry.

"Call the insurer first" ..... "Ask your mom first" ..... "Read the contract"

None of those things should be required for a life threatening medical condition. Ever.

Especially when that medical condition is threatening 2 different lives.

(I work the group health market btw... unfortunately)

And that exclusion is often not listed on the Benefit Summary.

 

[leevena]

Wow, these comments are a great example of exactly why the general public hates the health insurance industry.

"Call the insurer first" ..... "Ask your mom first" ..... "Read the contract"

None of those things should be required for a life threatening medical condition. Ever.

Especially when that medical condition is threatening 2 different lives.

(I work the group health market btw... unfortunately)

And that exclusion is often not listed on the Benefit Summary.

What are you talking about? None of those things (call insurer, ask your mom, read the contract) are required in a life threatening condition.

 

[scagnt83]

What are you talking about? None of those things (call insurer, ask your mom, read the contract) are required in a life threatening condition.

A pregnancy is a life threatening condition for both mother and child.

And not just when they do not receive the medical care required.

(statistically one of the most potentially dangerous health conditions a woman will face in her life)

And those were the replies from most agents so far.

Zero compassion or humanity for the actual people involved or the immensely complicated system they are forced to navigate just to survive and not die...

 

[fed up]

A pregnancy is a life threatening condition for both mother and child.

And not just when they do not receive the medical care required.

(statistically one of the most potentially dangerous health conditions a woman will face in her life)

And those were the replies from most agents so far.

Zero compassion or humanity for the actual people involved or the immensely complicated system they are forced to navigate just to survive and not die...

I , for one, have tons of compassion for people. I also advise my customers to call me if they have any questions about their coverage. When someone goes out of network I would work to see how much I can get covered but they made the choice to go out of network without finding out ahead of time if that was a good move. This 24 yr old and her husband made a conscious choice to get married and start a family while she was still on Mom and Dad's policy, they are not teens who slipped one past the goalie. It is an expensive lesson to learn and I don't see any reason to feel that they could not have inquired about pregnancy before they decided to conceive.

 

[vic120]

I , for one, have tons of compassion for people. I also advise my customers to call me if they have any questions about their coverage. When someone goes out of network I would work to see how much I can get covered but they made the choice to go out of network without finding out ahead of time if that was a good move. This 24 yr old and her husband made a conscious choice to get married and start a family while she was still on Mom and Dad's policy, they are not teens who slipped one past the goalie. It is an expensive lesson to learn and I don't see any reason to feel that they could not have inquired about pregnancy before they decided to conceive.

Because going out of the network or checking if a doctor is in-network is a reasonable thing to question anyone should do that

But when its blasted all over tv on the new or in the media in every way that the new healthcare law highlights women's reproductive health and its basically the number one thing

I don't think its reasonable for the client to suspect pregnancy would not be covered

Kind of like buying a hamburger to find out its seaweed

 

[junkman]

Carriers have mostly not covered dependent maternity. Exclusions keep claims down which keeps premiums down. Policies are sold at least based on price.

Checking medical coverage and contract reading isn't the 1st thing that comes to mind when engaging in activities leading to pregnancy.

 

[fed up]

Bethany and her husband decided to stay on parents plan because parents easily meet total OOP each year, thus Bethany was hoping to be able to skate free of charge through her pregnancy. A phone call or two beforehand could have answered any question before Bethany received her surprise. Now she is hoping that her plan with the January 1 effective date will cover her due date and her OOP will be reasonable

 

[junkman]

Time to read the new contract and do the calculations.

 

[yorkriver1]

This happened to a former client of mine. Parents helping out. Then once they found out the employer plan of the parent wouldn't cover the 24 year old's unplanned pregnancy, she dropped out and qualified for a special enrollment with ACA. Wedding, pdq and 2 more kids later, all is well. Spouse has a government job now, so whole family covered. This is how it was brought home to me about the adult child on parent's plan pregnancy situation.

 

[marindependent]

Its unfortunate