If you are self employed, or for another reason have an individual health insurance policy, it’s highly unlikely that the costs of pregnancy and childbirth are covered by your insurance. According to a study done for the March of Dimes, this cost (nine months of prenatal care and three months of postpartum care) when there are no complications, was on average more than $10,000.
While coverage for maternity care is required under the Pregnancy Discrimination Act of 1978, the law doesn’t apply to companies with fewer than 15 employees or to individual policies. A 2009 report by the National Women’s Law Center based on 3,600 individual policies countrywide found that only 13 percent provided maternity coverage.
This finding was verified by a recent investigation by the House Committee on Energy and Commerce. In an October memo outlining its findings based on responses from the four largest for-profit health insurers Aetna, Humana, UnitedHealth Group and WellPoint the committee reported that most individual policies at those companies didn’t cover most of the expenses for a normal delivery.
Maternity care is offered as an add-on in many cases. However f you get pregnant and want to add maternity care to your policy, insurers generally consider pregnancy a preexisting medical condition and coverage, will be denied.
And here is the essential premise that dictates health care attitudes towards pregnancy – that pregnancy and childbirth are medical conditions. As long as this idea is maintained, then the medical establishment will continue to dictate control of women’s birth experience, which is a significant factor in the huge increase of cesarean deliveries.
Thankfully the recent health-care reform enacted this year, will close this coverage gap in 2014. Policies sold through state-based insurance exchanges, as well as new individual and small-group plans sold outside the exchanges, will be required to cover maternity care as an “essential health benefit.” The new law will also prohibit health plans from turning away applicants because of preexisting conditions, including pregnancy.
Another article on this subject can be found in the LA Times here
photo courtesy of seanmcgrath