Posts Tagged ‘For-profit insurers’

House Panel Finds Many Individual Healthcare Policies Do Not Cover Pregnancy

Wednesday, December 1st, 2010

A recent investigation by the House of Representatives’ Committee on Energy and Commerce has found that many individual health insurance policies do not cover maternity care. The news is no surprise for women who are covered by these policies and experienced a rude awakening when they became pregnant. The four largest for-profit health insurers – Aetna, Humana, UnitedHealth Group and WellPoint – don’t cover normal deliveries for their members who have individual policies. The committee’s report confirms a 2009 report by the National Women’s Law Center (NWLC) that scrutinized 3,600 individual policies and determined that just 13 percent provide maternity coverage. For women with these policies, it gets even worse should they become pregnant. At that point, if they apply for coverage in the individual market, insurers typically determine that pregnancy is a pre-existing medical condition and deny coverage on that basis. Maternity riders are offered on some policies, but they are extremely expensive, provide very limited coverage and might take as long as a year to become effective, according to the NWLC. The average cost of maternity care – nine months of prenatal care, three months of post-partum care and a delivery without complications – averaged $10,652 in 2007, a March of Dimes study reported. The Pregnancy Discrimination Act of 1978 exempts companies with less than 15 employees and individual policies from providing maternity coverage, although some states maintain stricter requirements. This year, 12 states mandate maternity coverage in the individual insurance market and 17 in the small-group market, according to statehealthfacts.org, a project of the Kaiser Family Foundation. Thanks to the Patient Protection and Affordable Care Act, this coverage gap will cease to exist in 2014.