C-Section's and Health Insurance

[Welcome Kaiser Network readers!]

Time was, not too long ago, when maternity was not a covered expense. After all, it is (mostly) a planned event that is (almost always) preventable.

But times change and now most employer plans offer maternity "as any illness" in compliance with the law.

Individual major medical plans are still (in most jurisdictions) medically underwritten and may choose to cover maternity or not.

It seems a Colorado woman was "denied" health insurance coverage because of an earlier C-section.

“Obstetricians are rendering large numbers of women uninsurable by overusing this surgery,”

That's a bit overstated.

Not all carriers, in all jurisdictions refuse to cover women who have had a C-section.

And, there are alternatives.

Like a savings account.

Golden Rule, which sells individual policies in 30 states, said it would insure a woman who had had a Caesarean only if it could exclude paying for another one for three years. But in Colorado, such exclusions are considered discriminatory and are forbidden, so Golden Rule simply rejects women who have had the surgery, unless they have been sterilized or meet the company’s age requirements.

So this is more an issue concerning the rules in Colorado. In other words, the state makes it difficult for carriers to act in a free market and thus limit the availability of coverage.

Why is this not a surprise?

In Colorado, people denied individual health insurance can obtain it through a state program, Cover Colorado, which insures about 7,200 people. But the premiums are high, 140 percent of standard rates, a spokeswoman said, adding that some women had enrolled specifically because prior Caesareans had disqualified them from private insurance.

So there are alternatives.

Some folks just choose not to avail themselves of these choices.

Sure makes a nice headline.