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Miscarriage and Your Health Insurance (or Lack Thereof)

By August 27, 2009

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To use the tired cliche, you would have to be living under a rock to not have heard at least some talk of healthcare reform in the last several weeks. Along those lines, I found a commentary in Cleveland.com about whether fertility treatments will be covered under an overhauled healthcare system.

Given that miscarriages are more common in women with fertility issues, and because some health insurance companies consider recurrent miscarriages to fall under the category of fertility issues, I thought this could be interesting. As of yet, it doesn't seem like anyone has gone into detail on what would and wouldn't be covered. The article points out that contraception treatment would be likely to be covered, but it's less clear whether "high tech" treatments like IVF would be covered under the new system. Lawmakers will need to hammer out more specifics before we know for sure.

In any case, I was curious whether anyone out there has experienced problems with insurance companies (or lack of insurance) as it pertains to miscarriage. Have you had trouble getting your insurance company to pay for your miscarriage treatment, or for testing for causes after recurrent miscarriages? Post in the comments below or in the forums -- I'd like to hear from you.

Comments
September 10, 2009 at 10:01 pm
(1) Mike B. says:

Hi Krissi,

Thank you for your article. I am looking for information on the rates of miscarriage in the U.S. between women who have health insurnace versus women who do not. Could you direct me to where I could find such statistics? Thanks,

Mike

September 11, 2009 at 4:24 am
(2) miscarriage says:

Hi Mike! I am not sure if there would necessarily be a link between health insurance and first trimester miscarriages, but health insurance is a definite factor in how much prenatal care women receive, according to research — and lack of adequate prenatal care is tied to higher risk of stillbirth, preterm birth and other complications. Here are some links I found that relate to this:
http://www.state.nj.us/health/fhs/documents/brief_insurance.pdf
http://www.jaoa.org/cgi/content/abstract/100/8/485
http://www.ncbi.nlm.nih.gov/pubmed/1553174

October 12, 2009 at 11:27 am
(3) anonymous says:

I have had two miscarriages, and so far my trouble has been getting my insurance company to confirm if they will cover testing for recurrent miscarriages. They told me they need the CPT codes to confirm if the tests are covered. I got the codes, and they say they are “billable codes”, but they won’t confirm that they will be accepted once I have the tests done. I’m not sure what to do next. I feel like I need to have the tests done for peace of mind, so I’m thinking I’m going to go ahead with them and risk paying out of pocket.

December 9, 2009 at 12:22 am
(4) FIRST PREGNANCY MISCARRIAGE says:

My first pregnancy occurred at age 38 a few weeks ago while I had insurance for a year that supposedly had a pregnancy option that could be added on at any time to the underlying premium. When I unexpectedly became pregnant and inquired to add on the coverage, I was told that this would only cover $1-2,000 of the pregnacy. When I tried to switch to a carrier w/ better coverage (don’t try this) I was openly misled (lied to) by a new carrier and ended up purchasing coverage ,when the paperwork arrived DID NOT COVER MATERNITY AT ALL ! I then had a miscarriage at 5-6 weeks and saw my OB for the 1st time for the miscarriage as an ininsured cash customer.
Sorry this is long, but then when I looked into obtaining adsequate individual maternity coverage with BCBS, I was told that I would not be eligible for coverage because MISCARRIAGE renders you HIGH RISK= PREEXISTING CONDITION!
I am 38 and need to try again soon, if I can ever obtain reasonable insurance (or even without) but I must warn you that unless you have group insurance, where you are protected by HIPAA law:
1) Do not drop coverage until you obtain new coverage, esp. on the basis of insurance salespeople’s claims on the phone= GET NEW PLAN DETAILS IN WRITING BEFORE DROPPING EXISTING COVERAGE.
2) Make certain your plan covers maternity before accidentally getting pregnant, and SEE HOW MUCH IS COVERED (you might be very surprised)
3) I don’t know what to say about reporting an early miscarriage, as 40% of conceptions may statistically result in spontaneous abortion, but be aware that MISCARRIAGE RENDERS YOU HIGH RISK PREGNANCY, however you should see your OB Dr. as missed products of conception that could require D&C might affect later fertility.
I would be welcome to any advice on how to proceed for a middle class individual who does not qualify for assistance and has barriers to health insurance with maternity needs?

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