Bob and I have been looking at our respective health insurance plans with regard to marriage and family. I have an individual plan, which I pay nothing for, but to add a family plan I would need to pay all of the additional cost. Which led us to the question – if I continue to be insured under my plan, but our (hypothetical) future dependents are insured under Bob’s plan, at what point in the pregnancy/delivery are those hypotheticals considered individuals for the sake of insurance? In other words, when does Bob’s plan take over?
If during the pregnancy we have some procedure done that is solely for the benefit of the child, not me, does my insurance cover it? (Actual answer – yes, it does. Philosophical answer – why would it?) Do the various attempts to give the fetus legal status apart from the mother change this in any way? I mean – as long as the kid is legally part of my body, its needs are covered by my insurance. If it were declared legally separate, could my insurance company refuse to cover it unless I paid for the family plan? Could an unborn child be insured as a dependant on the father’s plan even if the mother was not covered by the plan? (And that’s a good question anyway – could unmarried fathers do that – insure the fetus if the mother doesn’t have coverage?)
(This is an ivitation to philospophical speculation, not a request for advice, btw. Any actualization of hypotheticals is still a ways off.)
Posted by Dagonee (Member # 5818) on :
Philosophically, I have no problem with the already arbitrary insurance regulations being augmented by one more arbitrary regulaton that says an unborn child is covered under the mother's insurance.
Any consistent rule will allow actuarials to predict the costs, and that's the key feature that's needed here.
Dagonee
Posted by Shan (Member # 4550) on :
Gosh, dkw - you sure know how to bait the hook! Posted by mothertree (Member # 4999) on :
If you are acquiring insurance for a family after having a baby, they won't insure the baby until it is a certain age. So for insurance purposes, a child isn't alive until well after they are born. Also, insurance doesn't cover abortions unless there is police reported rape or danger to the life (health?) of the mother (excluding as most insurers do, mental health) or the child has defects that will be very expensive to treat. I'm not big on taking ethical input from the insurance industry.
Posted by dkw (Member # 3264) on :
I just thought this might be a discussion that could mix-up "party lines." I'm sick of categorizing people as either/or and then assuming that determines their views on life, the universe, and everything.
[ January 26, 2005, 10:35 AM: Message edited by: dkw ]
Posted by Dagonee (Member # 5818) on :
On a similar note, I've never understood why people think that "life beginning at conception" means we have to change how we calculate age. Birth is a definite point in time and convenient to measure from. Our regulations based on age aren't theoretical entities, but averages based on empirical experience (or misinterpretations of empirical experience). So when we say someone of age 16 is ready to drive, we mean that, on average, people are ready to drive 16 years after they are born.
It's an arbitrary choice, based just as much on convenience as using the number of revolutions around the sun as the measuring unit.
Dagonee
Posted by Dagonee (Member # 5818) on :
quote:Also, insurance doesn't cover abortions unless there is police reported rape or danger to the life (health?) of the mother (excluding as most insurers do, mental health) or the child has defects that will be very expensive to treat.
This isn't true - many policies will cover elective abortions. I don't know if the regulations vary on that state to state.
Dagonee
Posted by ketchupqueen (Member # 6877) on :
Philosopy aside, it's worth looking into because some plans drop insurance on a baby as soon as it's born, while some will cover the baby for up to 2 days, giving you time to get the child added to someone's insurance.
Or, if you're like me, your insurance could just refuse to cover your pregnancy based largely on an inaccurate due date and refuse to pay back what you spent when you get a better one because, well, it's already paid. Posted by Belle (Member # 2314) on :
I went through this when I was pregnant with Natalie because we were covered by two insurance plans, one individual for me, and one for Wes. I was told that while I was pregnant, and through the delivery until the baby was discharged from the hospital, it was covered by my insurance. We would need family coverage to pick up after we left the hospital.
I don't know where the line would be if you had a procedure for the baby alone, like say, spina bifida surgery in utero.
Philosophically, some people justify abortion by saying it's the woman's body she should be able to do with it what she wishes. They consider the fetus to be just an extension of her body, not an individual person. So, logically, if she can have surgery to remove that extension, why not have surgery to affect or protect that extension? Still her body, yes? And therefore, covered by her insurance.
To deny medical coverage for a fetus because the mother doesn't have family coverage, is tantamount to admitting the fetus is an individual. That would cause big problems for those that support legal abortion, I would think.
Posted by Sopwith (Member # 4640) on :
I believe that since the health of the unborn child and the mother are completely entwined, the mother's insurance would be beholding to cover all of the costs associated with the pregnancy up to and including the delivery.
Whatever affects the fetus affects the mother, or will at some time.
That's just my take on it. And btw, we're in the final month now... just a few more short weeks to go. Posted by dkw (Member # 3264) on :
Congratulations! Posted by Amka (Member # 690) on :
I pretty much was going to say what has already been said. The baby and mother's health is so meshed together as to not be practical to distinguish.
Even in such an extreme procedure as in utero surgery, the mother is having surgery as well.
Congratulations, Sopwith. How are you feeling? When is the actual due date?
Posted by dkw (Member # 3264) on :
What about the case of insuring the fetus when the mother has no insurance? Possible? Could treatment for the mother then be covered, as necessary for the fetus, even though she was technically uninsured?
Posted by Dagonee (Member # 5818) on :
I doubt it. Again, it's a costing (not a cost-cutting) issue. Since it would be impossible to separate the two, the cost would have to be the same for insuring one or both. So I don't think the distinction would exist.
But, your question would have to be explicitly dealt with in the eligibility regulations. Since the child is a dependent of the father, could he get both on the plan? I have no idea how they handle this. The moral reasons for allowing dependents to be on insurance plans certainly speak to allowing the father to cover the mother of his unborn child.
Dagonee
Posted by mothertree (Member # 4999) on :
kqueen- I mean that if you don't have insurance and you become pregnant, your whole family cannot apply for insurance (at least this was the case with me in this state) until the baby is born and either 2 or 6 weeks old. Old enough to see that it doesn't have any birth defects. I realize that if you already have insurance before the pregnancy, the child is covered at birth though you have to update your paperwork.
I'm sure a more practical company will insure elective abortion. It's less expensive than extending care to another child. I'm just pointing out that insurance is about bottom lines as often as they can get away with it. It's not a place to have our ethical positions informed.
Posted by dkw (Member # 3264) on :
quote:I'm just pointing out that insurance is about bottom lines as often as they can get away with it. It's not a place to have our ethical positions informed.
Good grief, no. I hope you didn't read anything I wrote as suggesting that.
Posted by Amka (Member # 690) on :
I think we would be getting into territory that would require the fetus be legally defined as a distinct and seperate entity.
And in that case, the mother could only be treated as the life saving device attached to the fetus. This might work for physical health reasons, but the mindset that would adhere to this view of pregnancy is disturbing. How much say would the mother have in how her own body was treated? There are lots of medical intervention during labor that has little to no affect on the baby, but that is more convenient to some doctors and nurses, and they would invent reasons as to why such a procedure would be necessary and why the mother should be legally bound to it.
For instance, it is much easier to stick the mother in the bed on monitors with an IV than to have her up and moving around, needing assistance perhaps as she does so, needing water, etc. The IV insures she is getting proper hydration and that medicine can quickly be administered. Some hospitals have this as a hard and fast rule anyway, and a mindset which makes the mother merely the life support mechanism for the fetus will reinforce the rigidness of such rules.
Common sense tells us that typically, what is best for mom is best for baby. So it really is impractical on all levels to have insurance that covers only the fetus. As much as I say with conviction that it is an individual with a unique personality currently living in my womb, our selves are so intertwined as to make us indistinguishable for all practical purposes.
Posted by Shan (Member # 4550) on :
I just meant in terms of potential children . . . i.e., was there really big news . . . which of course I know, no!, not 'till after the big day.
*Okay - where's rivka to prop up my bilious humors again - I'm failing miserably at being funny*
*abashed*
Posted by zgator (Member # 3833) on :
quote: I was told that while I was pregnant, and through the delivery until the baby was discharged from the hospital, it was covered by my insurance. We would need family coverage to pick up after we left the hospital.
What would happen if the baby required medical treatment after birth but before discharge that was beyond what is typical?
Posted by mothertree (Member # 4999) on :
dkw, your thread title seemed like you were wanting to consider health insurance coverage as evidence in the question of defining the beginning of life.
quote: Do the various attempts to give the fetus legal status apart from the mother change this in any way? I mean – as long as the kid is legally part of my body, its needs are covered by my insurance.
(from your first post). So I guess I'm confused about what you did mean. Which I don't mean as a rhetorical. I respect you but we often fail to "vibe".
Posted by jeniwren (Member # 2002) on :
I wonder how an insurance company would handle surgery for the baby in utero, like to repair spina bifida (sp?). Interesting question.
My health insurance covered my babies as part of me until I was discharged from the hospital after delivery. They did offer a grace period after delivery to get the baby on the policy. Which was good in the case of my son's birth, since he spent a couple of extra days in the hospital after I was discharged. Those days went against his insurance coverage, not mine. Which was the same company and under my policy so it wasn't exactly a problem.
Posted by BannaOj (Member # 3206) on :
I think if insurance companies did start charging for the fetus separately, it would give some incentive for lobbying for the child tax credit to start at conception rather than birth.
I'm glad the insurance company give a grace periods. I don't think the two should be considered a separate insurance entity til the child is breathing air. Before that point the health of the mother and child are so intertwined, as to be inseparable from an insurance standpoint. While I know you can sue and sometimes get even criminal charges for wrongful death of a fetus, do the insurance companies actually cover that?
AJ
Posted by Belle (Member # 2314) on :
quote:What would happen if the baby required medical treatment after birth but before discharge that was beyond what is typical?
I was told the baby would be covered, for example, if it were born premature or something and required long term care, that would be covered as well.
Keep in mind this was 12 years ago...and a lot of things have changed in the insurance industry since then. I don't know if that is the case now.
Posted by Homestarrunner (Member # 5090) on :
Just having the same doctor care for both mother and fetus all the way up to the snipping of the umbilical cord is a good enough reason IMO to keep them part of the same insurance costs.
Posted by mothertree (Member # 4999) on :
Coverage of prenatal surgery would probably depend on whether the surgery were considered experimental or established medical practice.
So when receiving medical treatment, do you all find the doctors and nurses or midwives call it a fetus or a baby?
Posted by jeniwren (Member # 2002) on :
Homestar, when a baby has defects that are detected before birth, it often has its own doctor(s). A friend of our's daughter recently had a baby with significant heart defects...that baby had an entire team of his own doctors well before he was born. Don't know how that worked with insurance, though. I assume that it was covered under her father's policy since she is still a minor(17).
edited to add: MT, my OB always called it a baby. And once we had a name, he called the baby by her name.
[ January 26, 2005, 04:30 PM: Message edited by: jeniwren ]
Posted by ketchupqueen (Member # 6877) on :
mothertree, I wasn't arguing with you. You posted at the same time as me, I think. Posted by bCurt (Member # 5476) on :
These comments are related to insurance coverage in Texas:
Group plans under 15 employees do not have to have maternity coverage. However, if you work for a company with 15-50 employees (a small group by definition) maternity coverage is required. If you have maternity coverage, from my interpretation, any pre-birth procedures should be covered if deemed medically necessary.
If you do not have maternity coverage I would not count on any pre-birth procedures as being covered (if a company accepts it, they are being generous). Here in Texas, your baby is immediately covered upon birth contingent upon that baby being added to your coverage within 30 days. That requirement may be part of HIPAA which would make that a nationwide requirement (don't know if it is off the top of my head).
Posted by Homestarrunner (Member # 5090) on :
I was going to say that's where the insurance situation gets grayer. Still, because on most insurance plans you can't count an unborn fetus as a dependant yet, that surgery would have to be covered under the mother's plan or not at all.
Posted by mothertree (Member # 4999) on :
kqueen- no worried, I was just talking about a different situation than you.
Posted by rivka (Member # 4859) on :
Oops. Sorry, Shan. I wasn't around much the end of last week. *hands over a supply of U-Prop-'Em brand props* That should last you a while.
The last time I had to deal with multiple insurance companies and a pregnancy (which happened with two of my three kids -- spouse changing jobs during pregnancy), there was a 30-day-past-birth window during which the newborn was covered under the mother's coverage.
I believe a lot of these guidelines are dictated by state laws . . .
Posted by Shan (Member # 4550) on :
Phewww . . . thanks, rivka -
dkw and I had a good chuckle about it, anyhow . . .
Posted by Belle (Member # 2314) on :
quote:So when receiving medical treatment, do you all find the doctors and nurses or midwives call it a fetus or a baby? --------------------------------------------------------------------------------
Always baby. I don't think my doctor ever used the word fetus, at least not around me.
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