Impeding changes to our Health Care system

[richlevy]

From here.

I think this is another example of how the '%70 of the country who are covered by insurance' does not mean 'fully covered'. I'm guessing the $3000 limit on giving birth was not in the large print. I think the only way to have a baby for $3000 in this country is to squat and drop in a potato field with a midwife and a horse blanket.

The individual health insurance market can be a scary place for Americans who turn to it for health coverage. If they're accepted to a plan at all, patients often find that their coverage isn't quite what they were promised, and limits and restrictions lead to high medical bills for covered services that aren't really covered. That's how Sarah Wildman ended up with a $22,000 bill from the hospital where her daughter was born, despite having what she thought was good health insurance with a maternity rider.

Pregnancy on the individual health insurance market requires an additional rider that must be purchased before the pregnancy begins. Without this rider, the fetus becomes a pre-existing condition. Prenatal care, delivery, hospitalization, and any complications are not covered. Not a cent.
Wildman discovered that her maternity rider covered her daughter's birth, but with a limit of $3,000. That is not a typo. Her story ended with the company covering 90% of the bills, but, she suspects, this is only because she happened to be writing a story about it.

[jinx]

It cost my ins co $4,000 for me to give birth with a midwife in a free standing birth center. It cost almost $13,000 to get the same job done in a hospital 2 year earlier.

[richlevy]

Originally Posted by jinx

It cost my ins co $4,000 for me to give birth with a midwife in a free standing birth center. It cost almost $13,000 to get the same job done in a hospital 2 year earlier.

So they're basing their coverage on the lowest possible cost, even though a majority of women still use hospitals.

If the bill was $22,000, there may have been complications, which would possibly have required a switch to the hospital.

I just wonder if anyone told this woman up front "we're only going to cover $3000 because we're assuming that you'll use a midwife."