Cesarean Punishment
Tuesday, June 3, 2008 at 08:41AM Insurance companies have begun refusing coverage to post-cesarean moms unless they have been sterilized during their cesarean.
The International Cesarean Awareness Network - ICAN - reports:
"Peggy Robertson of Colorado. When she applied for health insurance coverage with Golden Rule, her husband and her children were accepted, but her application was denied. After multiple inquiries directed to the insurance company, she was finally told that she was denied because she had delivered one of her children by cesarean. 'It was shocking. I assumed that as a woman in good health I would be readily accepted,' said Robertson. 'When I finally found someone who would explain why my application was denied, they had the audacity to ask me if I had been sterilized, stating that this was the only way I could get insurance coverage with them.'"
The New York Times article says:
"She was turned down because she had given birth by caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified."
Also, "Insurers’ rules on prior Caesareans vary by company and also by state, since the states regulate insurers, said Susan Pisano of America’s Health Insurance Plans, a trade group. Some companies ignore the surgery, she said, but others treat it like a pre-existing condition.
'Sometimes the coverage will come with a rider saying that coverage for a Caesarean delivery is excluded for a period of time,' Ms. Pisano said. Sometimes, she said, applicants with prior Caesareans are charged higher premiums or deductibles.
'“In many respects it works a lot like other situations where someone has a condition that will foreshadow the potential for higher costs going forward,' Ms. Pisano said."
As an FYI, Golden Rule insurance company is owned by United Healthcare.
"Blue Cross Blue Shield of Florida, which has about 300,000 members with individual coverage, used to exclude repeat Caesareans, but recently began to cover them — for a 25 percent increase in premiums for five years. Like Golden Rule, the company exempts women if they have been sterilized."
While I hadn't heard of this, it doesn't completely surprise me. I am individually un-insurable because of the gastric bypass. I used to be un-insurable because of diabetes and morbid obesity. Even though the gastric bypass put both diabetes and obesity to in the background, the fact of the surgery alone is cause enough to never be able to buy my own insurance.
I seriously wonder what will happen to the cesarean rate if ALL women had to pay for the surgery out of their own pockets. Scheduling a cesarean will come with a whole new set of issues besides the uterine scar, the secondary infertility, the placental difficulties, the higher risk of dying and having a premature baby as well as post-op pain and a much longer recovery. I wonder if finances will have any impact at all.
A part of me applauds the possible ramifications of their discrimination. Not the actual denials, but the possibilities it affords women who've had cesareans previously. Will VBAC once again be the preferred subsequent delivery?
This is certainly an interesting (and sad) development; we will all have to watch unfold.