My Daughter Is on My Health Insurance and She Is Pregnan. Is the Baby Covered

The health-intendance overhaul provides a condom net for young adult children, who tin can now stay on their parents' wellness plans until they achieve age 26. But it doesn't guarantee that their parents' program will comprehend a common medical status that many young women face: pregnancy.

Grouping health plans with xv or more workers are required to provide maternity benefits for employees and their spouses under the Pregnancy Discrimination Human activity of 1978. But other dependents of employees aren't covered past the police, then companies don't have to provide maternity coverage for them.

Although difficult numbers aren't available on how many companies don't provide dependent motherhood benefits, "I would say information technology'south mutual," says Dania Palanker, a senior health policy adviser at the National Women'due south Constabulary Center. And the number could abound with the recent expansion of coverage to children under age 26, she says.

Dan Priga, who heads the performance audit group for Mercer, a human resources consulting company, estimates that roughly 70 percent of companies that pay their employees' health-care claims directly cull not to provide dependent maternity benefits.

In 2008, an estimated ii.eight 1000000 women ages 15 through 25 got pregnant, 12 percentage of all those in this age group, co-ordinate to researchers at the National Center for Health Statistics. (That is the most recent yr for which there are pregnancy estimates.)

Health insurers must cover members' children until age 26, but this dominion does not include pregnancy. (iStock)

An unwelcome surprise

When Wendy Kline learned this spring that her 17-year-old girl was four months significant, she took her to the physician for prenatal care. Her insurer denied the claim, citing her employer's policy non to cover motherhood care for dependents.

"At that point my jaw hit the flooring, because I did not know how nosotros were going to pay for this," Kline says.

Kline asked her visitor, a medical equipment retailer in Martinsburg, W.Va., to change its policy. But company officials turned the 26-yr veteran employee down.

"You piece of work all your life and pay these insurance premiums," she says. "And then you ask for help and tin can't get whatever. It's just so unfair."

In some states, a significant young woman might qualify for Medicaid, the federal-country wellness-care program for low-income individuals, even if she lived at dwelling house with her parents, say experts. But when Wendy and her husband, Andy, investigated, they were told that eligibility would be based on their household income, which was besides high to authorize for Medicaid.

So far, their daughter's pregnancy has been uneventful, and doctor visits and lab work have totaled $300. But the Klines know the big bills are withal to come. Andy recently took out a $2,000 loan from his 401(k) to put toward the hospital bill. It's a start.

Co-ordinate to the March of Dimes, the boilerplate toll for simple maternity care was $10,652 in 2007. That includes prenatal care, a routine delivery and three months postpartum care.

In 2010, researchers at the Centre for Business and Economic Research at Marshall University in Huntington, W.Va., published a written report that analyzed the costs associated with providing mandatory maternity coverage for dependent minors in Due west Virginia.

Teenagers, the study noted, are less probable to get early prenatal care, more than likely to smoke and less likely to proceeds enough weight during pregnancy. Thus, they're more likely to deliver prematurely, resulting in more complications, including a higher incidence of low-birthweight babies. The medical costs for such an babe is nearly 10 times higher than for a babe of normal weight, the report found ($32,325 vs. $3,325), citing March of Dimes data from 2009. Similarly, getting prenatal care sooner rather than after saved as much equally $3,200 in medical costs per person.

Ensuring that young women have access to prenatal care and other maternity services is "definitely cost-constructive," says Jennifer Toll, a senior research associate at the center and the lead author of the written report. "Merely it's such a polarizing issue."

'A basic health do good'

The health-care overhaul provides assist to some young women who go pregnant while on their parents' plans. Under the law, preventive health benefits that are recommended past the U.S. Preventive Services Task Force, a federal agency, must be covered by new plans and by plans that take changed plenty to lose their status of being grandfathered under the law. The recommended services include a range of screenings for pregnant women, including those for anemia, hepatitis B and Rh incompatibility.

In addition, starting this month, when a non-grandfathered health plan begins its new plan year, it must provide certain other women'due south health services at no charge, including an annual well-woman visit, screening for gestational diabetes and breast-feeding support, supplies and counseling.

Starting in 2014, maternity and newborn care is i of 10 and so-called essential health benefits that must be offered by all health plans in the individual and small-group markets, including those that are sold through the land-based health insurance exchanges that will be up and running so.

Large-group plans, however, are exempt from the requirement to provide the essential health benefits, at present or in 2014.

Only advocates say that companies and insurers should cover maternity care even if they're not required to. "For immature girls, this is a basic health benefit that they need," says Debra Ness, president of the National Partnership for Women and Families. "Why would they deny them access to a health benefit that's and so essential?"

This column is produced through a collaboration between The Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organisation that is not affiliated with Kaiser Permanente. Eastward-mail: questions@kaiserhealthnews.org.

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My Daughter Is on My Health Insurance and She Is Pregnan. Is the Baby Covered

Source: https://www.washingtonpost.com/national/health-science/parents-insurance-covers-children-up-to-age-26--but-not-for-pregnancy/2012/08/06/2b59f160-6a2c-11e1-acc6-32fefc7ccd67_story.html

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