Consumer’s Health Insurance Blog

Hank at the InsureBlog wrote an interesting post about a pregnant woman moving from Sweden to Florida (or North Carolina or Tennessee) who is interested in getting health insurance. It sounds like she wants the pregnancy to be covered by health insurance, which from Hank’s post is the only sticking point to the process of buying health insurance.

Perhaps she can just get an individual policy if something goes wrong outside of the pregnancy (from my perspective the most important reason for insurance) and take the exclusion of the current pregnancy. Trying to get coverage for the pregnancy is the problem - an approximately $5,000 charge if the child is born in a hospital, much less if born at home. It could be much more expensive if something really goes wrong. However, any other health issues not part of the pregnancy would be covered. The child should also be eligible to be added to the plan upon birth. She’d want to verify that just in case there are any problems.

Divide the expense of the pregnancy over a year, or multiple years, and it’s not that much. (ex.: $5,000/12=$600/mo. over one year or $5,000/24=$300/mo. over two years for hospital, or for delivery at home lets say $1000/12=$83/mo. over one year, or $1000/12=$41/mo. over two years ). Compare this to the difficulty and rate of trying to find an insurer that will cover the pregnancy. If a good individual plan will take her, excluding the pregnancy, and will put the child on the plan, then the additional expense of the pregancy can be “consumer driven healthcare” and the parents can choose between hospital/home/birthing center.

They can also do what other people do: have the child born where they already have coverage before relocating. A number of families separate briefly during difficult circumstances. While this is not the ideal, it may be a financially more palatable option for the couple. I’m sure they’re already having a hard time with a relocation like this with only 5 months before the baby is born.

Another solution that may come to mind but does not work is moving to a community issue state like Maine, Massachusetts, New York, New Jersey, or Vermont (or any of the others that offer a guaranteed issue option) she would typically face a 6 month exclusionary period. Even if she didn’t face an exclusionary period, the difference in premium between these states and her desired state may exceed the cost of delivery spread over a premium period of a year or two, without even taking into account the cost of an additional relocation.

Finally, why wouldn’t her or the husband’s employer (or the husband if he’s in business here himself) get a guaranteed issue small business policy? As many pointed out, a one person or two person small business policy would be right for them, given their circumstances.

I don’t believe that they should go with a Medicaid or other type of government program on principle: they seem to be able to relocate, afford a home in Florida, and the expense of moving including air travel. It isn’t fair to the taxpayers.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   Consumer Driven Healthcare · Florida · Health Insurance · Medicaid · pregnant · SwedenNo Comments