Surrogates are women who want to give, and give in a big way. However, in wanting to give and be selfless, many forget to make sure they, and their families, are one hundred percent protected. In our current culture, many surrogates state that they do not like nor trust our insurance companies.
Many surrogates tell us that they do not even really understand how insurance works. Surrogates take unnecessary risks because either they want to help so much that they are willing to brave the consequences, think that the bad things will not happen to them, or simply do not understand how devastating the consequences can be.
7 Surrogacy Insurance Myths
Myth #1: I know another surrogate who used the same insurance company that I do and they paid her claims so it is okay if I use my insurance
False. Insurance policies change from state to state, employer to employer, and from time to time. Do not assume that because you are using the same company, that your policy is identical. Call and ask if they cover surrogacy and get it in writing if they say they do.
Myth #2: My policy says is covers maternity care and does not state that surrogacy is excluded, so it covers surrogacy
False. Another huge mistake that surrogates often make is assuming that if their policy states that it covers maternity, and does not specifically exclude surrogacy, that it will pay for surrogacy claims. This is not the case!
Many insurance companies are realizing that surrogacy is a risk they are unwilling to undertake.
They have many ways of denying surrogacy claims.
They can deny claims based on the interpretation that surrogacy is not the same thing as maternity.
They can also review your application forms and if you stated that you were not pursuing surrogacy (even if you weren't at the time) or you made any other mistakes they can find, they can cancel your policy and not pay your claims.
Myth #3: My OB is great. She'll lie to the insurance company and tell them it is an adoption to get around a surrogacy exclusion in my policy
False. The insurance company can send forms to your OB asking if you are acting as a surrogate and the doctor must answer honestly or face serious consequences such as losing a contract or being prosecuted. These are not risks that OBs are willing to take for one patient.
Myth #4: I qualify for Medicaid (or other government insurance coverage for low-income individuals), so I should use it to save my intended parents some money
False. Government insurance is not provided so that its clients can profit. This is likely considered insurance fraud and abuse of government funds.
You can be banned from ever being on government assistance in the future, you will have to repay all claims, and you could also be prosecuted and spend time in prison.
These are not risks that any surrogate should take in order to help their intended parents save money. This is not a risk that any decent intended parent will allow their surrogate to take.
Myth #5: I don't want to call my insurance company and ask if they will cover surrogacy because it would raise red flags and they will not pay my claims
False. Call. Raise every red flag you can and then some.
If your insurance company is not going to cover surrogacy, they are not going to cover surrogacy.
It is much better to find out before you get pregnant than to find out when they deny your claims.
If they say that they will cover claims for surrogacy, GET IT IN WRITING!
Do not proceed to get pregnant without a letter from your insurance company stating they will cover your claims. If they later attempt to deny claims, you will have this letter to help prove your case.
Myth #6: I have a surrogacy contract with my intended parents and it says they will pay for my medical bills so if claims are denied then it is their responsibility
True, and False. Yes, your intended parents would be responsible, but they may not be able to afford your bills. If you have used your policy, then the claims are in your name. The insurance company does not care about your contract with a third party.
You are obligated to pay the bills and if you do not then they will send you to collections. Many surrogates have been forced into bankruptcy due to large medical bills that their insurance refused to pay and their intended parents could not afford.
Even if they were able to recover the funds from the intended parents via legal means, the damage has already been done to the surrogate's credit.
Myth #7: There isn't really anything the insurance company can do to me if I lie about being a surrogate
False. In the event, that your agency or attorney state that your insurance policy is fine to use for your surrogacy, you need to be your own advocate. Require the agency or attorney to provide you a letter stating that your claims will be paid for your surrogacy either by your insurance or by the Intending Parents. Do not move forward without it.
Other things surrogates and intended parents need to know:
Many major medical policies have lifetime caps.
This means, your family has a set amount of medical coverage forever.
For example: You have a $1 million cap.
If you use $500,000 of your coverage because you used your insurance for a surrogacy and had complications, then your entire family has only $500,000 more in coverage.
What if you are the victim of a serious accident or a spouse or child develops a very severe disease? You can run out of coverage very quickly.
Surrogacy agencies and even attorneys are not always on your side. Even if they say your policy is fine and they are able to use it, you need to be your own advocate. Call the agency and get a letter stating that they will pay claims for a surrogate pregnancy. Do not move forward without it.
Thank you for your excellent article. I will be sharing it with all of my potential gestational carriers from this day forward. Deborah Simmons, PhD, LMFT, Partners in Healing of Minneapolis
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