Wednesday, September 28, 2011

Surrogate Mother Stuck with Insurance Bills! Not If She Used New Life Agency!

Below is a classic example of why New Life is in business and has a passion to protect extraordinary people who are embarking on one of the most important journeys in life....creating children and family.

Even though surrogacy is not legal in Michigan this is important for New Life to get the word out to further warn both IP's and surrogates. 

It is also important people understand this maternity claims conflict ending in denial has been open since 2007! So of course it does not include the legal bills.  If these people would have had New Life in place they would have actually saved money not to mention the stress I am sure it added to everyones life.

Surrogate mom loses appeal over health insurance

A western Michigan woman who gave birth to triplets for another couple is stuck with $42,000 in medical bills after an appeals court said Friday that insurance benefits could be denied.

NGS American, a benefits administrator, had approved Stephanie Lehr's bills until the final trimester when she developed problems and a doctor noted in her chart that she was carrying the babies as a surrogate. NGS learned about it and said surrogacy was not covered under the Richland woman's insurance plan.

Wednesday, September 21, 2011

Healthy Triplets! and a HUGE THANK YOU to New Life Agency Staff!

We love it when those we insure share the joy of welcoming their new dream babies with us! Below is a short note from some very appreciative IP's!
 
 
 
"Thanks Lainie. We had a big team that helped to bring this journey thus far.  
And you and Richard are part of that team!  But, its two girls and a boy.  Riley is our son.  :) 
They are here!!   
Caitlin 4# 14oz 18"
Kelsie 3#11oz 17"
Riley 5#4oz. 17"
Born Aug 26 and all healthy!"
 
Very Grateful IPs

Wednesday, September 14, 2011

7 Surrogacy Insurance Myths Every Surrogate Should Know!


Surrogacy is a journey that involves many decisions, hours of research, and a lot of dedication.
       
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.

Wednesday, September 7, 2011

An Inside Peek at Individual Health Insurance Underwriting from New Life Agency

Individual health insurance is insurance you buy on your own, rather than having it provided by your employer. Please examine your options carefully before declining group coverage or continuation coverage, such as COBRA, that may be available to you. You should be aware that companies selling individual health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied coverage entirely.

If you are in the market for individual health insurance, most insurance companies have online tools to help you find out how much individual health insurance will cost. If you have a chronic illness or other health condition, it can be hard to buy individual health insurance. If you have applied for individual health insurance and been denied, the information below may help you determine why you may have been denied and if that denial was appropriate.

The following summarizes underwriting information that health insurance
companies have filed with the Department of Insurance.
AB 356: Summary of Underwriting Information filed re conditions for which no insurance coverage will be offered, application will be denied, or higher premium may be charged or benefit may be limited Condition Insurance Company Action
 
*Health problems for which you have not seen a doctor Automatic decline for some companies
*Health problems that a doctor can not explain Automatic decline for some companies
*Health problems for which you have not completed treatment Automatic decline for some companies*AIDS Automatic decline*Pregnancy, pregnancy of your spouse or significant other, planned surrogacy or adoption in process Automatic decline*Cancer, under treatment Automatic decline*Sleep Apnea Automatic decline or higher premium will be charged*Severe mental disorders, such as major depression, bipolar disorder, schizophrenia or psychopathic personalities Automatic decline*Heart disease Automatic decline*Renal failure or Kidney Dialysis Automatic decline*Diabetes with complications Automatic decline*Cirrhosis Automatic decline*Multiple Sclerosis Automatic decline*Muscular Dystrophy Automatic decline*Systemic Lupus Erythematous Automatic decline*History of transplant Automatic decline*Lymphedema Automatic decline or higher premium will be charged*Current infertility treatment Automatic decline*Hepatitis Automatic decline*Hemochromatosis Automatic decline*Rheumatoid Arthritis Automatic decline*Stroke, after 10 years with no reoccurring problems Automatic decline or higher premium will be charged*Allergies, while testing is in process Automatic decline or higher premium will be charged*Ear infections, controlled with medication Higher premium may be charged*Lyme's disease, without symptoms after one year Automatic decline or higher premium will be charged*Breast Implants (non-silicone) Automatic decline or higher premium will be charged*Ringworm Higher premium may be charged*Joint sprain or strain, recovered and no restrictions Higher premium may be charged*Migraine headache, mild and infrequent with no emergency room visits Higher premium may be charged*Mild depression Automatic decline or higher premium may be charged*Obesity Automatic decline or higher premium may be charged*STD (Sexually Transmitted Disease) Automatic decline or higher premium may be charged

Underwriting
When you apply for individual health insurance, the health insurance company uses a process called underwriting to look at your age, sex, and health history to decide whether it will cover you and how much it will cost to provide you coverage.

Do all health insurance companies have the same underwriting guidelines for offering insurance?No. Each insurance company has its own underwriting guidelines, which are usually not made public. However, insurance companies marketing and selling individual health insurance policies in California must file information with the Department of Insurance pertaining to their policies, procedures and underwriting guidelines for offering such insurance (Insurance Code
Section 10113.95 which was added by Assembly Bill 356 in 2005).