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Leaders in Family Matters

Jason's Story: An Insurance Nightmare

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For a variety of reasons, individuals and couples often need help when they decide they would like to have a child. In addition to the emotional journey, medical and psychological process, there is a large financial burden.

I want you to imagine for a moment that you’ve gone through IVF, medical visits, testing, doctor’s visits, and worked with a surrogate for pregnancy only to be told that you owe an additional tens or even hundreds of thousands of dollars on top of this. All because for a plethora of reasons you couldn’t carry your own baby. The additional cost might feel like discrimination and an additional penalty to an already lengthy and cumbersome process all before you’ve even had your child. In addition, the interaction and process with insurance added tremendous stress to an already challenging pregnancy. Our journey was one such experience and I am hopeful that in highlighting this problematic and ongoing situation with insurers, we can change this path for everyone.

Here’s Our Journey:

My partner and I spent years thinking about having children and decided we wanted to move forward with the process. In our case, we would need the help of assisted reproduction. Once you’ve decided you want to have a child navigating the journey is challenging and you typically want to go through a Agency to help you. In our case, we researched and were recommended an excellent agency based out of San Diego, California. We spent countless days interviewing, discussing, and connecting with potential egg donors with the help, thoughts, and recommendations of the agency along the way. We then worked with an exceptional clinic in Southern California to create embryos, finally returning to our agency to find a surrogate who could carry our baby. After matching with a surrogate and implantation of our embryos (we wanted twins), we worked with ArtRisk, an insurance agency, to advise us on buying an insurance policy for our surrogate. We settled on a Kaiser plan that was a standard plan based in California, the same plan anyone else needing insurance would seek.

We decided to attend all medical visits with our surrogate as a way of connecting with our children and connecting with the medical and pregnancy process. Our surrogate was an amazing human being who had three children of her own and had been through surrogacy before. Throughout the pregnancy, everything progressed well and interactions at the hospital and doctors visits were fairly routine.

Shortly before our children’s birth, things became incredibly stressful with the hospital, staff, and doctors. We received notification that we would not have our own hospital room, nor for that matter, necessarily be able to be present at our children’s birth. This felt incredibly stressful and sad as well as blatantly discriminatory. On the day our surrogate was to give birth, we had to plead with the Obstetrician and surgical team on staff to allow us to be present for our children’s birth. The thought of not attending our children’s birth was simply horrific and it was humiliating to have to try to plead with doctors to attend.

The intensity and level of stress continued while in the hospital for about 36 hours. The morning after the babies’ birth, we began getting repeated calls from the financial office of the hospital asking for payment “for these types of situations.” When we indicated we would followup after insurance had processed the bill, the financial office continued to call, ultimately calling nine(9) times before we left the hospital. This created tremendous stress for us and we actually weren’t certain we could leave the hospital given the intensity of the finance office calls. I invite you to imagine caring for not one, but two newborns while being harassed by the hospital’s financial team.

After our children were born, here’s where the financial situation becomes concerning and different from every other typical pregnancy. Although we were purchasing insurance to hedge against future risk to the pregnancy, the insurer (Kaiser) in this case, would ultimately demand that we pay them for the cost of medical care. How you might ask does this make any sense?

In what’s known as an insurance lien, insurers in California and other parts of the country (except Nevada where legislation has outlawed this practice) demand payback from the surrogate for the money she is receiving to carry the child for 9 months. Insurers view this as a windfall and essentially want to recover those funds. As this is the only way many individuals can reproduce, the process is discriminatory and unduly penalizes families. While I am not a lawyer, it may further represent violations of the Affordable Care Act (ACA).

These medical liens are not only discriminatory and wrong, they often cause incredible financial stress for many couples. In fact, many individuals needing assisted reproduction may not go through the process because they simply cannot afford these liens in addition to the incredible costs of surrogacy to begin with.

It is my hope that we can change this process. Those going through surrogacy are not asking for anything special, simply equal treatment with those other parents who do not need assisted reproduction.

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