A recent investigation by the House of Representatives’ Committee on Energy and Commerce has found that many individual health insurance policies do not cover maternity care. The news is no surprise for women who are covered by these policies and experienced a rude awakening when they became pregnant. The four largest for-profit health insurers – Aetna, Humana, UnitedHealth Group and WellPoint – don’t cover normal deliveries for their members who have individual policies. The committee’s report confirms a 2009 report by the National Women’s Law Center (NWLC) that scrutinized 3,600 individual policies and determined that just 13 percent provide maternity coverage. For women with these policies, it gets even worse should they become pregnant. At that point, if they apply for coverage in the individual market, insurers typically determine that pregnancy is a pre-existing medical condition and deny coverage on that basis. Maternity riders are offered on some policies, but they are extremely expensive, provide very limited coverage and might take as long as a year to become effective, according to the NWLC. The average cost of maternity care – nine months of prenatal care, three months of post-partum care and a delivery without complications – averaged $10,652 in 2007, a March of Dimes study reported. The Pregnancy Discrimination Act of 1978 exempts companies with less than 15 employees and individual policies from providing maternity coverage, although some states maintain stricter requirements. This year, 12 states mandate maternity coverage in the individual insurance market and 17 in the small-group market, according to statehealthfacts.org, a project of the Kaiser Family Foundation. Thanks to the Patient Protection and Affordable Care Act, this coverage gap will cease to exist in 2014.
Posts Tagged ‘UnitedHealth Group’
House Panel Finds Many Individual Healthcare Policies Do Not Cover Pregnancy
Wednesday, December 1st, 2010Healthcare Insurers Are Extending Family Coverage to Under 26s Early
Monday, May 10th, 2010
Two of the nation’s largest private insurers have decided to extend benefits to young adults under their parents’ policies starting in June — months ahead of the September 23 date specified in the Patient Protection and Affordable Care Act. WellPoint and UnitedHealth Group will allow the uninsured up to age 26 to be covered by their parents’ health plans as they graduate from college and lose student benefits.
Kathleen Sebelius, Health and Human Services Secretary, is working to persuade other healthcare insurers to begin compliance with the law prior to the official date. The insurers are acting early to assure that graduating college students avoid a coverage gap this summer.
Bradley Fluegel, WellPoint’s chief strategy and external affairs officer, said “Protecting access to healthcare is our first priority.” Gail Boudreaux of UnitedHealth Group concurred, saying “Accelerating the dependent coverage extension timeline for our graduating student enrollees is another tangible step we are taking to help translate the new, complex health reform directives into workable reality. We want students to graduate into a secure future, not the ranks of the uninsured, so we are working with employers to make sure these young adults have health coverage available to them ahead of the new requirement.”
Secretary Sebelius said “We are encouraged by the actions of WellPoint, UnitedHealthcare and other companies to bridge the gap between now and the fall when the law becomes effective.”
White House Asks Insurance Industry for Transparency on Premium Increases
Wednesday, March 17th, 2010
The outcome of the high-level meeting? Greater transparency is needed when companies request increases in healthcare insurance premiums. Sebelius suggested the executives post proposed rate increases and actuarial data supporting the need for them on the internet. “At the very least, we need some transparency,” Sebelius told the Associated Press.
Angela Braly, WellPoint president and CEO, said that transparency is “a particularly constructive place to start.” Although no firm agreement was reached at the meeting in the White House Roosevelt Room, Stephen Hemsley, UnitedHealth Group’s CEO said “I do expect there will be some follow-up from the secretary.”
President Obama spent a few minutes in the meeting, discussing costs and the individual insurance market, which is where the largest hikes are being made. The president gave the executives a letter from a woman in Ohio whose insurance premium is being raised by 40 percent to demonstrate the hardship the increases place on people.
Physicians Offered Incentives to Switch to Electronic Record Keeping
Thursday, January 28th, 2010
In 2011, physicians will be eligible for extra payments from federal health insurance programs if they implement electronic medical record systems. The extra money is courtesy of President Obama’s American Recovery and Reinvestment Act stimulus bill signed into law early last year. To help physicians – especially those in small practices – pay for the several thousand dollar systems, private insurers are also offering financing incentives of their own.
UnitedHealth Group, for example, is offering interest-free loans to small practices that start using Ingenix CareTracker, an internet-based system. Chicago-headquartered Allscripts-Misys Healthcare Solutions, Inc., is offering a six-month, no-payment program for qualified buyers of its electronic healthcare records software.
Under the federal legislation, physicians who start using electronic medical records can receive more than $40,000 in Medicare payments over a five-year period. At present, the Obama administration is soliciting comments on new regulations to “lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record technology.” Although electronic records keeping will cut paperwork, control costs and create a more efficient system, physicians have been slow to adopt the technology because of the high cost of purchasing the equipment.
Even though 75 percent of Americans patronize doctors in small practices, less than 15 percent of physicians now use electronic records systems. UnitedHealth, which says its CareTracker system can cost less than $7,000 annually, is “helping physicians overcome the challenge of funding their upfront investment – the biggest barrier in implementing health information technology,” said Bill Miller, executive vice president of Ingenix, the firm’s health information technology subsidiary.
