So I'm pregnant.... now what????

[FloridaMama78]

Hi Girls,

I thought I was good to go with insurance.... I have United Healthcare with maternity benefits - they covered 90% of my pregnancy with my son. I knew that the policy "excludes surrogate parenting". I talked to my OB and she agreed that she would take care of ME as her patient regardless of how I got pregnant. And that unless I specifically tell her that I'm a surrogate, she wouldn't put it in the charts. So..... I thought I was good. Then yesterday, we had the 2nd ultrasound and the RE released me to my regular OB. He asked for her name and address and told us that he would be dictating a letter to send to her along with all my medical records. I asked the insurance coordinator how I should approach this since my insurance (United Healthcare Choice) excludes "surrogate parenting". She told us that they MUST tell my OB that I'm a surrogate and give them all the records. Otherwise, it would be insurance fraud. She even told me that the doctor would have never agreed to have us as patients if we weren't going to tell the OB all of my medical history.

My IP's attorney suggested that we might just find a new OB, who doesn't know any of the background and then don't tell them anything. But then, how will that work at the hospital? I'm sure the doctors and nurses at the hospital are going to wonder why my IP's are the ones loving on and holding their baby and then taking her home!!

So now I'm feeling really stressed. I certainly don't want to commit insurance fraud (I think that's a FELONY- yikes), but I also don't want my IP's to be stuck with a gigantic bill from the OB or the hospital.

Any suggestions from you experienced surrogates???

Thanks so much girls!!!

Averi

[abfree]

Oh, Averi, I have no idea what to tell you! I just wanted to say HI, good to see you posting...

Blessings to you,
Andrea

[auroradawn41803]

You are not "surrogate parenting"! IMO you are covered.

[lanserx]

ok.. kym taught me this...

We have UHC and it reads no surrogate parenting under the fetility part and not the maternity part.. which means that if you were not able to get pregnant it would not cover you to get a surrogate, but since you are he client and pregnant it will cover you. Don't just talk to a rep at your ins, talk to a rapid resolutions officer...

That being said our ob would not bill and we had to self pay and do all the billing and they still paid the OB and now we are fighting to get the money. It has been a huge headache, but UHC WILL pay!

[quinnavery]

First off LOVE THE NAME!!!!!!!!!!

second I had UHC for one of my journies before my husbands company changed insurance in the middle of my pregnancy. I had no problems and we told my OB everything. I was told it is my pregnancy and it is covered. That it wouldn't cover someone using a surrogate.

Are you worried the OB will tell the insurance or have you already talked to the insurance and they said no

[flame_chick]

oh yeah I just had my first surro babe with UHC insurance, and they covered it like a normal pregnancy. it had the same exclusion, which only means YOUR insurance will not cover ANOTHER person as YOUR surrogate..get it?
you are fine with UHC

[Kymztwinz]

I have the same insurance (of GA), except my pregnancies are covered 100% after a single $25 copay, with only $200 due at delivery for the hospital admission. I have the same surrogate parenting exclusion. Surrogate parenting is defined as the IPs having their surrogate's pregnancy covered. You are the policyholder so your pregnancy is covered even as a surrogate. My charts did have that I was a surrogate in there and my pregnancy and delivery were covered without a problem.

Jolene, I had no idea that even after all of that, your OB wouldn't bill insurance on your behalf! What a pain! It's good to hear that UHC is following through with payment as deserved, though!

[just me]

I would interpret your surrogate parenting to mean that as an IM it will not pay for your surrogate's bills. An atty. would be the best person to sort thru it. With that said, FL has some really strange surrogacy insurance laws. What seems to be normal throughout the entire US ceases to be 'normal' in FL. Even though many states with BCBS insurance allow surrogacy, FL BCBS specifically excludes it (serving as, or using a gestational surrogacy with or without money exchanged).
My insurance changed btw my 1st and 2nd journey (same IPs) and my IPs had to foot the bill (we were already pregnant when we found out).

Unfortunately, there is nothing you can do if it is not covered. But it seems to me that by the wording you have posted, you are fine. If you have an atty in place, have him or her research it for you so that you and your IPs can be prepared for whatever, good or bad, their response is.

[SurroMomTera]

Averi, I'm so sorry you are going through this. I, too, just found out that there is a surrogacy exclusion in my insurance (we just got new Benefit Plan books, and it was in there). When I first started my journey (over 2 years ago), I had even called them, and they said my pregancy would be covered, just not HOW i got pregnant. I hope things work out for you....I wish I had some words of advice, but I don't....I'm kind of in the same boat.

I'm not trying to hijack your thread, but do have a question for those of you that say "surrogate parenting" is covered...I don't think the wording in mine is like yours.....mine says under "Exclusions"..."Inccurred as a result of any Covered Person acting as or contracting to be, a surrogate parent." I guess I'm SOL, huh?

[brokenlola]

[quote]ok.. kym taught me this...

We have UHC and it reads no surrogate parenting under the fetility part and not the maternity part.. which means that if you were not able to get pregnant it would not cover you to get a surrogate, but since you are he client and pregnant it will cover you. Don't just talk to a rep at your ins, talk to a rapid resolutions officer... [quote]

I don't know about this, I talked to everyone under the sun at UHC, including the rapid resolutions supervisor and was told many many times that my pregnancy, as the surrogate, would NOT be covered! I don't know what to tell you, this is a very sticky situation.

[FloridaMama78]

The RE has sent all my records to the OB, so I know she will know. I actually told her - 6 months ago - and she agreed to keep it "off the record". But now that the RE is sending documentation, she will have to report it. Otherwise, she's being unethical.

I talked to two different reps at UHC. But after reading the posts, I'm to call back and ask for a rapid resolutions specialist. Maybe I'll have better luck there.

It's encouraging to know that some of you have been honest with the OB and still had UHC pay the bill. Thanks so much for the encouragement!!

Averi

Originally Posted by quinnavery

First off LOVE THE NAME!!!!!!!!!!

second I had UHC for one of my journies before my husbands company changed insurance in the middle of my pregnancy. I had no problems and we told my OB everything. I was told it is my pregnancy and it is covered. That it wouldn't cover someone using a surrogate.

Are you worried the OB will tell the insurance or have you already talked to the insurance and they said no

[FloridaMama78]

I'm calling for a rapid resolutions officer NOW.... In my policy, the "surrogate parenting" part is under EXCLUSIONS, REPRODUCTION.

Thanks for the ideas!!!

Averi

Originally Posted by lanserx

ok.. kym taught me this...

We have UHC and it reads no surrogate parenting under the fetility part and not the maternity part.. which means that if you were not able to get pregnant it would not cover you to get a surrogate, but since you are he client and pregnant it will cover you. Don't just talk to a rep at your ins, talk to a rapid resolutions officer...

That being said our ob would not bill and we had to self pay and do all the billing and they still paid the OB and now we are fighting to get the money. It has been a huge headache, but UHC WILL pay!

[FloridaMama78]

Rapid Resolutions said that if anything on any of the claims says anything about surrogacy, surrogate parenting, gestational carrier, etc. they will deny the claim.

So I'm just going to leave it up to my IP's to decide whether to cross our fingers and hope the claims are approved... or to make other arrangements now.

Thanks ladies for your responses!

Averi

Originally Posted by FloridaMama78

I'm calling for a rapid resolutions officer NOW.... In my policy, the "surrogate parenting" part is under EXCLUSIONS, REPRODUCTION.

Thanks for the ideas!!!

Averi

[lanserx]

[quote=brokenlola;1417150]

I don't know about this, I talked to everyone under the sun at UHC, including the rapid resolutions supervisor and was told many many times that my pregnancy, as the surrogate, would NOT be covered! I don't know what to tell you, this is a very sticky situation.

Did you specifically say those words,,, "to my understanding since it is under reproductive that means ins wouldn't cover me to hire a surrogate if I was infertile, but since I am the client and I am pregnant my maternity benefits should cover it" I get a no, no, no and then a your right when I argue with those words. Thier job is to pay as little as possible, and most people don't question it further, so they save their company a LOT of money if just one person doesn't push it further.

[lanserx]

PS>. I'm in FL too, but my ins is UHC of Georgia

[colleenz]

Do you have medical insurance through your employer? If so, the EEOC requires them to cover pregnancy the same as they would any other medical condition.

[hopefulsurro1]

I have UHC, was completely upfront with my OB doc, it was in my chart and UHC paid everything.