This woman had an IUD implanted. An IUD is an effective method of birth control, and her insurance company paid for it. However, when she was ready to start a family, her insurance company refused to remove the device, saying it wasn't medically necessary. She filed a complaint, and won. She is now the mother of a six month old baby: http://www.blogforchoice.com/archives/2011/08/the-right-to-ch.html Why on earth would anyone refuse to remove the IUD? And if they can refuse to remove a birth control device, can they refuse to implant one?
Why on earth would doing so be considered medical treatment a major medical insurance policy should pay for? The glaring question is why did they pay to have it implanted in the first place. That wasn't medically neccessary either!!!
They should pay for everything right? But they's better not raise my premiums!!!! This is like making a homeowners insurance policy pay for your kitchen remodel.
Um...What was stopping her from just going to a random doctor to get it removed? Insurance companies have no veto on what you can do with your body. You can have anything done to your body you want and insurance companies cant stop you from doing it.
No one refused to remove, the insurance company just wouldn't pay for it. Insurance is not there to cover every single elective procedure. If she wanted the IUD out you pay a OB/GYN and they remove it, case closed. Don't expect insurance, which is designed for emergencies, etc.. to cover every little sniffle and wipe.
Don't put words in my mouth! They should pay for what they're contractually and legally obliged to. The outcome of this case suggests they initially failed to do so. Whether the IUD implant or removal should be covered by the insurance (specifically or at all) is a different question. It seems it was when they took her premiums, it was when they paid for the device to be fitted but suddenly stopped being when she wanted it removed.
So, the deafening silence to my question appears to be a tacit admission that the title of this thread is basically a lie. That insurance companies can NOT prevent this woman from becoming pregnant if she wants to.
Why would anyone go to an insurance company for a medical procedure? Usually I see a doctor, or some other medical practitioner for that. I love my insurance guy, he gets me great prices on most things (healthcare is too regulated to be cheap) but I don't think I'd trust him to fix anything more than a ham sandwich. Of course, the article is more clear about the matter. She had the procedure done, then demanded payment. And, of course, those who want *real* health insurance, that is, insurance which indemnifies against unexpected loss, must foot the bill for people like this.
Once again, we have people who don't understand reality. The insurance company didn't stop her from getting pregnant. She was. My question is, why is insurance paying for an IUD in the 1st place? Those who complain about insurance being "unaffordable" better take a long look in the mirror and realize, if you expect an insurance company to pay the brunt of every single, solitary procedure known to exist, then premiums are gonna be expensive. There is no logical reason for an insurance company to pay for IUDs. It's like paying for Viagra. Why?
Doesn't an insurance company get to decide what level of coverage they offer and what level of premiums, co-payments etc. they charge in return? Once they've made that agreement they can't simply renege on it, no more than the customer can just stop paying the premiums. You can make that argument. I'd suspect the key point in the mind of this patient though was that while they'd been more than happy to pay for it to be implanted, they wouldn't pay to have it removed.
My personal opinion is that if they were happy to pay for it to be implanted, they should also cover her when she wanted it removed. Either cover the implantation and removal, or don't cover it at all.
No. Most states have mandated coverage items. In some states, like California, there are over a thousand mandates. When one buys "insurance" one has a limited choice as to providers because there are so few companies that can be in the business, and then one must purchase coverage that one may or may not want.
Fair enough. So they were legally obliged to cover this treatment and presumably sold their coverage on the basis of working within that law. They had absolutely no right to suddenly refuse to do so. If the company didn't think it is right for them to be forced to cover this procedure, they should lobby to get the law changed. If they really wanted to make a stand, they should publicly state that they're not going to cover this kind of procedure at all - that way their customers know where they stand. The immediate issue remains that they paid for one part of the procedure (the implantation) without complaint but suddenly refused to cover the second part (the removal). Regardless of the bigger picture, I see no justification for that.
The insurance companies would prefer that women not get pregnant because childbirth is their biggest expense. That is why it costs so much more to cover your spouse than it does to cover just yourself. A married woman is a "loss unit" that insurers would prefer not to cover.
Why are they obligated to do that? Thats like saying that if they agree to pay for my liposuction, they should agree to stuff the fat back in later if I want. Its a retarded expectation. The title of this thread is inflammatory and flat wrong. The fact that this woman has to pay for this procedure herself does not mean the insurance company if forcing her to do a (*)(*)(*)(*) thing.
Technically, it wasn't medically necessary. If Lasik eye surgery is not covered by insurance, why would removal of an IUD be covered? If she wanted it removed, she had the option of paying for the removal herself. It's not like they were denying her the freedom to remove it. That, I would agree, would be a violation of her rights. However, unless someone can point to the specific law which states so, becoming pregnant is not a right.