Couples who have difficulty getting pregnant can turn to surrogate pregnancy as an option to have a child. A surrogate pregnancy is when a fertilised egg from a mother and father is implanted into a surrogate mother to carry the baby to term. The surrogate mother does not have any genetic ties to the child, and the surrogate mother is usually paid a lump sum of money to carry the child for the couple. Any couple considering surrogacy should contact a lawyer for a contract to be drafted for the surrogate mother to sign that will cover payment, as well as health insurance coverage.
In addition, health insurance coverage can be tricky during a surrogate pregnancy. Oftentimes, the parents' health insurance will not cover the cost of the surrogate's medical coverage, and the surrogate mother's insurance may have exclusions as well.
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Health Insurance Coverage for Surrogate Pregnancy
In most cases, the parent's health insurance will not cover a surrogate's medical expenses during a pregnancy. Insurance companies consider surrogacy as a type of infertility treatment and often do not cover any costs associated with the treatments. Instead, the surrogate--the woman carrying the baby--will be responsible for obtaining health insurance. Under law, her health insurance cannot deny her coverage whether it is her child or not. HIPPA laws require that any patient information not be disclosed for privacy reasons. If she does not have health insurance, it is best to try and get her covered under a plan before the pregnancy begins. The parent's will be responsible for this cost in most cases, which will provide health care coverage for the mother during and shortly after the pregnancy for postpregnancy checkups and treatments.
You as a patient are covered by many state laws and regulations protecting your identity and medical information. It is tempting to say that a surrogate mother's health insurance will be obligated to pay for her health care needs, since it is none of their business whose child it really is. However, her plan may have a surrogacy exclusion clause, meaning they will not cover any costs associated with the pregnancy if you plan on becoming a surrogate. You should check with your provider before planning a surrogate pregnancy. If you lie, it is considered insurance fraud if they find out, which they will then require you to pay back all of the fees in full, plus you may get sentenced to jail time. Insurance companies take this issue seriously, and it should not be taken lightly.
The parents' health care insurance may not extend gratitude in covering a surrogate mother under their plan either. Many insurance companies have a clause that specifically excludes surrogate pregnancy care for the parents as well. Instead, the surrogate mother's insurance should be used if at all possible, and the parents will pay any fees and co-pays associated with the pregnancy.
No Health Insurance
If the surrogate mother does not have health insurance, or her insurance does not cover surrogacy, the baby's parents will likely cover the costs. In rare cases, the parents may choose to pay out of pocket. However, it is much cheaper to get the mother enrolled into a health care plan separately, which usually costs about £13,000 to £16,250. Since the parent's health care plan will not cover the cost of the surrogate mother's bills, the surrogate mother's health insurance plan will cover the prenatal, delivery and postnatal care for her.
There are various surrogate health care plans on the market today, including ones from companies like the New Life Agency (see Resources). Before enrolling in any of these plans though, check with your doctor and hospital to be sure he takes this insurance. These plans are designed specifically for surrogate mothers and have a designated expiration date and limited coverage for certain procedures. For instance, the number of ultrasounds covered, some prenatal testing and the number of prenatal and postnatal doctor visits may be limited.
If the surrogate mother has no health insurance, or the price to obtain coverage is expensive, another option is the Maternity Advantage Maternity Card. This is an advocate system that negotiates with hospitals and doctors offices to lower their bills. This group may also help set up payment plans for as long as you need. The Maternity Advantage Maternity Card is not insurance itself, but an advocacy group that you enrol in to help you lower your bills.
Keep in mind that using Medicaid as health insurance for a low-income surrogate mothers could be viewed as a misuse of state funds and of the governmental system and could be a crime in some states.
While there are many insurance companies that have surrogacy exclusions, there are several that do not. Medi-Cal, California's state medical insurance provider, has no surrogacy exclusion. In addition, Tri-care, which covers military personnel and their families, also covers surrogate pregnancy costs. In addition, you should check with your own policy as they vary from state to state and company to company. Some companies provide more extensive health care benefits to their employees than others, and you may have extended coverage for a surrogate pregnancy.
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