The insurance landscape has been a rocky one this year! We have not known from one month to the next what will happen with marketplace policies. Even our insurance agents aren’t entirely sure what things will look like in 2018.
Since there hasn’t been much movement on the insurance scene in Congress this summer, we are assuming that most policies will stay in place as-is. But, we are noticing a few changes that could impact the surrogacy world:
1. Open Enrollment – in the 2016-2017 insurance season, open enrollment was from Nov 1 – Jan 31. For 2017-2018, this time-frame has been reduced to Nov 1 – Dec 15.
2. Marketplace Policies – it looks like many insurers have pulled out of the Texas market, with Blue Cross Blue Shield HMO being the main provider. There are several levels available, with premiums depending on deductible and max out-of-pocket. Typically, these policies will cover prenatal care at 100% after the first office visit.
3. Pre-existing Conditions – at this point, we are not seeing any changes in policies and exclusions for pre-existing conditions.
4. Physicians – many physicians are no longer taking marketplace policies.
So, what do you need to do?
If you are a gestational carrier with existing insurance: Contact your physician and delivering hospital to ensure that they will be taking your insurance in 2018. With the number physicians accepting marketplace policies, you may be affected.
If you are wanting to be a gestational carrier: Start researching what doctors in your area will be taking marketplace policies (specifically BCBS). You will only be able to sign up between Nov 1 and Dec 15 – if you have not matched then, consider purchasing the insurance yourself in the meantime, if possible. A gestational surrogate candidate will be matched more quickly if she’s got existing insurance, especially after the market has closed.
If you will be needing a gestational carrier in 2018: Of course, everyone will be hoping for a gestational carrier with existing insurance. But unfortunately, this is not always the case. Know that there are options available for you, however. Several companies, including New Life and Art Risk offer coverage for gestational surrogates that you can add at any time of the year, but you will pay a premium for that. Another option is to see about a catastrophic or short term policy for the carrier, which will not cover the pregnancy, but will likely cover any major medical after a high deductible, and then pay out of pocket for the prenatal care and delivery. Keep in mind that this option is only recommended for those doing a single embryo transfer and planning for a vaginal birth.
The insurance landscape will likely continue to be a volatile place in the coming couple of years. We will continue to monitor it as well so that we can best guide both our gestational carriers and intended parents in the future.
That’s all for now…