Conference turris::womannotes-v2

    Not with most HMO's (health maintenance organizations) that I know
    of.
    
    anyone else?
    
    -Jody

    I can attest that the baby my daughter just had was not covered by
    insurance in either Mass or New Hampshire and cost JUST under $5000.00
    to have in Corcord, New Hampshire.
    
    Gale

    My HMO, Central Mass covered my pregancy and I was single when 
    I had my son.

    Re: .3
    
    My HMO is Fallon and it did not cover it. Maybe it has to also do with
    dependency. My daughter is still classified as my dependent for IRS
    purposes.

    That is absurd.
    
     The Doctah

    Gale,
    
    Based on what you've told us...
    Your daughter did not carry insurance, that would be why she wasn't
    covered. It had nothing to do with her being single. 
    
    It would be unreasonable to expect a company to provide coverage
    to your dependents, dependent.
    
    Gail

    
    
    When my boyfriend's daughter was born in 86 her mother was covered
    by Harvard Community Health.  She was unmarried at the time and
    had no problems with the insurance coverage.

    Re: .6

    I darn well expected her to be covered - she was only 14/15 at the
    time... there is no way in this green earth she could have gotten
    insurance for herself!... 

    As it was, I had to pay for the cost of the birth up front to the
    hospital BEFORE they would even see her on a regular basis...

    I do have avenues for getting *some* of it back, but not as much as if
    the insurance had covered it... Also, the adoption agency picked up the
    actual pediatrician/hospital costs for what they baby used. But the actual 
    cost of lab work, the 2.5 weeks she was in the hospital BEFORE the birth, 
    etc, I contend the insurance *should* have covered, because she *is* my
    dependent and I pay for dependent coverage.

    As far as I'm concerned, that is what insurance is for... its a gamble
    between two people (yourself and the insurance company) that what you
    pay won't be needed...

    G

    Gale,
    
    If you are enrolled in the Digital Medical Plan 1 or 2 then the costs
    for your dependent daughter's maternity admission should be covered. 
    If you did not follow the policy for medical review process then you
    might not receive full maternity coverage.  If you are enrolled in one
    of the HMO's then I do not know what the individual policies are. 
    Check Your Benefits Book, page 3.25 for details re: maternity coverage
    under the Digital Medical Plan.
    
    Regards,
    
    Laura
    

    I am enrolled under an HMO. That was part of the problem... however, my
    EX also has them (the kids) covered, and we that is where we ran into
    the problem - and he has a major medical insurance company.
    
    G
    
    

    Gail, did you bring this situation to the attention of the Corporate
    Benefits folks who manage Digital's relations with HMO providers?  If
    not, I would encourage you to do so, and can provide you the name of
    the appropriate individual.  I'm sure your situation is one he'd
    be concerned about in reviewing HMOs for next year's offering!
    
    Send me mail if you'd like.
    Karen

The Digital Benefits book says exactly nothing about being married being
an eligibility requirment for maternity benefits.  And it does explicitly
state that pregnant dependents are covered.  Since they don't say 
otherwise, that would lead me to believe that single pregnancies are
covered by the basic DEC health plans, not matter what state you are in.

As for whether such a situation exists in Vermont, I would guess that
it varies from insurance company to insurance company, and policy to
policy, rather than depending on what state you are in.

And I find it utterly absurd that any insurance policy that covers
pregnancy for married women wouldn't cover it for unmarried women.  :-P

D!

    With some insurance companies you must have a "rider" for maternity
    coverage.  When I was working for and Architect in Arkansas there
    were only 5 employees so we had a very small insurance policy and
    as no-one other than myself was in child-bearing years the office
    opted not to take the rider and I had to pay for my own maternity
    coverage.  (we moved to Canada 1 month before I delivered and Ontario's
    wonderful socialistic medicine picked up the entire tab and I got
    back most of the money I had prepayed in Arkansas!)
    
    This may be what you roommate was referring to.  It has nothing
    to do with marital status.  Also, if single women do not have
    dependent coverage they may run into problems with the pediatric
    coverage.

    There was a time when Digital's insurance did NOT cover maternity
    benefits for dependents other than wives.  I believe that changed
    back in June 1986.  I know this because my daughter was having some
    gyn problems and in the course of some conversations I had with
    John Hancock they told me that the policy was being changed to 
    provide maternity benefits for depnedents (other than wives).  I was
    struck by the fact that under the then current policy I paid the same 
    $$ for coverage that men did and the only dependent I had that could
    ever be pregnant didn't have the same coverage.  Had she been pregnant
    I probably would have pushed it.
    
    Anyway, medical coverage is determined by a contract between the provider
    and the company (in this case) and if you think that contract should be
    changed you need to let Benefits know.  Understand they may or may not
    be able to work that with any given HMO and that the cost of adding the
    coverage will probably be a factor.  Personally, I think that NOT
    covering maternity for unmarried dependents is unrealistic in today's
    society and smacks of a moral judgement that a company should not be
    making.
                                 

    re: .14
    
    >>Anyway, medical coverage is determined by a contract between the provider
    >>and the company (in this case) and if you think that contract should be
    >>changed you need to let Benefits know.  Understand they may or may not
    >>be able to work that with any given HMO and that the cost of adding the
    >>coverage will probably be a factor.
    
    This "contract" issue has changed since under Digital Plan 1 and 2
    Digital is self-insured.  The contract between Digital and John Hancock
    is one that ensures that John Hancock pays claims based on policy that
    Digital establishes, and I'm sure the terms of the contract also
    outline the charges that DEC pays JH for administering the two plans.
    
    As for HMO, there is no contract between DEC and the HMO as to what
    services will be provided to employees.  The terms of benefits coverage
    are determined by the HMO, what gets negotiated is the group rate that
    DEC pays when employees enroll into these various HMOs.
     

    I don't know whether my HMO, Matthew Thorton/Hitchcock Clinic in New
    Hampshire, covers maternity for dependents, but they do try to take
    some of the stigma away from being an unmarried parent.  The wording in
    the pre-natal booklet they give out uses the term "partner" instead of
    husband.  They also offer a separate Lamaze (sp?) class for single 
    people who aren't comfortable with the partner oriented class that is
    given.