Surviving the Workday

If you need an individual plan for health insurance, you might just find yourself denied if you’ve had a c-section.

It’s really hard to express the frustration over individualized health insurance plans to people who don’t have them. The basic difference is that if you have an employer, the employer can negotiate for group rates, and coverage for everyone. As an individual seeking insurance without an employer, you negotiate on your own and the insurer can raise the rates whenever it wishes, deny all sorts of coverage, cancel you without a reason (illegal), and your only recourse is to go elsewhere. Oh, but where is elsewhere? It’s just another insurance company. And if you’re denied coverage by one insurer, you’re red flagged for the rest of your life as a risk only to be denied, and denied, and denied. It is a terrible situation to be in. I know.

This is the story of a woman who had a C-section, and was then denied health insurance because of it. Why? It raised the chance of having another C-section. Note that her C-section was not elective, and had she had the good sense (ha, ha, I kid) to get herself sterilized, she could have coverage:

“Obstetricians are rendering large numbers of women uninsurable by overusing this surgery,” said Pamela Udy, president of the International Caesarean Awareness Network, a group whose mission is to prevent unnecessary Caesareans.

Although many women who have had a Caesarean can safely have a normal birth later, something that Ms. Udy’s group advocates, in recent years many doctors and hospitals have refused to allow such births, because they carry a small risk of a potentially fatal complication, uterine rupture. Now, Ms. Udy says, insurers are adding insult to injury. Not only are women feeling pressure to have Caesareans that they do not want and may not need, but they may also be denied coverage for the surgery.