So here's my drama. We have health insurance through Anthem's individual plan, which considers pregnancy a pre-existing condition and requires a maternity rider. We couldn't afford the additional $800/mo for the rider that didn't kick in until we had it for 9 months (like that makes sense anyway) and we were planning a home birth. I called Anthem, asked what would happen if I didn't have the rider and an emergency came up that required a hospital birth. The answer: You will be covered if you or the baby are in danger. I called again (3 times!) when we found out ds was breech to make sure this was still the case and every time they said the same thing. Well, our sweetie was an emergency c-section nightmare, and guess what--Anthem refuses to pay. Our surgeon submitted an appeal on our behalf and Anthem admits it was "emergent" but now they're saying they don't have to pay. I'm planning another appeal, but I'm wondering if anyone has advice or has had a similar experience?
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2/8/10 at 2:38am