or Connect
Mothering › Mothering Forums › Pregnancy and Birth › Understanding Circumcision › Why does insurance cover circ in the US?
New Posts  All Forums:Forum Nav:

Why does insurance cover circ in the US?

post #1 of 45
Thread Starter 
I'm from Canada; so our medical 'rules' are different here. OHIP (our universal tax-funded health 'insurance') used to cover circumcision until they realized it wasn't necessary. It got me thinking...

Insurance companies as a whole are only concerned with one thing: their bottom line. I've seen many references to how insurance companies simply decide not to cover someone's lifesaving surgery because it's too costly. So, why is it that they so readily cover un-necessary circumcision??



On a side note: If they stopped covering circ's; they'd have more money to save more people -- but that's never how it works, is it?

*** Please read post #17 before replying. Thanks.
post #2 of 45
As far as I know, many of them have stopped covering it. It's now considered "cosmetic" and the last stats I read say that 1 in 3 boys/men in US are now intact.
post #3 of 45
Thread Starter 
I wonder if anyone here can confirm that...? If you're insured, does your insurance cover circ...?
post #4 of 45
My DD is on Medicaid (state health insurance for children)-- and it does cover circ in our state

We haven't recieved any info on hubby's new health insurance, but I'll be sure to ask as soon as the paperwork comes in.
post #5 of 45
Kaiser covers it, at least a good portion. I was groaning to myself that they could NOT pay for these circs, and then DO pay for doulas, and everyone would be better off!
post #6 of 45
Something that irks me is that some parents are all gung-ho for circumcision until they find out their insurance won't pay for it and it has to come out of their pockets... then, it's let's leave the boys intact. The almighty dollar ($$$) is sometimes a deciding factor.

I guess a win's a win; hopefully, when they grow up to have kids there's more of a chance of future boys being left intact. And if it's not insurance, it's laziness usually involving a dad who does want to circ, a mom who doesn't and the mom says the day can do it he makes the appointment and takes him there. We've read many stories here about boys staying intact that way.
post #7 of 45
Quote:
Originally Posted by Microsoap View Post
involving a dad who does want to circ, a mom who doesn't and the mom says the day can do it he makes the appointment and takes him there. We've read many stories here about boys staying intact that way.
That's what happened with my sister and her boys!
post #8 of 45
Medicaid does not cover infant circumcision in North Dakota. Neither does my insurer (at least as a state employee), which is Blue Cross/Blue Shield of North Dakota.
post #9 of 45
When I was pregnant with my youngest (he's now 4 1/2), dh called to find out if circ was covered. They told him it WAS NOT. We assumed we'd have to pay for the circ ourselves (this was before I was educated).
They circed him at the hospital and we never got a bill. I'm not sure what happened, but I wonder if they just billed it under "something else".
I know my dr told me outright when I was pregnant with my 2nd son (16 years ago) and my Insurance Co said they would only pay for a 3 day stay instead of a 5 day stay (I was having c-section and they liked to keep you a lot longer back then) that I would have a "fever" after the third day so I could stay. And I was there all 5 days and never got billed for anything, insurance paid for all of it (and I never had an actually fever, but I wonder what my bill to the Ins Co says in regards to that).
post #10 of 45
Not all insurance covers it, but most patients don't check their EOB's or hospital bills. The hospital will submit the procedures with codes, so when patients get the bill for their "Labor and Delivery" unless they actually audit the bill, they don't realize they are paying the full amount for the circ. They just grumble about how much they pay for insurance and how much it costs to have a baby, and pay the bill.

Something else to consider is that state law may REQUIRE insurance companies to cover it. So, if you live in a state that does that, you are paying for coverage for cosmetic circumcision, whether you want it or not. The same goes with many other procedures that you probably don't want coverage for, like Port Wine Stain removal in Minnesota. Nice, huh?
post #11 of 45

And on the flip side....

Some insurance only covered "emergency circumcision", some unscrupulous doctors will have their staff commit insurance fraud by typing a code out saying it was for "emergency" reasons.

One member her said she was doing data entry and encountered this quite a few times. Sad. Wrong.
post #12 of 45
Medicaid doesn't cover it here, but my private plan (through dh's employer) does. I'd love to see them drop it, seeing as they employ A LOT of people in this area.
post #13 of 45
Medicaid in NC does not cover it! It was a recent change, because of the work of intactivists.
post #14 of 45
i don't know of any insurance in the us that covers circ ... which is good!
post #15 of 45
Anthem Blue Cross in CT covers it...I also believe Connecticare does as well. I have written letters but have never gotten any response.

I even asked why they wouldn't cover my tummy tuck since they cover other cosmetic surgery.
post #16 of 45
Tricare (military health insurance) covers neonatal circumcision, with no justification required. This is so much worse than an independant insurance agency paying for circ - YOUR TAX DOLLARS ARE PAYING FOR MGM!!!!!
post #17 of 45
Thread Starter 
Ok, so if many insurance companies cover circumcision; wouldn't it be wise to write letters with information to the president of the insurance company (or wherever they make their decisions); and send them information proving it's totally cosmetic and they don't have to cover it? If information is provided that other insurance companies don't cover it (perhaps even, by name); they'd seriously consider not covering it, right? Afterall, why pay for something they don't have to, when it puts more money back into their pockets...?
post #18 of 45
Medicaid covers it here. For some reason though it has to be done as an outpatient (at least at our hospital). If the parents have medicaid and want it done in the hospital they pay $200 dollars. I don't know why that is, and I dont' know if that is some sort of co-pay or it that covers the entire thing.

I don't think my private insurance (at the time...I was not on my husbands) covers it. When I first got pregnant, I had to pay my OB a fee for my prenatal care (in installments). The itemized list listed circumcision as costing $600.00 (if you chose to have it done) out of pocket. I can't imagine that being a co-pay. If it is, that is utterly insane.

I'm not sure if my husbands insurance covers it.
post #19 of 45
duplicate. oops.
post #20 of 45
Quote:
Originally Posted by Fyrestorm View Post
Anthem Blue Cross in CT covers it...I also believe Connecticare does as well. I have written letters but have never gotten any response.

I even asked why they wouldn't cover my tummy tuck since they cover other cosmetic surgery.
Three "cosmetic" surgeries that I KNOW are covered by the Arizona welfare health care system: circumcision, gastric bypass, and "excess" skin removal after a large weight loss. You have to "manipulate" the system for the last two, but you can get the state to pay for it, and there are doctors willing to help you. I'm not at all surprised that circumcisions are paid for by many states.
New Posts  All Forums:Forum Nav:
  Return Home
  Back to Forum: Understanding Circumcision
Mothering › Mothering Forums › Pregnancy and Birth › Understanding Circumcision › Why does insurance cover circ in the US?