Why does insurance cover circ in the US? - Page 2

[llamalluv]

Originally Posted by Blu Razzberri

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...?

You are assuming that state law doesn't REQUIRE insurance companies to cover it.

[MamaVolpe]

I have worked for two insurance co. and circ is often an option that employers can purchase for their employees. The company itself may not offer circ to all policys but some states mandate the coverage and some employeers option to have that additional coverage. It is the same for gastric bypass, some employers pay extra for those coverage options.

[mack]

Quite recently, Federal Employee's Blue Cross/Blue Shield stopped covering it, I believe due to the change of heart from the American Assosiation of Pediatritions who no longer recommend it. So that's a pretty big company saying "NO". I wonder if the companies that still cover it are just behind the ball and have the change in the works, now that they have the backing of the AAP in refusal.

[stever_45723]

I just checked the federal BC/BS that my partner carries, and it does indeed cover RIC. I don't know whether different agencies in the country have different coverage policies. THe government also allows different levels of coverage. It is ppossible that on the lower level coverage policies RIC is not covered, but it certainly is on my partner's policy.

[delphiniumpansy]

I normally don't post here because I have girls but I do recall from when I was preg the first time that our insurance does not pay for circumcision. Blue Cross of WA does not consider it medically necessary.

[Night_Nurse]

Can anyone please explain why government *would* mandate that insurance cover circ???? I've never known that. I know the government stepped in an made ins. co. give minimum stays for vag & c-sec births, but I didn't know circs must be covered in some states. I'm wondering why.

[fruitful womb]

Originally Posted by Night_Nurse

Can anyone please explain why government *would* mandate that insurance cover circ???? I've never known that. I know the government stepped in an made ins. co. give minimum stays for vag & c-sec births, but I didn't know circs must be covered in some states. I'm wondering why.

Night_Nurse,
Could it possibly be because the vast majority of the government are circumcised themselves and are pro-MGM? And purposely perpetuate circumcision for the sake of their own ego's?

Just a thought.

[Night_Nurse]

Originally Posted by fruitful womb

Night_Nurse,
Could it possibly be because the vast majority of the government are circumcised themselves and are pro-MGM? And purposely perpetuate circumcision for the sake of their own ego's?

Just a thought.

Maybe. I just thought the govt would only mandate something if there was a real need.
Now I may be preaching to the choir here, but I don't think there is a real "need" for RIC.

[abiyhayil]

Do you know how to find out if your state mandates coverage?

[Eben'sMama]

In California, most private ins companies don't cover it (BC/BS, Pacificare, etc.), I believe. I also know for a fact that Medi-Cal (state health coverage) does NOT pay for circ, as it is considered medically unnecessary.

[Frankly Speaking]

Originally Posted by MamaVolpe

The company itself may not offer circ to all policys but some states mandate the coverage.

The only state that mandates coverage for routine circumcision is New Mexico. That law was only recently passed. I think it was 2002 or 2003. This came at a time when other states were passing laws defunding Medicaid circumcision so this was an unusual action.

.

[layla983]

Fun fact our mine insurance (it's state employee insurance, DH is a teacher). I called to find out what was & what wasn't covered. My stuff, minus any pain meds for labor, was covered at 100%. DS was only covered at 80% after he filled the $100 deductable. I thought that was weird since I was covered at 100%, I just assumed DS would be because it read in the policy book like it would be. When I mentioned that I thought that was odd, the lady on the phone blurted out, "But the good news is that we cover 100% of circ, done in the hospital or at the peds office later!"

My response?

"Um, no, that's the worse news considering I have no interest is cutting parts of my baby off any at point without just reason. But I tell you what, how about you apply that $600 fee you'd pay for a surgery that isn't medically needed for my newborn to the actual NEEDED cost of his hospital stay? I think THAT would be the good news."

She changed the subject quickly.

So they won't pay the $350 for DS's actually needed charges, but they WOULD HAVE paid an extra $600 for surgery. Makes perfect sense, doesn't it?

[Raelynn]

Originally Posted by layla983

"Um, no, that's the worse news considering I have no interest is cutting parts of my baby off any at point without just reason. But I tell you what, how about you apply that $600 fee you'd pay for a surgery that isn't medically needed for my newborn to the actual NEEDED cost of his hospital stay? I think THAT would be the good news."

Great response! It sure makes no sense what is and isn't covered.

[bluetoes]

When we renewed I wasn't given the option and was too wimpy to ask. Wish I hadn't been.

[trmpetplaya]

Originally Posted by delphiniumpansy

I normally don't post here because I have girls but I do recall from when I was preg the first time that our insurance does not pay for circumcision. Blue Cross of WA does not consider it medically necessary.

Premera in WA also doesn't cover it - I know because my ex-co-worker had a boy Medicaid doesn't cover it in WA either I should have asked KPS when I called them about how they cover homebirth, but I didn't think to.

[thixle]

Found out today that TennCare covers it, only if it is done within 30 days
It's actually in the manual-thingy that you choose doctors/care providers from. :

[MarnieMax]

Originally Posted by Eben'sMama

In California, most private ins companies don't cover it (BC/BS, Pacificare, etc.), I believe. I also know for a fact that Medi-Cal (state health coverage) does NOT pay for circ, as it is considered medically unnecessary.

We had Pacificare when my sons were born and they covered it at the time (10-15 years ago). Perhaps things have changed. DH has a new job and we are now under Blue Cross. Circumcision is specifically listed as covered under 'infant care', etc. I was very disappointed.

[KBecks]

it's elective cosmetic surgery and it should not be covered. Insurance companies would save!

[Keeping up]

Interesting stuff (well, odd choice of words).

Canada's circ rate is significantly lower than the US - and I would suggest no insurance coverage as the primary reason, which I guess is a good thing. [FWIW, I think Canadians have a different perspective on the 'look' of anything, in general - so a bit different than americans.]

I wonder what would happen if the US rules were changed (i.e. no coverage, no legal requirement etc.) I wonder how long it would take for US circ rates to decline to Cdn levels.

I have super-duper insurance through my employer that covers the periphery items (i.e. 100 drug coverage, massage, PT, private room, blah blah blah). I wouldn't at all be surprised that circ is covered by my employer.

I didn't know circ wasn't covered by OHIP (again, universal health care coverage) with #1 son - it wouldn't have made a difference. My husband made the decision not to circ his boys long before he was born - and I never went a step further to determine any costs.

[Frankly Speaking]

Originally Posted by AnnD

Canada's circ rate is significantly lower than the US - and I would suggest no insurance coverage as the primary reason

That is a small contributing factor. At one time, the Canadian circumcision rate was about where it is now in The US but by the early part of this century, it had fallen to about 17% nationwide and most of that 17% was concentrated in the western provinces. An event in 2002 made a major contribution to the current rate that is about 6%. Prior to this time, Dr. Dennis Kendall had been issuing warning memos to the College of Physicians and Surgeons of Saskatchewan that they were at financial risk in performing circumcisions and those memos spread among the other provinces. However, before August 2002, they were not given much attention. That all changed in August 2002 when Ryleigh McWillis was circumcised in Vancouver and died a couple of days later. Dr. Kendall's warnings became very real. Instead of parents rejecting circumcision, the doctors in Canada started refusing to perform circumcisions at all. Soon after that, the governments of the various provinces in Canada stopped paying for circumcisions.

It was this combination of factors, the very public death, the doctors refusal, the education of parents and the end of coverage for the procedure that mostly brought it to an end.

Likewise, it will be a combination of factors that will bring circumcision to an end in The US. At some point, there will probably be an action that acts as a catalyst like Ryleigh McWillis' death or a court case that will consolidate the work on other fronts to bring it to an end.

.

Likewise


, which I guess is a good thing. [FWIW, I think Canadians have a different perspective on the 'look' of anything, in general - so a bit different than americans.]

I wonder what would happen if the US rules were changed (i.e. no coverage, no legal requirement etc.) I wonder how long it would take for US circ rates to decline to Cdn levels.

I have super-duper insurance through my employer that covers the periphery items (i.e. 100 drug coverage, massage, PT, private room, blah blah blah). I wouldn't at all be surprised that circ is covered by my employer.

I didn't know circ wasn't covered by OHIP (again, universal health care coverage) with #1 son - it wouldn't have made a difference. My husband made the decision not to circ his boys long before he was born - and I never went a step further to determine any costs.[/QUOTE]