Why does insurance cover circ in the US? - Mothering Forums

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Old 01-08-2008, 10:03 PM - Thread Starter
 
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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.

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Old 01-08-2008, 10:11 PM
 
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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.
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Old 01-08-2008, 10:38 PM - Thread Starter
 
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I wonder if anyone here can confirm that...? If you're insured, does your insurance cover circ...?

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Old 01-08-2008, 10:40 PM
 
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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.

---feeling like an emu on acid---
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Old 01-09-2008, 01:54 AM
 
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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!
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Old 01-09-2008, 04:15 AM
 
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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.
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Old 01-09-2008, 11:38 AM
 
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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!
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Old 01-09-2008, 02:00 PM
 
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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.

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Old 01-09-2008, 09:31 PM
 
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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).
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Old 01-10-2008, 01:08 AM
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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?
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Old 01-10-2008, 06:11 AM
 
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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.
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Old 01-10-2008, 03:19 PM
 
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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.

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Old 01-10-2008, 05:45 PM
 
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Medicaid in NC does not cover it! It was a recent change, because of the work of intactivists.

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Old 01-10-2008, 05:50 PM
 
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i don't know of any insurance in the us that covers circ ... which is good!

me, dh and 2 boys = our family (oh and a cat...who is also a male...lol)
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Old 01-10-2008, 05:59 PM
 
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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.

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Old 01-10-2008, 06:38 PM
 
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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!!!!!

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Old 01-10-2008, 08:39 PM - Thread Starter
 
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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...?

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Old 01-11-2008, 04:30 PM
 
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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.
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Old 01-11-2008, 11:49 PM
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duplicate. oops.
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Old 01-12-2008, 01:29 AM
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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.
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Old 01-12-2008, 01:32 AM
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Originally Posted by Blu Razzberri View Post
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.
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Old 01-12-2008, 04:14 PM
 
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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.

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Old 01-12-2008, 04:36 PM
 
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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.
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Old 01-12-2008, 04:53 PM
 
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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.
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Old 01-12-2008, 04:59 PM
 
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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.
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Old 01-13-2008, 12:39 AM
 
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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.

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Old 01-13-2008, 01:00 AM
 
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Originally Posted by Night_Nurse View Post
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.
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Old 01-13-2008, 04:17 AM
 
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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.

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Old 02-14-2008, 05:31 PM
 
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Do you know how to find out if your state mandates coverage?

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Old 02-14-2008, 05:44 PM
 
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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.
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