Should maternity coverage be optional?

Maternity coverage (usually at 100% coverage) is usually included in most health benefit coverages and yet only applies to a small fraction of the people who have health coverage. It's also the highest malpractice specialty out there. Should those people who are over a certain age, or know they cannot or will not have children be forced to pay for coverage they know they'll never use? Should it be optional?

Well, good question. But if you start breaking out maternity coverage for people "over a certain age" or "not a certain gender" then you have to give the option of deleting prostate cancer coverage for women, and ovarian cancer treatment for men, etc.

Which boils down to, insurance companies having to do SO many different sets of rates, that it's too expensive to do ANY health insurance.

Additionally, the only people who would BUY maternity coverage, would be those who want to have a baby, or who are "at risk" of having a baby. So some women would have babies, uninsured, if they were unplanned. And all the women who bought the coverage, well, it would go through the roof, price wise.

So from a practical point of view, eliminating some coverages for cost, across the board, will be expensive to the insurance companies, and result in more uninsured people, and unhappy clients.

On the other hand, there ARE companies that exclude maternity benefits now - you could just switch over to one of those!

It is optional in my State, for some of those reasons. However, it's usually requested by employers taking out group policies because employees want it; but for individual policies in my state, it's completely optional. So, for example, a man isn't paying for a maternity benefit he cannot possibly use, and a woman who can't or won't have any children isn't paying for something she doen't need.

I don't think the malpractice risk should be the driving force behind whether a maternity benefit is offered. To be fair, there are other specialties with malpractice lawsuit statistics nearly equal to obstetrics. According to a 2005 Harvard study that looked at services rendered from 2000-2003, these specialties carry the highest risk: emergency medicine, general surgery, orthopedic surgery, neurosurgery, obstetrics/gynecology, and radiology. If each pose nearly the same risk, it would be inequitable (and discriminatory), for an employer to shy away from providing a maternity benefit for its employees due to malpractice risk. In states where the maternity benefit is mandated, removing the mandate to avoid adverse premium effects would be an inequitable "knee jerk" reaction, again because of the Harvard statistics.

I see your point, but I have always felt that the BEST way to reduce health insurance premiums adversely effected by malpractice lawsuits is comprehensive reform of our laws, coupled with strengthened state laws that remove a bad doctor after one valid lawsuit or complaint. It's absolutely sickening to me that incompetent physicians are given a slap on the wrist and then permitted to continue practicing.

Just my two cents.

EDIT: In the U.S., there is no federal statute, per se, requiring a maternity benefit MUST be included in a policy. However, depending on the circumstances, the lack of this benefit can be viewed as a violation of Title VII of the Civil Rights Act of 1964. That's why the states closely regulate how this benefit is applied to policies.

Most group carriers automatically include maternity, and most individual policies don't offer maternity coverage. On a group, if there are 15 or more employess, maternity must be included. This is even if they are all male. You can find individual coverage that does not include maternity.

Boy you'd sure think so.

Many years ago it was. But change in Federal law made it mandatory about 25 years ago!

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