Steven has health insurance through Anthem Blue Cross, a company that deals in direct-pay individual policies, instead of employer-subsidized group health insurance. A recent change to the plan adds a service, maternity coverage. (Yes, many direct-pay plans require you to buy insurance covering pregnancy and delivery separately, and before you get pregnant.) The problem? If he and his wife want to have a baby, he’s going to have to carry and give birth to it. The maternity coverage only applies to the policyholder, not their spouse or dependents. Pretty sweet if you’re a fertile woman with her own policy. Pretty useless if you’re not.

I received a notice from my health insurer (Anthem Blue Cross) that notified me of changes to my policy. One of the changes they made was adding maternity coverage (I’m assuming at an increased fee, since my premium has been consistently increased every few months). Two lines later it clarifies that this applies to the policyholder-only and does not apply to a spouse of children. I’m a man and don’t see myself needing maternity coverage.

I may be totally misreading this (I’ve attached an image of the text), but it seems like Blue Cross is adding coverage that will never be used and justifying premium increases to generate more revenue without having to provide any additional services.

Well, no, they’re adding this benefit because California law requires them to as of July 1st. (All individual plans in the country will be required to include maternity coverage starting in 2014.) They’re going to keep raising premiums either way, whether they add services or not. And everyone’s health insurance includes services that they’ll never use. That’s the nature of insurance. Presumably some Anthem customers, if not half of them, do have functioning uteruses that they plan to use in the near future.

MORE INFO
I’m pregnant. Can my health plan refuse maternity coverage? [Consumer Reports Health]

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