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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsMillion dollar baby: Canadians handed $1M bill after woman gives birth in U.S.
Last edited Tue Nov 18, 2014, 07:33 PM - Edit history (1)
http://www.ctvnews.ca/canada/million-dollar-baby-canadians-handed-1m-bill-after-woman-gives-birth-in-u-s-1.2107020Huculak was six months pregnant when she flew to Hawaii for a holiday with her husband in October 2013. Before her trip, she bought Blue Cross insurance and received approval from her doctor.
But two days into her trip, Huculak's water broke and she spent the next six weeks on bed rest in a Hawaiian hospital. Her daughter was born nine weeks early and spent two months in intensive care.
While she's grateful that her 11-month-old daughter is now healthy, Huculak and her husband were left with a $950,000 medical bill.
Note: this occurred in 2013 and wouldn't have been a problem post-ACA.
Fawke Em
(11,366 posts)All those Canadians come down here to partake of it!
reflection
(6,286 posts)It's the American way!
hughee99
(16,113 posts)It's just the costs that are all messed up.
pnwmom
(108,978 posts)Unfortunately, it wasn't yet in effect in 2013, when this woman was hospitalized and gave birth.
SickOfTheOnePct
(7,290 posts)Doubtful that the ACA would apply.
pnwmom
(108,978 posts)SickOfTheOnePct
(7,290 posts)elias7
(4,006 posts)Before you get all sarcasmy, consider the medical issues first-- pregnant woman's membranes ruptured in the first trimester, yet the fetus survived, only to be born at 29 weeks and still survive to be discharged from the hospital. This is a testament to modern medicine and our healthcare system.
If you can't see that, God knows what would satisfy you.
PotatoChip
(3,186 posts)But two days into her trip, Huculak's water broke and she spent the next six weeks on bed rest in a Hawaiian hospital. Her daughter was born nine weeks early and spent two months in intensive care.
6 weeks + 8 weeks = 3 months, 2 weeks.
As to her "medical issues", she had none that would have caused the early labor.
Her specialist at home in Saskatchewan has written to Blue Cross, saying that the bladder infection did not lead to Huculak's early labour. But her coverage was still denied.
Read more: http://www.ctvnews.ca/canada/million-dollar-baby-canadians-handed-1m-bill-after-woman-gives-birth-in-u-s-1.2107020#ixzz3JYZy2o00
Furthermore, even if one were to take your post at face value, it does not demonstrate any sort of superiority of our health care system over Canada's, as was your assertion.
Nor do I see any justification for such an outrageous charge. I realize that her hospital stay, as well as the neonatal care is going to be very expensive, but $950,000 expensive? Really!?!
In any event, the woman's travel insurance should be the ones to pay for and dispute the bill; if they are so inclined.
Liberal Veteran
(22,239 posts)Or if we wanted to break it down a bit more...the final price tag is equivalent of around 24 coronary bypass surgeries. It is sorta tangential to the story, but it does raise some interesting questions about the nature of hospital billing.
The next thing we'll hear is the usual "what is billed and what ends up being paid by an insurer are very different things." While true, it's stupid. The song and dance between the hospital bean counters and the insurance bean counters gives us what exactly? Hospitals that have master chart list prices that are ridiculously high in the hopes that somewhere between what they actually get and what they say they charge is close to turning a profit? And woe to the person who gets caught in what happens when the insurance denies the claim legitimately. "Oooops....sorry while you were having your surgery, we secretly replaced your in-network anesthesiologist with out of network Folgers Crystals! Here's the ridiculously overpriced bill for that service. Sucks to be you."
All this story does for me is make me angry at how stupidly expensive and ridiculously bureaucratic our healthcare system has become and even going out of one's way to make sure that you've done the right things still can end up costing you a fortune and/or a nervous breakdown trying to correct.
ScreamingMeemie
(68,918 posts)Ummmm... "pregnant woman's membranes ruptured in the second trimester..."
dionysus
(26,467 posts)Strelnikov_
(7,772 posts)OTOH, if you don't have the money, yer' up shit creek.
Blue_Tires
(55,445 posts)and I was like, when the hell did the treasury start printing a million-dollar bill?
jberryhill
(62,444 posts)DesMoinesDem
(1,569 posts)dionysus
(26,467 posts)reflection
(6,286 posts)PoutrageFatigue
(416 posts)....Murrka!!!
KamaAina
(78,249 posts)Nay
(12,051 posts)its life, unless the parents file a form rejecting citizenship for their child!
Nay
(12,051 posts)back to your home country so sane prices for your healthcare can prevail.
US citizens with decent healthcare should plan to be medivacked back to the US where their health insurance and/or Medicare is in effect. Medicare, for example, will pay nothing if you are injured outside the US.
pnwmom
(108,978 posts)This kind of situation is exactly why the law was passed in the first place.
ctaylors6
(693 posts)They are neither covered nor required to buy coverage as visitors to the US.
pnwmom
(108,978 posts)ctaylors6
(693 posts)and non citizens? I thought that not included in ACA.
That's great for people visiting now.
pnwmom
(108,978 posts)ctaylors6
(693 posts)of people visiting the US. People who are not citizens or legal residents, etc.
I had to purchase travel insurance this past summer for a trip within the US, and I had to jump through a few hoops to ensure that pre-existing conditions were covered. It was a very reliable, highly rated insurance plan, but I did not get the impression that pre-existing condition issues were gone because of ACA.
I've never read anything about the ACA that say it would apply to travel insurance for people visiting the US temporarily like that. (Again, I'm not asking people who are here for anything more than a vacation.)
pnwmom
(108,978 posts)Here's an example of a policy wording:
https://www.hthtravelinsurance.com/aca.cfm
At this time, our international health insurance plans do not provide Minimum Essential Coverage and are not required to meet the regulations of the Affordable Care Act (ACA). The plan you are applying for is filed as a limited duration policy designed specifically for international living.
The plan is exempted from certain ACA provisions. Coverage by the insurer can be:
1. accepted
2. accepted with a rate increase, or
3. denied based on the health history of the applicants(s).
A waiting period for pre-existing conditions applies unless you have 6 or 12 months of prior creditable coverage depending upon the policy you are purchasing.
There is no tax penalty for purchasing this policy if you are outside the U.S. for 330 days or more in a calendar year. In this instance, you are deemed to have met the individual mandate. Additionally there is no tax penalty applicable to J1, F1, M1 visa holders and other populations that meet one of the exemption categories related to the ACA individual mandate.
ctaylors6
(693 posts)ago (a travel insurance policy) and frankly none of that pre-existing condition language seemed to have changed that much since that time and this last summer. They certainly didn't seem ready to tell me not to worry about pre-existing conditions, and I'm a US citizen.
On the last trip we were out of the country part of the time, and I researched medical coverage for many, many hours for the places we were visiting. One of my kids has a pre-existing condition so I made sure we wouldn't get screwed even with something like a medivac situation.
pnwmom
(108,978 posts)in the Canadian company's insurance policy. It shows how important it is to read the small print. Glad it worked for you -- thanks to your efforts.
ctaylors6
(693 posts)I'm extremely thankful we didn't have to test out any coverage limits
laundry_queen
(8,646 posts)There have been several news stories on this topic over the last few months because so many Canadians travel to the US for the warmer weather...basically, the policies have such convoluted language that all the news stories I've seen who have asked lawyers to read the policy, they cannot understand it. Lawyers cannot understand it ffs.
And there are a gazillion loop holes in each policy that the insurance company can exploit in order to avoid paying for care. There was a case not too long ago that was publicized here where an older man had a heart attack while on vacation in the US. He had bought what he thought was a comprehensive policy. The experts interviewed said he chose the right policy for his needs. However, there was something on his medical records THAT HE DIDN'T KNOW ABOUT, and he answered the question on the policy as if he didn't have the issue (a super minor issue, so minor the doctor never told him). The insurance company said, "too bad, so sad, you should've read all that medical speak in your medical records before answering incorrectly. You aren't covered." This was despite the fact that the question that was answered 'incorrectly' had no relevance with regards to the heart attack.
There has been a lot of publicity surrounding these cases here in Canada, and most people I know absolutely hate insurance companies with a passion. Everyone wants this changed, but it won't happen because if Stephen Harper is in charge and if he had his way, we'd have the US system pre-ACA. He knows it would probably cause massive unrest though. So he whittles away at it, and leaves the insurance companies alone to rip people off.
Nay
(12,051 posts)presumably for the trip. I don't know if she bought a policy based in the US or Canada, but since it was sold to someone who was not a US citizen, I assume all decent rules did not apply.
pnwmom
(108,978 posts)their citizens are still at risk when they travel.
And people who travel to Canada should be aware that the Canadian system won't offer them free care.
Louisiana1976
(3,962 posts)sounds like a rip-off.
KamaAina
(78,249 posts)since only Mexican policies are valid down there.
LeftInTX
(25,361 posts)Inquiring minds want to know.
KamaAina
(78,249 posts)I have never been to Mexico and don't drive.
pnwmom
(108,978 posts)and eliminated pre-existing condition clauses.
pnwmom
(108,978 posts)instead of 2013 -- the ACA rules would have been in effect and she couldn't have been dropped.
So single payer wouldn't be the only solution. The ACA would have taken care of her problem -- if it had been in effect.
frazzled
(18,402 posts)because then she wouldn't owe a penny (or owe only a deductible or cost share). Because there are no pre-existing conditions in any ACA (Obamacare) policy.
I can personally attest to this. For reasons too complicated and uninteresting to outline here, my son ended up enrolling in an ACA plan (also Blue Cross-Blue Shield) last December, which went into effect January 1, 2014. His wife was then 5 months pregnant. They probably could not have gotten private-market insurance before that. Every penny (minus whatever copayment they had) of the delivery was paid for. If they or the baby had had a complication, it would have been paid for, too.
You see, "pre-existing conditions" is one of things the Affordable Care Act banned for now and forever in this country (for those who participate in it). Too bad this Canadian didn't have access to that. I'm surprised that her Canadian health insurance isn't paying this bill.
That's why everyone here should be a little glad that Obamacare is the law of the land. Let's hope it stays that way.
pnwmom
(108,978 posts)a preexisting condition clause, whether bought on or off the exchange. So in a sense, every policy since January (except for a few grandfathered policies) has been an ACA policy.
Doctor_J
(36,392 posts)Stop, please. My sides hurt
pnwmom
(108,978 posts)conditions and prevented insurers from refusing to pay for that reason? Unfortunately, it didn't go into effect till 2014.
A number of people here are jumping to the wrong conclusion that this happened even with the ACA in place -- which it didn't.
riqster
(13,986 posts)Bashing the ACA seems to be a crusade for some, dann the facts.
reflection
(6,286 posts)The story was published today.
pnwmom
(108,978 posts)reflection
(6,286 posts)Let me try to update, am on cell phone.
pnwmom
(108,978 posts)So this would be subject to Canadian regulation, not US.
http://www.cbc.ca/news/canada/saskatoon/jennifer-huculak-kimmel-billed-950k-us-after-giving-birth-in-u-s-1.2839319
nilram
(2,888 posts)Not sure that's the case. Don't know that it is, just wondering.
pnwmom
(108,978 posts)with the US insurance law.
SickOfTheOnePct
(7,290 posts)indepat
(20,899 posts)It's a wonder travel to America hasn't dried up. Go USA, rah, rah, rah.
pnwmom
(108,978 posts)Also, Canada's healthcare system, like ours, doesn't provide free care for non-residents. Someone traveling there should also have travel insurance.
http://www.hc-sc.gc.ca/hcs-sss/medi-assur/faq-eng.php#a2
laundry_queen
(8,646 posts)even if she would've been a foreigner in Canada without any health care coverage, she'd be paying far, far less than she was charged in the US.
helpmetohelpyou
(589 posts)Doctor_J
(36,392 posts)Now trashing thread to avoid temptation to read more idiocy about how this is Canada's fault.
valerief
(53,235 posts)You know, like our healthcare system, only Obamacare permits existing conditions. She was bitten in the ass by them the way many Americans have been. You know, those Americans who've been made homeless by these for-profit insurance companies who make whatever rules they want.
In a letter to Huculak, the company noted the following: "Ms. Huculak was diagnosed and treated for a high-risk pregnancy in the six months prior to departure. As Ms. Huculak is currently hospitalized and being treated for this high-risk pregnancy, any expenses incurred are not eligible under the terms of your policy."
But Huculak says that she did not have a high-risk pregnancy, she had a bladder infection which led to bleeding.
"The specialist in Hawaii said that these things just happen. There's nothing that causes them," she said.
laundry_queen
(8,646 posts)a large point is being missed here - even if she had zero healthcare coverage in Canada, her costs would've been far, far lower out of pocket than they were in the US. Private, for profit medicine in the US has artificially inflated the true costs of healthcare.
Yes, people here in Canada are talking about how shitty the insurance companies are to try to get out of paying, but they are also shaking their heads and talking about how ridiculous US medical costs are. This story is not solely about some insurance company refusing to pay.
valerief
(53,235 posts)Once Saint Ronnie gave us HMOs it was a scramble to see who could make the most buckos from sickness and suffering in the United Police States of America.
If we had taxpayer-paid medical coverage like the first-world countries, these healthcare predators would have to find another industry to feed off.
shenmue
(38,506 posts)My mother told me that's how we get babies.
LanternWaste
(37,748 posts)For-profit healthcare and the intermediaries that exploit it are star-spangled awesome.
KamaAina
(78,249 posts)It was only $950,000.