[Linny]

A few years ago, I asked this question on another adoption board and got mixed responses:
Our HMO will pay to cover IVF treatments (and pays well it seems).....and they'll cover the costs for surgeries to assist couples to get pregnant.
Given that, WHY won't they also help pay for adoption fees? I know, I know.........the HMO WILL pay for adopted baby stays and deliveries; and it's retroactive, so this is nice, I agree. But, many insurance companies will pay for a couple's baby expenses of birth, hospital stay, etc., whether the baby is adopted or biological.

I'm asking just as a general question: "If insurance companies are willing to pay INCREDIBLE fees for the procedures I listed above, then WHY wouldn't they pay for the fees to conduct an adoption with a reputable agency/attorney?"

Any thoughts or comments on this one?

Sincerely,

Linny

[timbo30]

I am frustrated with our insurance company right now. Our son will be 9 months old on Monday and we still have not been reimbursed for his hospital expenses. Even though they say it is retro the hospital stay was not an emergency so it isn't covered. WHAT? It's a birth. I don't get it. So frustrating.

Timbp

[mj77]

Linny,

An adoption itself isn't medical so suggesting a medical insurance to pay for something that is not medical doesn't seem right, JMHO of course. Because fertility treatments require a dr. and often other professionals to monitor health, it makes sense to have health coverage. Many people's medical coverage does not cover procedures the same for fertility issues as they do for other concers. For example: I had a laparoscopy for pains that I was having. It was questionable if these pains were related to me not getting pregnant. If I had my procedure done for fertility reasons (check tubes etc..) my insurance would only cover half. But since we put emphasis on the pain and irregularity of my cycle, my insurance covered all but a copay.

Though I could be wrong, for fertility treatments, I don't believe there is a tax write off (like I said, could be wrong) but I know there's one for adoption expenses. State special needs comes with a larger credit. So, no complaining on my end. Curious to hear other perspectives.

[CAToso]

I agree with mj77 - the adoption agency fees, advertising, bmom living expenses, etc., are not remotely medical, so I don't think it's right to expect our health insurance to cover those.

I did, however, call and ask if they would cover the bmom hospital expenses, since that is medical. They said no, of course, but I figured it didn't hurt to ask.

~Courtney

[Fran27]

I think you should consider yourself grateful to even have an insurance company that pays for infertility treatments and cost of delivery etc for an adopted child... Lots don't.

[HappyTwinsMom]

Our insurance doesn't pay for anything related to fertility, be it testing, IVF, or adoption. Fortunately for us, our daughters' hospital expenses were all covered by insurance (to the tune of $130,000) from the moment of their birth.

With medical expenses and insurance premiums skyrocketing every year, I don't agree that adoption should be covered by insurance. The medical expenses related to the baby's care after birth, yes...but not the other expenses associated with adoption.

I sat in a budget meeting yesterday and heard from our finance director (I work in county government) that medical insurance expenses increase approximately 10% per year. That's precisely why many insurance companies DON'T cover things like weight management, fertility, cosmetic procedures, etc. Can't say I blame 'em.

[Linny]

I think you should consider yourself grateful to even have an insurance company that pays for infertility treatments and cost of delivery etc for an adopted child... Lots don't. --Fran

Fran, we do consider ourselves very fortunate, because we can easily remember years ago when we were paying something like $500. per month for a deductible of 5k.
Please don't take offense, as I didn't mean to ask this 'general question' (as I stated in the OP) as a means to complain.
I guess I just have a real problem with insurance companies paying huge amounts to cover IVF treatments and surgeries to 'correct infertility'. (And thus, one reason for higher premiums).

Sincerely,

Linny

[SanInUtah]

[quote=Linny]A few years ago, I asked this question on another adoption board and got mixed responses:
Our HMO will pay to cover IVF treatments (and pays well it seems).....and they'll cover the costs for surgeries to assist couples to get pregnant.



Linny...sign me up! We're there and it's gonna cost us a freakin fortune to move forward, if we choose to at all.

[SanInUtah]

Originally Posted by Linny

Fran, we do consider ourselves very fortunate, because we can easily remember years ago when we were paying something like $500. per month for a deductible of 5k.
Please don't take offense, as I didn't mean to ask this 'general question' (as I stated in the OP) as a means to complain.
I guess I just have a real problem with insurance companies paying huge amounts to cover IVF treatments and surgeries to 'correct infertility'. (And thus, one reason for higher premiums).

Sincerely,

Linny

Infertility is about more than the inability to conceive a child. It's ultimately about a familie's emotional development. For a lot of couples it's the end of their stability in marriage. I think there's been a court case that proved all of this and got some companies to pay up. That said; I'd love to know the name of your HMO!!!

Adoption is so subjective in fees that an insurance co. would probably have to put a 'sum' figure on it rather than 'coverage'. My adoption cost $100 total. My friends who've done private adoptions paid about $40k (and wound up with a child who had the same exposure issues and medical history). Ther'e's no logic or reason in adoption, lots and lots of emotion.

[Linny]

I mean no offense to anyone who felt the need (feels the need) to go the IVF route; but here's my rational:

The inability to conceive, isn't life threatening. Surgeries done specifically to promote conception are done because the couple chooses to follow that path of trying the odds and having a baby.
If an insurance company will pay for these 'tries'....that are not life-threatening, are not medically necessary for life, then why wouldn't 'adoption' be considered 'another option and alternative' to birthing?
An insurance company pays 'boo-coo' bucks toward these procedures, and our premiums pay for these 'tries'; so what's to stop them from paying X amount of monies toward adoption fees?

Might this seem excessive? Yes, I agree with HappyTwins mom on this one; but.........no one seems to think that IVF treatments-- that are risky at best-- are too excessive. Which, in this light, companies seem to say that 'adoption is second best'. (Before anyone has a hissy fit, let me state that I DO NOT believe that adoption is second best in any way. )

But, I think that paying for 'one option', but not paying anything to a couple who have chosen 'this option' seems a bit unfair. Excessive? Yes. But IMO, so is paying for IVF treatments.

Sincerely,

Linny

[Vogi2002]

Most insurance companies that I know of don't cover infertility, or very very little. Mine covered nothing with infertility. I personally think this is bogus. They cover ED problems with men, is this life threatening? I personally do not feel that, just because a operation isn't life threatening, it shoudn't be covered. I mean, by that route there are a LOT of surgeries that could not be covered, for example (ONLY example) hip replacement- not life threatening, just woudln't be able to walk, so really a quality of life procedure, just as having a child would be. Again, just my opinion. I do think there should be restrictions on the procedures (fertility for over a certain number of years or reason you would not be able to concieve, maximum number of tries, etc).

Having a child, IMO, is an extremely HUGE part of the quality of life. So, in that case, adoption really IS covered (foster care) if you choose that route....

Just my opinion...

Natalie

[Linny]

Having a child, IMO, is an extremely HUGE part of the quality of life. So, in that case, adoption really IS covered (foster care) if you choose that route.... ---Runyan

I'm not understanding that last part of your comment, 'that adoption really is covered (foster care), if you choose that route.'

I'm not following. If you're saying that because a couple can adopt through foster care, the expenses are 'covered'....they aren't always. And, having gone through the older child route myself, adopting an older child is not the same as adopting an infant.

A hip replacement is a matter of walking or not. You're right, it's not a matter of life or death, but it's a matter of the person being mobile at all. I just don't see the comparison of that to IVF.
But, as I said, if we see that as 'quality of life or not'.....the insurance company (for whatever the reason) is paying toward the IVF....then why not pay toward the 'option' of adoption???

So, while you and I might disagree on what constitutes the 'quality of life in regards to procedures'........why does the distinction arise between adoption and birthing? Given that they both bring about parenting a child/baby.........why is one subsidized by insurance premiums, and the other isn't?

Sincerely,

Linny

[nycfsa]

Having worked in the pricing unit of an insurance company, I think the problem would be figuring out what premium to charge for adoption expense insurance. Labor & delivery are well-defined, if you know what I mean. Insurance companies know about how much the hospital, doctors, etc should cost and they have lots of data about how and how often the services are used. They can also control claim expenses by choosing which doctors and hospitals are in their networks.

If insurance companies were to cover adoption expenses, the premiums would likely be set very high, due to the disparity in adoption situations...for example, my two sons were both adopted domestically at birth, both are minorities, both are healthy, but one cost almost double the other. There's no way to predict that sort of thing based on previous experience data, so the company would have to be conservative and charge a premium that would cover a more expensive situation. By the time you pay that premium, you might as well just pay the adoption expense directly.

[Vogi2002]

Sorry, should have been more clear in my previous post. What I meant by foster being covered is that, normally, there is minimal to nill expenses involved in that route. Foster/adopting through the state is not always an older child adoption, infants are available. I'm not saying that you should HAVE to go that route, I'm saying it is an option available. I personally, am going through an agency, for various reasons, but am willing to pay the costs (not saying i'm happy about it at ALL).

With the hip replacement example, that is all it was, is an example, of how quality of life could be portrayed. One persons opinion is completely different from anothers. Infertility is something that, until experienced, people just don't understand why it is so important. I even had someone tell me that costs shouldn't be covered because they could "just" adopt. HA.

I guess I do not expect adoption to be covered by medical insurance. Do I think that they could have a certain amount (maybe 5,000) go TOWARD adoption cost? Maybe. But I just am not sold on that idea. I say take the money that they were going to spend and put it towards finding a solution to high adoption prices period (legislation, etc). But if it goes directly toward the costs agencies will just raise the prices to adopt and it will even out.

I do however, think infertility SHOULD be covered (i'm still deciding on if IVF should, really your not talking about 10,000 that it would cost toward insurance companie, with all thier discounts, it would probably be about 5,000, so put a maximum to three or what not...anyways, jurys still out on that one). But definetely IUI or at least sonograms. Many people do not understand that NOTHING is covered with infertility in many cases. Sonograms, blood tests, NOTHING. THAT is ridiculous to me. The same procedure is covered for discomfort but if anywhere on there is because infertility it's not covered. Where we pay 100$ for a blood test it would cost the insurance company 50 with all thier discounts....

Is infertility more important than adoption? No, but adoption is not really a "medical" issue per say (meaning, not a exact "procedure" done, or a "blood test" so there is a very specific cost). So there would be fluctuating costs, all across the board.

I actually think the IVF comparison is mute because not many insurance companies cover this, as a matter of fact MOST don't. I don't know ANYone who has insurance that covers it (although I'm sure there are some). I do know that some do put money toward adoption (not sure who/what/which company) but I do know of people who have recieved this. Adoption has so many facets, are you talking about covering the labor, the agency fee, the bmom expenses, the travel expenses, the homestudy...I mean would you expect your insurance company to pay for the lawyer fee to finalize?

Great discussion...hope you didn't take offense to anything, it's just my opinion and is subject to change, haven't thought about it much really...

Natalie

[Linny]

No, I didn't take offense......and I'm thinking that the monies would be to go 'toward' the adoption expenses, as you mentioned.
But, something you brought up that I DIDN'T think about (and really I should have)....is that IF this were a wide spread thing, agencies would probably take advantage of it and raise their fees even more! THAT is a very real possibility.
If you've been in the adoption 'ring' long enough (and perhaps you have).....you'd agree that once the federal gov't put the 'adoption tax credit' into force, MANY agencies/attorneys took that as full permission to raise THEIR fees too!!!! Grrrrrrrrrrrr!
(Yet, some continue to say that everyone should consider this credit as a means to 'pay back' their adoption expenses, and it's just not always true!!!!)

Anyway, thanks to all for the discussion. I appreciate it!

Sincerely,

Linny