I received an email from BCBSAZ this week regarding my appeals. They wanted to let me know that after an in-depth review of my case, “Unfortunately, we are unable to provide coverage in this case, as our contracts for individual policies exclude maternity coverage except in very specific circumstances.”
Just because it’s your policy, it doesn’t make it right.
Interestingly enough, it seems that if I’d needed a cesarean section prior to October 1, 2008 it would have been covered. The revision to Blue Cross Blue Shield of Arizona’s definition of “complication of pregnancy” to no longer include cesarean sections “during labor” seems to be a decision driven by the bottom line, not what is best for their patients. If Lily hadn’t been delivered via cesarean it’s a definite possibility that BCBSAZ could be paying for Lily to have physical therapy right now. Hmm… which is better for the patient, a cesarean section to avoid future complications or physical therapy for an infant?
BCBSAZ has offered me a meeting with their Medical Director. That should be interesting.
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