Million dollar baby: Canadians handed $1M bill after woman gives birth in U.S.

[reflection]

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-1.2107020

Jennifer Huculak and her husband have been saddled with a medical bill of nearly $1 million after she gave birth to her daughter in the U.S.

Huculak 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]

1. ...but, but our healthcare is the BEST!

All those Canadians come down here to partake of it!

[reflection]

2. Of course, the most expensive is always the best.

It's the American way!

[hughee99]

5. It sounds like she got excellent care

It's just the costs that are all messed up.

[pnwmom]

19. Getting rid of the preexisting clauses was a major part of the ACA.

Unfortunately, it wasn't yet in effect in 2013, when this woman was hospitalized and gave birth.

[SickOfTheOnePct]

26. Pretty sure it was BC/BS Canada for travel insurance

Doubtful that the ACA would apply.

[pnwmom]

31. Then no one should be blaming the US system for the failure of this Canadian insurance co. n/t

[SickOfTheOnePct]

33. I agree n/t

[elias7]

46. How much should a 6 month hospitalization for her a 2 month neonatal ICU hospitalization cost?

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]

54. Among other, uhm... inaccuracies in your post, she did not have a 6 month hospitalization.

Huculak 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.

6 weeks + 8 weeks = 3 months, 2 weeks.

As to her "medical issues", she had none that would have caused the early labor.

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.

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]

60. $950000 averages out to about $16000 per day.

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]

59. "pregnant woman's membranes ruptured in the first trimester"

Ummmm... "pregnant woman's membranes ruptured in the second trimester..."

[dionysus]

56. it IS the best; IF you can afford it...

[Strelnikov_]

58. The best money can buy!

OTOH, if you don't have the money, yer' up shit creek.

[Blue_Tires]

3. LOL...At first I thought we were *giving* them money

and I was like, when the hell did the treasury start printing a million-dollar bill?

[jberryhill]

4. Same here

[DesMoinesDem]

6. No million dollar bill, but they do print a 10 million dollar bill.

[dionysus]

57. lol, i JUST finished watching that movie for the first time!

[reflection]

14. I went through the same thought process. n/t

[PoutrageFatigue]

7. Yikes!!!

....Murrka!!!

[KamaAina]

8. A small price to pay for having an anchor baby.

[Nay]

11. Yeah -- now that anchor baby will be subject to US income taxes for the rest of

its life, unless the parents file a form rejecting citizenship for their child!

[Nay]

9. Lesson to be learned here for everyone is to get the insurance that medivacs you

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]

17. Second lesson: the ACA eliminated preexisting clauses as of January 2014.

This kind of situation is exactly why the law was passed in the first place.

[ctaylors6]

29. But the ACA doesn't apply to visitors does it?

They are neither covered nor required to buy coverage as visitors to the US.

[pnwmom]

30. It applies to health insurance policies sold in the US. n/t

[ctaylors6]

32. Even short-term travel insurance for non residents

and non citizens? I thought that not included in ACA.

That's great for people visiting now.

[pnwmom]

34. It turns out that it was a Canadian insurance policy, so this doesn't have anything to do with

US law.

http://www.cbc.ca/news/canada/saskatoon/jennifer-huculak-kimmel-billed-950k-us-after-giving-birth-in-u-s-1.2839319

[ctaylors6]

39. I'm still curious if ACA applies to travel insurance

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]

40. It might not, but that fact must be disclosed.

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]

42. Ok thanks. I had bought a policy a few years

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]

43. It is definitely something to be careful about. I wonder how clear the language was

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]

44. I wonder that too about her policy

I'm extremely thankful we didn't have to test out any coverage limits

[laundry_queen]

61. It's usually not clear at all

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]

47. Doesn't apply in this case, because she bought her insurance in Canada,

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]

48. She bought it from a Canadian company. So even though Canada has a good public system,

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]

10. They must wish they'd stayed home with that single payer. And that insurance they got

sounds like a rip-off.

[KamaAina]

12. Sounds like the auto insurance policies you buy at the Mexican border

since only Mexican policies are valid down there.

[LeftInTX]

21. Do those policies even work? Or are they just a way to scare you from driving?

Inquiring minds want to know.

[KamaAina]

22. I have no idea.

I have never been to Mexico and don't drive.

[pnwmom]

16. They must have wished it was after Jan 2014, when the ACA went into effect

and eliminated pre-existing condition clauses.

[pnwmom]

18. If they had a Blue Cross policy here and the mother needed hospitalization after January, 2014 --

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]

13. Too bad she didn't get an ACA policy

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]

15. This was in 2013, so she couldn't. But thanks to the ACA, no policies since January can contain

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]

50. the million dollars would now be zero?

Stop, please. My sides hurt

[pnwmom]

20. Why are you reporting a 2013 case without making it clear that the ACA eliminated preexisting

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]

23. Because the ACA SUUUUUCCCCKKKSSSSS! According to the Pony Platoon, anyway.

Bashing the ACA seems to be a crusade for some, dann the facts.

[reflection]

24. I'm passing on a tragic story with no ulterior motive.

The story was published today.

[pnwmom]

25. But you could have clarified that this was in 2013 and wouldn't have happened this year, post ACA.

[reflection]

27. didn't even think of it.

Let me try to update, am on cell phone.

[pnwmom]

38. It turns out that the policy was sold to them by a Canadian company.

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]

35. The ACA covers travel insurance purchase by foreign nationals?

Not sure that's the case. Don't know that it is, just wondering.

[pnwmom]

37. You're right -- this was a Canadian company's insurance policy. So it has nothing to do

with the US insurance law.

[SickOfTheOnePct]

41. No, it doesn't

http://www.visitorscoverage.com/how-does-obamacare-affect-visitors-to-usa/

[indepat]

28. A primer of the horror right-wing interests have inflicted on America.

It's a wonder travel to America hasn't dried up. Go USA, rah, rah, rah.

[pnwmom]

36. Not really. It was a Canadian insurance company that denied this payment.

http://www.cbc.ca/news/canada/saskatoon/jennifer-huculak-kimmel-billed-950k-us-after-giving-birth-in-u-s-1.2839319

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]

62. Still, there is the point that high end care in the US is much more expensive than in Canada

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]

45. wow!

[Doctor_J]

49. I read on du that this had nothing to do with our healthcare system.

Now trashing thread to avoid temptation to read more idiocy about how this is Canada's fault.

[valerief]

51. It has to do with getting medical care via a for-profit insurance company.

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.

Blue Cross is refusing to pay any of the amount, arguing that Huculak had a pre-existing condition.

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]

63. Again, that is not the whole point

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]

64. Right, because insurance isn't the only part of the for-profit game in America.

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]

52. Why didn't they just call the stork?

My mother told me that's how we get babies.

[LanternWaste]

53. For-profit healthcare and its intermediaries are star-spangled awesome.

For-profit healthcare and the intermediaries that exploit it are star-spangled awesome.

[KamaAina]

55. Oh, for crying out loud. Enough with the hyperbole already.

It was only $950,000.