Fri | Jan 19, 2018

Cedric Stephens | Barren market for multiple-birth insurance

Published:Sunday | November 26, 2017 | 12:00 AM

QUESTION: My wife and I are professionals. We are in our late 30s and are trying to have a baby. Our doctor recommended that we try 7n vitro fertilisation (IVF) technology. The costs for this type of treatment, according to our research, are very expensive. Are the charges recoverable from our health insurance plans? Also, my wife is one of twins. This plus the proposed method of conception are likely to result in multiple births. Can we get insurance to protect ourselves were this to happen?

T.J.,

Kingston 7

INSURANCE HELPLINE: I like your questions. They provide the grey matter in my brain with much needed exercise. I was running around in many directions at the same time. Say what you will about our health minister and his PR apparatus, I admire the curiosity he brings to the job and like the way he moves.

My sources of information were many: the July 2012 issue of The West Indian Medical Journal ("Evolution of In Vitro Fertilization at UWI"); our two daily newspapers; Google, particularly those about multiple birth insurance; local and foreign health insurance contracts; and, "Pregnancy and Health Insurance: An Independent View" an article I wrote in this newspaper about six months ago.

Local and overseas health plans do not generally cover any IVF costs. One of the 40 exclusions (yes, you read that correctly) listed in the contract of a leading local provider is: "Any claim with respect to diagnostic investigation or medical treatment related to infertility, fertility or birth control unless otherwise specified".

Because these costs were not "otherwise specified" it is safe to conclude that they are not insured.

The exclusion language in the overseas policies uses twice as many words to say the same thing. "Treatment in connection with male and female birth control, infertility, contraception, sterilisation (or its reversal) and any form of assisted conception, artificial insemination, sexual dysfunctions or inadequacies, or any complication or pregnancy arising as a result of assisted pregnancy or fertility treatment or contraceptive devices" are not covered.

In the United States however, there are "options and steps to obtain medical insurance coverage for IVF and other first-line infertility therapies". This topic is "complex and the rules are confusing and inconsistent". As a rule, purchasing individual health insurance covering infertility and in vitro fertilisation is very difficult.

One source suggests that getting a personal loan from a credit union or bank could be a better bet.

 

WHERE TO GET COVERAGE

 

Multiple birth insurance, or twin insurance, is not available in Jamaica. This is not because there is a law against it. It is unavailable because our insurance market is very small, unsophisticated and the demand for it is low.

Coverage can be obtained in the United Kingdom through a local broker that has access to that market. It pays a lump sum to the parents of unexpected twins or multiples. The policy must be secured early in the pregnancy, between 11 and 18 weeks of gestation. The insurance must begin prior to an ultrasound confirmation of multiple birth.

The lump sum payment is meant to help with the additional cost of multiples. In reality the lump sum may be used for anything the policyholder wishes. It can be used for clothes and necessities, to pay medical bills or start a college fund.

According to www.growingfamilybenefits.com the lump sum can even be used to buy a bigger car or contribute to the down payment on a home.

Policies are designed to pay on a sliding scale increasing based on the number of children in the home. Selected premium levels yield different levels of payout. In other words, the more you pay in, the more that is paid out.

Premiums also go up based on maternal health and family birthing history. If there is a history of twins, especially on the mother's side, premiums will be higher. Age and lifestyle

choices also affect the payment. Also, the policies are almost never open to women who have undergone fertility treatments, especially if those treatments occurred in the prior two years.

I recommend that you consult an insurance broker. Bear in mind also that you and your wife may have to make changes to your existing health insurance plans. Additional costs and expenses are associated with multiple births and these plans are generally not designed for non-typical births.

- Cedric E. Stephens provides independent information and advice about the management of risks and insurance. For free information or counsel, write to: aegis@flowja.com