Woman Battles Insurance Companies to Get Her IUD Removed

Over at NARAL’s Blog for Choice, blogger Thomas tells the story of a woman living in West Seattle, Washington, who found herself entangled with insurance companies over the right to become pregnant. This woman was a busy working mother who had an intrauterine device (IUD) implanted after the birth of her child. Her husband’s insurance company, Regence BlueShield, covered the insertion of the IUD, but when she decided that she wanted to get pregnant again, they refused to remove the device, saying that it was not “medically necessary.”

It turns out this woman wasn’t alone. After repeated denials and lots of paperwork from Regence, she filed a complaint with the Office of the Insurance Commissioner. When the state investigated, they discovered that this women had filed the only complaint. However, 984 women had their claims illegally denied, and presumably paid the removal fee (which runs around several hundred dollars) out of pocket.

None of the women spoke up, perhaps because they were so busy. As the West Seattle woman explained, most women who have IUDs are working mothers with at least one child, so “it’s easier to just pay it, so you can move on to something more important — like sleep.”

Washington has a contraceptive equity law, so Regence’s actions were blatantly illegal. The state told Regence to reimburse the women who had filed claims, and to drive the message home, fined the company $100,000 and required it to pay the women eight percent interest on the denied claims.

As Thomas points out, Washington is one of 28 states that requires insurance companies to cover prescription contraceptives in the same way that they would cover any other medication (although 20 of these states have religious exemptions, which is a debate for another day). But there are 22 states where it would be legal to deny this woman her IUD removal, and where insurance companies wouldn’t have to pay for its insertion in the first place.

This, of course, won’t be a problem anymore in a year, when insurance companies across the country will be required under the new health-care reform law to provide birth control without a deductible. But until then, women could be wading through paperwork, or simply paying for services out of pocket, because of insurance companies’ unwillingness to treat contraceptives like other medications.

Although the woman from West Seattle certainly wasn’t given appropriate financial compensation, at least she achieved her original desire: she’s now the mother of a 6-month-old baby girl. But just think about it. She was the only woman – out of nearly 1,000 – who had time to successfully complain.

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Photo from kate* via flickr.

Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

Martha E.

4:27PM PDT on Sep 11, 2011

yes, private insurance companies are our friends -- we pay and pay each month for coverage, and then when you need it, you are given excuses. MEDICARE FOR ALL like other civilized countries! Health care should NEVER have been the business of business -- the goals are antithetical. Health care is for CARE and business is for the BOTTOM LINE, which means denying that care. So simple, yet we were denied that in the health care debate.

send a green star

Christine S.

9:04PM PDT on Sep 3, 2011

Sheesh- they aren't preventing her from removing the IUD, they just don't want to pay to have it removed...

Grace A.

11:03AM PDT on Aug 26, 2011

Medicare for all.

Lepidopter P.

6:09PM PDT on Aug 25, 2011

Dawn: If they didn't want to pay for the removal,then why did they pay for the insertion?

Probably because as long as it stays in, they don't have to pay for prenatal or baby care.

Monica W.

5:51PM PDT on Aug 25, 2011

awful.

Faith P.

3:01PM PDT on Aug 23, 2011

i think i'm more concerned with the fact that this woman was the first to complain out of almost 1,000 women! why did no one else stand up for themselves?!

dawn w.

6:30PM PDT on Aug 22, 2011

The IUD is supposed to be removable,that is,not permanent.But I guess the insurance companies want to make it permanent.If they didn't want to pay for the removal,then why did they pay for the insertion?

Fa'izah J. A.

5:54PM PDT on Aug 22, 2011

Absolutely people should fight their insurance companies; we pay a lot in premiums. Sometimes I think they rely on the fact that people will just accept a denied claim. If I had not fought and had an advocate, I would have been stuck with a huge ambulance bill after being rushed to the hospital following a severe allergic reaction; I could barely breath and my blood pressure dropped dangerously low. The insurance company wanted to insist that it wasn't medically necessary for me to go to the ER by ambulance.

Linda E.

1:58PM PDT on Aug 22, 2011

Thanks for bringing this situation to light. I think more women fear the fight with big insurance than have too little time to question the rejection of their claims. It shows that writing a letter can cause things to happen, even when an individual disagrees with Big Insurance.

nasale M.

12:58PM PDT on Aug 22, 2011

Wow! Its hard to believe these things happen! I'm a Canadian and I think I'll keep our health care system, if you don't mind.