Question
undefinedWhat is the name of your state? IL
My insurance company offers a "discount" in base rates to those in good health, based on answers to an annual questionnaire. Last year, I was not pregnant and qualified for the discount. This year, the only difference in my answers to the questionnaire was that I am pregnant. Now, the insurance company is saying I have to pay the higher base rate -- even though I pay (and have been paying) extra for a maternity rider to the policy. Is this "double whammy" discriminatory and/or some sort of bad faith insurance practice?
Answer
Not unless pregnancy is the ONLY condition for which this might happen.
The Pregnancy Discrimination Act says only that someone who is pregnant has to be treated exactly the same as if they were not pregnant. You can't be discriminated against, but you don't get any special privileges either. If someone who had a broken leg or pneumonia would also have had the discount taken away, then it's legal to take it away for you.
Answer
When you're pregnant, you see a physician more than when you're not - thus the insurance carrier pays more to cover you. The costs might not be that high now, but your delivery and care will run into at least a couple of thousand, barring that there are NO problems! (and I hope there are not)
It's sad, but there are loopholes to so many things, and with the rising costs of health care, it's tough.
I am sure your insurance carrier is not doing anything illegal - they get audited (all carriers) and they have to justify what they are doing to tons of eyes, so my guess is it's on the up and up.
I have never heard of a pregnancy rider, drug and eye riders I have heard of, but never a pregnancy rider. Are you sure about that?
Answer
Yes - The base policy excludes pregnancy and maternity. (That's why I thought it was kind of shabby to effectively raise the base rate based on that factor.) The insurer offers a separate maternity rider at additional cost, which I have been paying ever since I became eligible to purchase it.
Answer
That's a completely separate issue from the discount.
You chose to purchase the rider. Anyone else who wanted that coverage had the same option. I'm sure you're not the only one who did.
Nothing in the law says they have to offer you a discount at all. It certainly oesn't say that they have to continue to offer it when you do not qualify it, as long as you are (a) pregnant of (b) purchasing a maternity rider.
As I said, unless you have some kind of evidence that ONLY people who are pregnant had the discount removed and not those who used the plan for other conditions, this is not illegal discrimination, regardless of whether you are purchasing a maternity rider or not.