Will my insurance cover abortion?

Women will incur additional travel, care and accommodation costs if they leave the state for an abortion. Many may ask: Will I have to pay out of pocket for the procedure or will health insurance cover it?

For those who have employer-sponsored insurance in Texas, they must first know if their insurance is “fully funded” or “self-funded.” Fully funded employers rely on insurance companies to cover health care costs, essentially paying premiums to insurers. Self-financing employers pay all or most of their health insurance claims themselves and hire insurers to administer their plans.

Under a state law passed in 2017, fully funded employers cannot include abortion coverage in their comprehensive plans. Employees will have to purchase additional plans to cover abortions by law.

Critics of the law say no one is planning an abortion and would expect to need such coverage. It is not clear how many insurance companies offer these plans.

However, the state has no authority over self-financing employer plans, which are regulated by the federal government. It is up to the employer to cover the abortion services.

In a case called Dobbs v. Jackson’s Women’s Health Organization, the Supreme Court on Friday overturned Rowe’s remarkable ruling, which in 1973 established a constitutional right to abortion and left the legality of abortion to state legislatures and Congress. About half of the states are ready to ban or severely restrict abortions. Texas has introduced a so-called trigger law related to the repeal of Roe, which will soon ban abortions in the state, except in a few narrow circumstances.

The largest insurance companies in Texas – Blue Cross Blue Shield and UnitedHealth Group – are still assessing how the decision will affect them.

“We are assessing the potential impact that the U.S. Supreme Court ruling in the Dobbs v. Jackson Women’s Health Organization case could have on our clients and members,” a Blue Cross Blue Shield spokesman in Texas said in a statement. “We are here to support our clients and members in a careful manner as we navigate this complex and evolving situation, in accordance with federal, state and local laws.

UnitedHealth Group said it was also still considering the impact of the decision.

“Our teams were actively preparing for this decision,” the company said in a statement. “We are currently reviewing the court’s opinion and will provide more information as soon as possible.

Most Americans did not have insurance to cover abortion before Dobbs’ decision, said Ken Janda, a former health insurance executive who heads the consulting firm Wild Blue Health Solutions. According to Hyde’s so-called amendment, federal funds cannot be used for abortion, except for rape, incest, or if pregnancy is life-threatening.

Some states use their own funds to pay for a Medicaid abortion, but Texas is not one of them.

Most patients pay out of pocket for an abortion, research shows. About 69 percent of patients surveyed patients at six abortion facilities across the country paid for the procedure themselves, including those with private health insurance, according to a 2014 study in Women’s Health Issues, a peer-reviewed academic journal. The most common reason for not using insurance is that abortion is not covered.

Meanwhile, the cost of procedures is rising as fewer abortion clinics are insured, according to a report by Health Affairs, a peer-reviewed health journal. From 2017 to 2020, abortion clinics that accept insurance fell to 80% from 89%, while the average price for medical abortion rose to $ 560 from $ 495, and procedural abortion in the first trimester rose to $ 575 from $ 475.

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