Health Insurance and Surrogacy
Intended parents in a surrogacy arrangement must have access to reliable health insurance coverage for their surrogate. Health care costs for complications of pregnancy can easily and quickly reach $100,000, and have been known to exceed a half million dollars. Without health insurance coverage for the surrogate, the risk of financial catastrophe for the intended parents, who are usually responsible for the medical bills of the surrogate, is very real.
The real issue in obtaining appropriate coverage is determining whether the surrogate's own health insurance policy, or the policy to be purchased specifically for the surrogate’s pregnancy, covers health care expenses of a woman during her surrogate pregnancy.
While there are some policies that expressly cover surrogates, they are not typical. It is much more common to find health insurance policies that state they do not cover surrogacy related expenses, or make no statement on the subject. Intended parents wanting confirmation of coverage for their surrogate can seek a “health insurance coverage opinion letter.”
A well-written insurance coverage opinion will contain all policy provisions impacting on the issue and an explanation as to their meaning. It will also include a statement of the jurisdiction(s) likely to interpret and enforce the policy and a review of all local, relevant court cases, along with the applicable laws of those states. It will give a clear statement whether insurance coverage exists, or it will state what additional information is needed to answer the question. In those situations where a clear answer cannot be given, it will explain why and will also give the author’s reasoned opinion as to what a court considering the issue may do.
Insurance coverage opinion letters are usually written by lawyers specializing in the field of insurance coverage. However, recently, insurance agencies have also started providing these opinion letters in the area surrogacy. It is important that any opinion is from a credible source, signed by the author and including contact information for the writer.
The reliability of opinion letters should absolutely be questioned when they do not include the information, rationale and conclusions as stated above and also in the following situations: opinions that include an offer of the writer to sell the writer’s health insurance coverage to the intended parents and a letter which gives an opinion, but also include a disclaimer that the opinion cannot be relied upon.
If you are unsure as to the reliability of a coverage opinion you have received, be sure to raise the subject with your AAARTA attorney.