Man With Private Insurance Paying for Maternity Care

Fred, living in Santa Monica, was unknowingly paying for maternity coverage. Being single and a guy mattered not due to a clerical error.

Fred, a confirmed bachelor and still single, upon receiving his monthly statement, was shocked to discover that his health insurance premium had nearly doubled one month. Upon further investigation when he called his agent to complain, he learned that for more than two years he’d been paying an extra $104.00 per month, and that this resulted from maternity coverage.

“That should be easy to fix,” he confidently told his agent, “I’m single and a 59-year-old male. When do I start getting the lowered rate, and maybe money returned to me retroactively?”

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“Not so fast,” Fred’s inadequate agent blithely replied, “You failed to correct it.”

“I failed to correct it?”

“That’s right. It’s your responsibility.”

“How is it my responsibility?”

“I can explain it to you.”

“Please do,” whimpered Fred, now shaken to the core of his being after realizing that for two years he’d been categorized by his trusted insurance carrier as having the potential to become a pregnant woman and never so much as eaten a pickle. Recovering a bit of his dignity, he started to become indignant, something that the agent could instinctively sense.

The agent now realized in the nick of time that explaining how the mistake had come to be was not only prudent but the right thing to do.

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“Here’s what happened,” he began blithely spouting, “When you first joined up with this health insurance plan, we sent you a booklet describing coverage in every particular. The maternity coverage clause was mentioned in that. You should have chosen a plan that excluded maternity coverage to begin with. The plan you picked had maternity coverage in case you became pregnant. ”

“But I’m a guy.”

The agent softened a bit hearing that. “You had ten days to examine the coverage. We never heard from you about maternity coverage.”

Fred won’t get his money back but it’s not too late to find a competent California Health Insurance Agent.

Get to know your health insurance agent. Don’t let this happen to you. There are plenty of reliable health insurance agents like Matt Lockard of who have the experience and knowledge to help you find a health plan that will cover what you need and only what you need.

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