A 6-months pregnant Canadian woman took a personal trip to Hawaii. While there, she gave birth to a daughter, who ended up in the Neonatal ICU for several months, racking up $1 million in medical bills. Her national health insurance plan paid $20,000, and (for some undisclosed reason) the US paid an additional $12,000.
The controversy arises due to the fact that, prior to departure, she had apparently purchased a travel plan from a Canadian Blue Cross affiliate, and they have denied the claim. According to Ms Huculak, they are citing pre-existing conditions as the basis for their denial.
[ed: In case you're wondering, one of the worst kept secrets about the Canadian national health care scheme is that folks "in the know" purchase private coverage to supplement it]
And here's where it gets, well, interesting. For example, Ms (Mrs?) H claims that her doctor had given her a "green light" to take the trip, despite the fact that, only two months previously, she'd had a bladder infection and hemorrhaged. She says that her "doctor saw no reason for me not to go." Which is nice, but entirely irrelevant. Perhaps she could turn the delinquent bills over to him for payment.
She also says that "her doctor sent a letter to Blue Cross confirming that Huculak’s pregnancy was stable when she went on vacation, but the claim was still denied." Again, without more detail as to why the claim was denied, we can only speculate. Regardless, an insurance company has no obligation to give any weight or credence to anything a doctor not in their employ has to say.
I reached out to the folks at Saskatchewan Blue Cross to see if they could shed some light on some of these issues, and will have an update when (if?) I hear from them. The Canadian Blue Cross is not affiliated with the one here in the states, and has a different product line, including travel medical plans.
So, since traditional media continues to do such a shoddy job of basic research, I went to the SBC site and took a look at the policy details, and specifically the exclusions. And lo and behold, we find this at the #3 spot:
Any expenses related to a medical condition (whether or not the condition has been diagnosed or the diagnosis has changed) for which any symptoms occurred during the six (6) months prior to the Effective Date for Covered Persons:Well, she'd obviously consulted a physician, and it's entirely likely that she'd been hospitalized for the hemorrhaging. The fact that she had failed to read the policy (and note its exclusions) is on her.
• consulted a physician
• was hospitalized
Oh, the most profound lesson here: turns out nationalized health care doesn't work. Who'da thunk it?