Reece Huculak-Kimmel has become known as the million-dollar baby.
The 11-month-old Canadian girl was prematurely born at Kapiolani Medical Center for Women & Children on Dec. 10 and her parents are now responsible for a $950,000 bill that insurance won’t cover.
BY THE NUMBERS Some of the charges included in the $950,000 medical bill: >> Baby’s hospital stay: $600,000 >> Mother’s hospital stay: $161,000 >> Air ambulance flight: $44,000 >> Specialist fee: $57,000 >> Radiologist fee: $10,000 Source: Jennifer Huculak-Kimmel |
Jennifer Huculak-Kimmel was vacationing on Maui with her husband, Darren, when her water broke two days into their stay.
She was airlifted to Kapiolani Medical Center, where she was put on bed rest for six weeks and delivered baby Reece by emergency C-section nine weeks early.
While still in the hospital, she learned that her travel insurance company, Saskatchewan Blue Cross, had denied her claims due to a pre-existing medical condition exclusion in the policy. More than a month before, Huculak-Kimmel had a bladder infection that caused minor hemorrhaging.
"At no point was I ever told by a doctor that a bladder infection could cause a water breakage down the road," the 30-year-old mother told the Honolulu Star-Advertiser in a phone interview from Canada. "The doctors at Kapiolani told me there is no specific cause. They can’t link a water breakage to anything. These things just happen."
The baby was kept in the neonatal intensive care unit for two months and the couple, who live in Humboldt, Saskatchewan, have been desperately trying to get Blue Cross to cover the huge expense or they may be forced into bankruptcy, she said. Huculak-Kimmel said she paid $60 for the travel insurance policy.
"As Ms. Huculak’s emergency medical claim has been denied on the basis that her medical emergency is excluded from coverage under the terms of her pre-existing condition provision, her baby is also not eligible for coverage," Blue Cross said in a letter dated Dec. 16 to Kapiolani Medical Center.
A spokeswoman for Hawaii Medical Service Association, which is part of the Blue Cross Blue Shield network, said the insurer couldn’t comment on the case because the family wasn’t covered by HMSA. Officials at Kapiolani Medical Center declined comment.
"I guess I was naive. When a doctor tells you, ‘You are fit to fly,’ I thought that I would be insured," Huculak-Kimmel said. "Having a new baby sick in (intensive care) alone is stressful enough, but your insurance company denying your claim when you thought you were covered, it’s extremely stressful. It’s traumatic. We honestly don’t know what we’re going to do."
Canadian residents have government-sponsored universal health care as long as they’re in the country, but once they travel elsewhere they must purchase private policies, which are limited in benefits, said Scott Stanley, an insurance lawyer based in Vancouver, British Columbia.
"She had a spotting in her pregnancy, nothing became of it, but that was a sufficient prior medical condition to disqualify her from coverage," said the attorney, who doesn’t represent the family. "They have to disclose all prior medical conditions when they apply, but some people don’t think it’s a big deal. It may not be a big deal medically but it is a big deal from an insurance perspective. There’s a good chance the insurance company does have a leg to stand on."
HMSA said it has many members who travel out of the country. The majority of its plans will pay members for urgent medical services received in a foreign country at least up to the amount that would have been covered if the services were performed in Hawaii, the company said.
Depending on their plan, HMSA said members may need a prior authorization (clearance form from their doctor) so they can get health care services out of state if they need it.
"While Reece was in the hospital … I tried every avenue. I went through finance at the hospital trying to apply for help through different government programs, Obamacare, and nobody would help me because I was not a U.S. citizen," Huculak-Kimmel said. "We will declare bankruptcy as a last option. If I’m going to go down, I’m going to go down kicking and screaming."