OT: Paying for pregnancy and birth

[taylorcpa]

I can give you my experience. I have private medical insurance with no maternity coverage. To add maternity, it would have been $300 more a month and then subject to my deductible. When I was pregnant with my first, the doctor's office did not know I did not have maternity coverage so they figured up what I owed them with my insurance. I told them I did not have maternity insurance so they redid it. Guess what, it was $100 cheaper without the insurance because of my deductible. Now that was basic care - no extras. Then my hospital visit was extra and was about $3,000, which was cheaper than what my insurance premiums would have been. So, I paid out of pocket about $6,000 for office visits and delivery. Both gave me discounts for paying within 30 days. Keep in mind that I had uncomplicated pregnancies and deliveries - no epidural or pain meds, nothing. I have had two kids in a three year time span that way and paid OOP for both. As I figured it, my premiums for that period would have been $11,000 and my deductible 2x would have been $5,000, plus my 20% which I don't know, so I came out ahead.

I also considered that my insurance would cover complications with ME during delivery - ie if I would have had an emergency c-section due to medical problems, my insurance would have covered it. Also, the kids were covered at birth on DH's policy so any complications that would have arose would be covered there. This limited my exposure.

Do you have any health insurance? Will your kids have health insurance at birth?

I would start by finding out how much your doctor would charge you for a normal delivery and then call the hospital to see how much it would be. You could also see if there are midwives in your area who would deliver at your home if you feel comfortable with that.

Honestly, I'm not sure I would go to the Indian clinic/hospital but I would probably make a visit there just to see since you have a while to research your options.


HTH!

 

[disprincessatheart]

disprincessatheart: The second option was that we would go to the Indian clinic for prenatal care which is free. We wouldn't pay for prenatal care. $1k for a 3D u/s? You got jipped! LOL. I paid $125 for mine in 2003 and it's still the same here!

Our 3D included a bunch of genetic testing as well, so I'm guessing that's why it was higher. We actually only paid our $15 copay, but the $1k is what they charged to the insurance company at full price (before their negotiated discount which I think brought it down to $600)- just came on my statement in the mail last week.

 

[SageFemme]

Thank you taylorcpa! That is why we're doing BCBS for all of us when the baby is born. We would have to pay for maternity coverage for an entire year before we can even TTC due to the waiting period...then for another year while I'm pregnant.

I don't know!

 

[Pixie Dust for Me!]

Hi, I'm the OP.

Pixie Dust For Me: What are you confused at? My first sentence in my post was "DH and I want to TTC next year."

OK...but what in the heck is TTC? Ticket Transporation Center, a military term, something slang in your neck of the woods???? Sorry, but I still don't know what TTC is!

 

[annagirl]

What are you confused at? My first sentence in my post was "DH and I want to TTC next year."

Oh - that must stand for Try To Concieve? not very obvious to me, either.



Personally, I would never, ever have a child without insurance. Too many possibilities of very expensive consequences during pregnancy, birth and after.

 

[taylorcpa]

OK...but what in the heck is TTC? Ticket Transporation Center, a military term, something slang in your neck of the woods???? Sorry, but I still don't know what TTC is!

TTC = Try To Conceive

SageFemme, can you get the BCBS coverage before you get pregnant w/o the maternity? Otherwise, are you going to wait until after the baby is born before getting the coverage? Also, is this an individual or group policy?

 

[SageFemme]

double post

 

[SageFemme]

Personally, I would never, ever have a child without insurance. Too many possibilities of very expensive consequences during pregnancy, birth and after.

Either I will go through the Indian hospital which is free, or have insurance after a 365 day waiting period. Either way, there will be coverage. I have ruled out the second option.

 

[laceemouse]

That is what I told my coworker...however, I do need them to respect my wishes on not wanting a certain procedure such as an episiotomy in certain circumstances, etc. That is what I'm worried about. I don't know 100% if you get to choose the doctor and if it's the same one during the delivery...I need to find this out.

I understand. For sure you need to go tour the place and ask a million questions. I had my second at a military hospital and the bedside manner was terrible. I saw a different doctor at each appointment and the doctor who came in to deliver me I had only seen once before. HOWEVER, I think I got good care and everything was fine.
Best of luck to you in whatever you decide

 

[ccgirl]

Forgive me, I didn't read all threads but did want to reply. If you can afford, I would get the insurance asap!!! Pediatric care can also be expensive. There are well visits every few months, vaccines etc. You also want to be covered if your child gets sick. I live in MA so the insurance may be different. All residents are required to have insurance. A lot qualify for free insurance. I know my mom does - she has 0$ copay and her prescriptions are only $3 each. Does your state have state insured/run plans? You may want to check into those too. Good luck!

 

[jboysen]

we have BCBS of MN. I love our insurance through them, we've had no problems and I had quite a complicated pregnancy last year. $400 is not bad for out of pocket for insurance, this is because this is not through your employer right? So your employer is not paying anything. You can probably get that deducted from your paycheck before taxes are taken out, if not you will have a tax deduction on that. My parents for just the two of them pay $600 a month, also not through their employer and it comes right out of my Dad's paycheck. If you can wait out the 365 days until you can TTC I say this would be the option, you sound iffy on the other. You mentioned waiting until next year anyways, so would you be waiting much longer? Just my 2 cents.

 

[SageFemme]

TTC = Try To Conceive

SageFemme, can you get the BCBS coverage before you get pregnant w/o the maternity? Otherwise, are you going to wait until after the baby is born before getting the coverage? Also, is this an individual or group policy?

We can't get the insurance coverage without maternity because we will not be covered by the time I get pregnant because you have to have maternity coverage for 365 days before it is even covered. Hopefully that makes sense. It's an individual policy.

 

[SageFemme]

we have BCBS of MN. I love our insurance through them, we've had no problems and I had quite a complicated pregnancy last year. $400 is not bad for out of pocket for insurance, this is because this is not through your employer right? So your employer is not paying anything. You can probably get that deducted from your paycheck before taxes are taken out, if not you will have a tax deduction on that. My parents for just the two of them pay $600 a month, also not through their employer and it comes right out of my Dad's paycheck. If you can wait out the 365 days until you can TTC I say this would be the option, you sound iffy on the other. You mentioned waiting until next year anyways, so would you be waiting much longer? Just my 2 cents.

Thanks for your reply. I believe we have decided to go ahead and get the insurance. As far as waiting, it is a difference of Spring 2010 and Spring 2011. But if that's what we gotta do, it's what we gotta do.

I do have a question about networks. We will meet with an agent next week but until then, I wanted to ask. They have different "networks" that pay 60%, 70%, and 80%. From my understanding, you pick a doctor that has the network that pays whatever percetage you want, correct? Or do you have to choose one network for everything? Does this change your premium cost?

 

[disney_family_1247]

In 2002, we had expensive private insurance that covered 0% of maternity. We earned too much to qualify for the state's free coverage for pregnancy. We discovered that doctors and hospitals have special rates for cash patients. I paid my OB $2,500 over the course of the pregnancy. The hospital's cash price was only $875 for a normal delivery. Everything went wrong, and I ended up with a surprise c-section. That added like $6,000 to the bill. You might find out the costs of those things ahead of time and save up the money.

The most important thing is that you have insurance for the baby from birth.

 

[Zeebs]

Sorry totally off topic but your name SageFemme brings up an advertisement at the top of my page for SageFemme - independant midwives in the UK. Is that just the weirdest thing.

Kirsten

 

[allyphoe]

If you apply for an individual policy after the baby is born, it's possible that the baby would be uninsurable or would have significant preexisting condition exclusions. Individual policies are notorious for nitpicking stuff out. For instance, my dad wrote on his application that his eye doctor had referred him for a glaucoma screen, but that it had come back clear. His policy has a lifetime exclusion for glaucoma.

If you get the individual policy before the baby is born, the baby is automatically covered for the 30 days following birth, and can be added to the policy with no exclusions thereafter. (If the baby will be eligible for Indian benefits, this may not be as much of an issue, because you'd have that as a fall-back option.)

My individual policy, which does not include maternity benefits (no longer needed!) wouldn't have paid a penny for a normal delivery, including elective C-section. Interestingly, the fine print says that they would cover non-normal stuff related to pregnancy, including an emergency C-section. If a similar policy is available to you (we live near Tulsa, and have Assurant as our insurer), that might be a third way to go.

 

[malibuconlee]

OK, my post didn't go through the first time so hopefully it does this time...



That is what I told my coworker...however, I do need them to respect my wishes on not wanting a certain procedure such as an episiotomy in certain circumstances, etc. That is what I'm worried about. I don't know 100% if you get to choose the doctor and if it's the same one during the delivery...I need to find this out.

No matter where you go you cannot guarantee that the doctor you choose is going to be the one in the room. Every practice works differently and even different doctors within the practice may work differently than the others. My OB/GYN has standing orders to call him if a patient of his came into the hospital for delivery whether he was on call or not. He told me he tries to be there for every delivery if at all possible. Another doctor in the practice will hand off a delivery to whomever is on call if it's not her day on call or after office hours.

I had a c-section and before insurance the costs for pre-natal care, my hospital stay, the OR, the CRNA (anesthesia), and the ped charges were over $20,000. The financial person at my OB/GYN practice stated that the costs of a "perfect" delivery were around $12,000.

 

[TheRatPack]

$400/mnth is a lot. Is this through your employer or dh's? Would it be possible to search for a job that offers something more? I wouldn't quit my job first, of course....

I actually think 400.00 a month is GREAT LOL Our is 600.00 a month for a family plan.

 

[TheRatPack]

Sorry totally off topic but your name SageFemme brings up an advertisement at the top of my page for SageFemme - independant midwives in the UK. Is that just the weirdest thing.

Kirsten

That is strange LOL

 

[Catananche]

That is strange LOL

Sage Femme is the French for a midwife (literally "wise woman").