Cost of pregnancy?

[lehresman]

Originally Posted by sweeps

I just joined an HDHP, and this is what would happen in my case: You would pay 100%* for services until you hit your deductible. Then you would be covered 100%.

Ideally you would have funded an HSA along with the HDHP. You can tap the HSA for all the charges leading up to the deductible, but you don't have to. You can leave the money in the HSA if you prefer.

* Note that you only pay the amount that the provider has negotiated with the insurance company. So a service that might be $200 for someone without insurance might be $120 for someone with insurance.

Yeah, that's what I love about HDHP/HSA plans. You still get the negotiated rate, and the most you'd pay is your deductible, and it's covered 100% after that. So since we have a $5000 deductible, the most we'd pay is $5000, and that comes from our tax-free HSA which we've been building up instead of paying for expensive health insurance.

The only question I'm a bit concerned about is whether or not maternity medical expenses will be counted toward my deductible. I'm still waiting to hear back from my health care provider for an answer on that one.

[M-squared]

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The only question I'm a bit concerned about is whether or not maternity medical expenses will be counted toward my deductible. I'm still waiting to hear back from my health care provider for an answer on that one.

I'd look into that. I am extremely healthy, but somehow manage to have complicated pregnancies. I'd say each of my pregnancies probably ran $30-$50K. That included dozens of ultrasounds and time spent hospitalized for pre-term labor. My son was born 5 weeks early and required a little extra time in the hospital.

[DebbieL]

Wow! Just - wow! None of this stuff costs anything here in Canada. I cannot even imagine having to think about medical expenses (I've obviously been here all my life). Holy cow.

I always say my kid's expensive, but I think you all have me beat before yours are even home from the hospital, lol.

[aida2003]

I read on some other forum that you must be very vigilant to check out the medical bills.
Mommies whose pregnancies+deliveries were covered by insurance co. still requested itemized bills from the hospitals. Then they told what ridiculous amounts hospitals billed their insurances.
E.g. a lady who had a C-section was billed for forsceps (?spelling?). Or another mom who had a natural delivery and didn't have any drugs put in her body was charged for IV, epidural. Anyway, I was reading and couldn't believe it how dishonest hospitals can be. No wonder health insurance is increasing by leaps and bounds .

So, my point was that request itemized bills and peruse them

[FrugalFish]

Originally Posted by lehresman

FrugalFish, we do have insurance.. we just pay for the first $5000 and are covered 100% after that. That's why we were able to get such a great rate ($88/month). The other quotes we got for normal health insurance for my wife were in the range of $300/month, not including maternity coverage which was an extra $150. We still paying about that much per month, except we are putting it in an HSA instead of just paying it to the insurance company. Thus, we have a sizable savings built up. That seemed like a better option for us. The money is still in our control, and we're covered in case of major medical expenses.

OK, I misunderstood. I read it that your insurance did not cover maternity at all. I've known more than one person in that situation.

In that case, expect to spend your full deductible- at least in the year of the actual birth.

GL.

[PrincessPerky]

Originally Posted by lehresman

Now to my actual question. How much does pregnancy cost, and what is actually necessary? I've heard it can cost anywhere from $3,000 to $10,000 depending on where you go and what you do all during the pregnancy. We are open to alternatives to birth at the hospital -- birthing centers or a midwife (but I don't think midwifes are allowed in NC).

Oh, thought I would add, midwives are allowed inNC (and you sound anti dr so doubly recommend one) but home births are not allowed..or rather home births are allowed just not births at home tended by a midwife..makes no logical sense. but that is the law. Finding a midwife may be hard though.

[jIM_Ohio]

Originally Posted by tripods68

Wow! I'm still amazed how many people spend on medical cost just to have a baby. But Because we belong to HMO plan employer covered plan, we paid ZERO cost when we had our first child 4 years ago. When we had our daughter 2 years ago, our cost was $250.00 hospitalization. That's it. But all our medical insurance coverages is through my wife employer and I get monthly stipend on top of my base salary; for not electing my employer's health covered plan. Our monthly health care cost is $210 for family of four. The rest is paid by her employer.

Something similar in our case. Wife will pay a $300 fee, and each kid is also $300 for each kid being admitted (and since DS2 was admitted to 2 hospitals, his fee will be $600).

There is a chance the lab testing and a few similar things will not be covered under the admittance, so the out of pocket max for in network is something along lines of $1000 per individual (per admittance).

If we used my HSA it would have looked like this:

I pay ~$30/check for HSA ($408 per year). The bill is actually $2400/year, company pays almost $2k for me).

I have a $1500 deductable per person. So first $1500 of hospital stay is paid by my wife. Then once kids are born, each addmittance for them is $1500 (so $4500 in our case for 2 kids/ 3 admittances). After the $1500 we pay 20%, incurance pays 80% until we hit out of pocket max of $5200 per year I believe- at that time the insurance pays 100%.

[M-squared]

I will add that I paid $20 for each pregnancy. My very first OB visit required a $20 co-pay. After that, I was charged nothing. There was some funny mix-up when I had to get a referral for the specialist I was seeing, so I had to make an appt with my primary care doc, to confirm that I was indeed pg, who then had to get a fax from my OB stating that I did, indeed need to be seeing the maternal and fetal specialist. It was really silly.

[Spud]

I have a PPO plan.

For Maternity care, I paid a single $20 copay to my OBGYN plus a few lab fees here & there, and some copays for some prescriptions -- probably a couple hundred in total. However, I was hospitalized overnight for high blood pressure. Of course, that was in 2006 which was a different plan year than the birth, so I had to pay another $1700 for that. For one night. A couple months later, I had a C-Section. New plan year of course, so the $1700 did not count toward fulfilling my deductible. My portion of the hospital bills (I had an extended stay due to blood pressure issues) were $4152 and the doctor bills were $2863.

So you just never know.

[tripods68]

Spud--You just made my point why we don't have PPO because of high deductible costs. HMO is far better and more affordable IMO.

[Spud]

There are benefits and drawbacks of doing it both ways. *shrug* Ya pays yer money and ya takes yer chances.

My kid is way worth the $15k or so we've spent on her so far.

OP - there is another similar thread here that you might be interested in reading:
How much do you spend on your kids now?)

[LivingAlmostLarge]

I think a kid would cost me $10 for DH's POS plan. It's $80/month for the two of us and with a kid $100/month. Gosh I love his insurance.

But his previous insurance in graduate school, only one in the US, ZERO for everything out of pocket. I paid not even copays. I walked into anything and everywhere and saw anyone. NO limitiations on who I could see.

[rupeeman]

hey i think we all should be prepared for this kind of situation because it's a part of the life so never run from your responsibilities. I have also caught between my financial problems but at last i checked all my bank accounts and credit cards too to grab out money from them and at last i got success! Nowadays many banks are offering finance services for pregnancy cases so get aware of these kind of schemes...

[disneysteve]

Originally Posted by aida2003

I read on some other forum that you must be very vigilant to check out the medical bills.
Mommies whose pregnancies+deliveries were covered by insurance co. still requested itemized bills from the hospitals. Then they told what ridiculous amounts hospitals billed their insurances.

This is true for ALL hospital bills, not just those related to delivering a baby. You should always get an itemized bill and review it item by item. If there is anything you don't understand or aren't sure if you actually got, call and ask. Make them review the records and justify the charges.

When my wife had her gallbladder out 2 years ago, I got over $1,000 knocked off the bill after I reviewed it.

To be fair, it isn't all fraudulent charges. If you've ever spent time in a hospital or worked in an OR, you know how things run. They might prep a room for everything they anticipate possibly having to do. Each piece of equipment that gets opened gets billed to the patient even though it might not actually get used.

In my wife's case, before she went in for the operation, they set up her room with a compression pump for her legs (to prevent blood clots). But in the OR, they hooked her up with a pump so when she got back to her room, she didn't need the one that was set up there. Of course, it had already been billed to her account. I got them to remove the duplicate charge. Stuff like that happens a lot.

[lehresman]

Ok, I said I'd update once I heard from my insurance company. Like I said, I have an HDHP with an HSA. After $5000 deductible, they cover 100%, but I did not get maternity coverage. They said they would cover complications on the pregnancy, just not normal routine delivery expenses. The kicker though is that the child would not be covered at all, so if there are any complications with delivery resulting in the child needing more medical attention, it would not be covered.

[noppenbd]

Originally Posted by lehresman

Ok, I said I'd update once I heard from my insurance company. Like I said, I have an HDHP with an HSA. After $5000 deductible, they cover 100%, but I did not get maternity coverage. They said they would cover complications on the pregnancy, just not normal routine delivery expenses. The kicker though is that the child would not be covered at all, so if there are any complications with delivery resulting in the child needing more medical attention, it would not be covered.

Now I am really worried for you. The routine pregnancy costs you can budget for, and maybe negotiate down since you can pay them cash up front; any complications will cost you $5000 but the rest would be covered. But if the baby needs to go into NICU you will be totally screwed. I would remedy this ASAP, before your wife gets pregnant.

[disneysteve]

Originally Posted by lehresman

The kicker though is that the child would not be covered at all, so if there are any complications with delivery resulting in the child needing more medical attention, it would not be covered.

Its been a few years since I did infant care, but the law used to be that newborns were automatically covered by their parents' insurance for the first 30 days of life. That gives the parents time to contact their insurance company and get the baby added to the policy. Maybe they do it differently now. As long as they make the coverage retroactive to birth, I guess it doesn't really matter.

[PrincessPerky]

Originally Posted by lehresman

Ok, I said I'd update once I heard from my insurance company. Like I said, I have an HDHP with an HSA. After $5000 deductible, they cover 100%, but I did not get maternity coverage. They said they would cover complications on the pregnancy, just not normal routine delivery expenses. The kicker though is that the child would not be covered at all, so if there are any complications with delivery resulting in the child needing more medical attention, it would not be covered.

I wonder if that is a state by state law that a baby is covered under moms ins?

I do know that for non covered moms, buying separate insurance for the baby only starts after the babies first 'well baby' visit. which if there is a complication will not happen for quite some time, otherwise it tends to be around one week.

[LivingAlmostLarge]

I had heard this from friends that they had to add the child to the policy upon birth and retroactively pay.

Boy does that suck. So you still have to pay 100% of the normal delivery? But complications above and beyond $5k they cover? What is the lifetime or annual payout? Is there a limit?

And then you need medical in case the baby is sick in delivery?

A friend had the child go into distress during labor and take in some of the amniotic fluid while she was trying to delivery. Turns out she went c-section and the baby into the NICU for over a month because of it. Supposedly from the stress of 18 hours of labor.

[disneysteve]

Originally Posted by PrincessPerky

I do know that for non covered moms, buying separate insurance for the baby only starts after the babies first 'well baby' visit. which if there is a complication will not happen for quite some time, otherwise it tends to be around one week.

Do they make the coverage retroactive to birth? There has to be some way to have the baby covered since the baby will have medical expenses from the moment they are born even if everything goes perfectly smoothly.