10 answers

Medical Insurance and Pregnancy - How Does It Work???

Anyone out there have some advice? Insurance is one topic that thoroughly infuriates me! I have a high deductible plan. It has all kinds of loopholes on how insurance will not cover costs - i.e.: if I conceive in a different YEAR than deliver - I have to pay 2 times the deductible - - so one child could cost $10K??? And that is just MY charges. Baby if any complications will have to meet a separate deductible.

Oh, and has anyone ever bought a "rider" from the hospital that they delivered at??? WHO KNEW!?!?

What can I do next?

Featured Answers

Yes, you might have to pay the deductible twice. However, you could switch to a different plan on the second year...one with a lower deductible and better coverage. It might be a good idea since you will spend a lot of time at the doctor's office the first year of baby's life! (It is an unfortunate fact.) Good luck on getting pregnant. Life doesn't always happen the way we plan, but we do what we can!

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I would say plan for a home birth, safer, more relaxed and cheaper. Midwive fees are not so bad, for sure consider it.
G.

1 mom found this helpful

I had a high deductable on my insurance as well- $5700 and after I became pregnant I found out I was not even covered for pregnancy- the agent messed up and there was nothing I could do about it. Check with your gyno- they typically have plans for people who do not have insurance that are less money than what it would cost if you had insurance and they take it in payments you set up with them. I ended up paying 75% of their fee and then decided to have my baby at home with a midwife and even though it was like paying twice it was so worth it (and still less than the deductable). If you are open to having a home birth, check out Shell's site: http://www.themidwife.net/ she covers the phoenix area is is fabulous:)

Good luck!

1 mom found this helpful

Have you considered a homebirth? A local homebirth midwife generally costs about 2,000 for all prenatal, birth, and postpartum fees, and some are even willing to barter services for part of your fee. We found the care of midwives to be highly superior to typical maternity care and would never go back now that we know they're out there.

(We started looking into midwives because we didn't have insurance coverage when I got pregnant, and are SO thankful it happened that way!! We love midwifery-style maternity care.)

1 mom found this helpful

Check with your insurance company. I am a plan administrator. The way most births work is that the doc does not bill the insurance company until the end of the pregnancy. That means that you will not have to pay 2 deductibles if you get pregnant one year and have the baby the next. It is all billed all at once as a "balloon". Double check your policy.

Be aware, not only will the doctor bill you, but so will the hospital and the anesthesiologist, if you use one. All seperate!

The doctor's office should be able to tell you what your responsibility will be. My first visit as a newly pregnant lady, the doc's office gave me a print-out showing my portion ($1800). They set up a monthly payment for me so that I would be paid in full by the 8th month. They then informed me that I would have seperate responsibilties to the hospital.

Anyway, check with your insurance company, insurance administrator (benefits department at your employer) and check with your doctor. They should all be able to give you a pretty clear picture of what to expect.

Good Luck

Hi A., I'm an agent so here's some other info. You can't get pregnant, then try to get health ins....you would be automatically declined! Also, very few plans will cover a pregancy if delivered in the first 12 months of the policy. You would need to check with your plan specifically.

Also, whether you have health insurance or not, Aflac is another option that PAYS YOU CASH to help offset costs. Here is an example: The first plan that covers this is the Sickness Plan. It pays $500 for initial hospital stay and $100 for each day thereafter. It also has a surgery benefit for either normal or caesarian birth. This pays either $300 or $400. There is additionally up to 8 physician visits per family that can cover at $25 each. There are a couple other plans available and the premium for these are very low! Of course, you have to have the plans BEFORE you are pregnant!

Let me know if you have any questions or want more info! It's smart of you to check into this BEFORE and then maybe get some surprises if you are not aware! Good luck!!

Hi A.,

Society may think babies are cute, but insurance companies sure don't. I went the midwifery home birth route, but I did have insurance in case we had to transport to hospital...otherwise I think I would have been terrified.
Get insurance or discount plans ahead of time (before preg). Read fine print and see if anyone on the internet is blogging about being burned (and just how that happened). See if any women advocacy organizations have any particular recommendations.
I had a plan with Assurant that would cover emergency delivery issues at hospital even in the first year...but I am not sure about loopholes (I had not planned to get preg while with them). Good Luck!!!

Yes, you might have to pay the deductible twice. However, you could switch to a different plan on the second year...one with a lower deductible and better coverage. It might be a good idea since you will spend a lot of time at the doctor's office the first year of baby's life! (It is an unfortunate fact.) Good luck on getting pregnant. Life doesn't always happen the way we plan, but we do what we can!

Hi A.,

I had the same questions when I got pregnant. I called my insurance company with all my questions, I made sure that my doctor was in their plan and the hospital and everything. I found out what they cover and for how long they cover. They were very helpful in answering all my questions so when I had my daughter I knew exactly what to expect. Good Luck.

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