4 answers

Seeking Estimate of Bills for Pregnancy Care

Hi Moms,
I have a beautiful 19 month old boy and want to add to my family. When I had my son I was under my husband's benefits but since then my husband has took a leap of faith to get into the career he enjoys and is working on his MBA!! He still works but he is contract so the benefits are now under my job. Long story short we have a high deductble plan so we are responsible for the first $2400 then they cover up to 80% until we reach $4800 then everything is 100%. That being said I am wondering if anyone has ever had to pay out of pocket for their office visits and everything else. I went to united health (who we are under) and saw ultra sounds are about $150-$200 which isn't so bad, I am just worried about the doctor's visits and tests (like the one you drink that nasty stuff;-). My company does give me $1200 use for bills (but that is for the whole year and is for everyone in the household!!) and the plan does pay the whole hospital bill when I deliver. Just need to know about how much I will be out off before I decide to move forward.

1 mom found this helpful

What can I do next?

So What Happened?™

Well I took everyone's advice (especially Sarah W). I contacted the provider who paid for everything and got an itemized bill. My insurance does pay for the birth so I don't have to worry about those bills and my company does give me $1200 to use on my own bills. After I added everything up I think I will be out of pocket about $1500 which to me is worth it!!!

More Answers

Hi M.:

I don't know if this will help you, but when my husband was going to school for his MBA we were able to get insurance through his school. The benefits were costly to get but I remember that maternity was covered at 100%.

Just a thought.

A.

2 moms found this helpful

I would start by contacting the billing specialist at your OB and discuss what the total prenatal package would cost. Maybe they will work out a discount for you, because you are paying out of pocket. I would expect you would eat up the majority of the $2400 deductible in prenatal expeneses, especially if you need several scans and labwork done.

We had United, with a high deductible, for my daughter's birth. The midwife cost 2700, and then I had an assortment of other bills for ultrasounds, etc. The hospital bill was something like 800 (at Alexian). I think we spent a total of about 4000-4500k, over premiums.

I labored naturally, so I didn't have any expenses for pain meds. I think an Epi costs a bit of money.

When I had my first baby, my husband and I had not married yet and my son was born under my insurance. I too had United. Your plan seems better than what mine was. I was responsible for the first $500, then after that they paid 80% until I reached $5000, then they covered 100%. HOWEVER, once your child is born they are now on their own deductible and no longer covered under you. Meaning that all the care and birth is under your deductible but then once the baby is born, they have their own deductible to fullfill. My max out of pocket was $5000 but my son's was $2000 plus another $500 deductible making a total out of pocket for the 2 of us $8000. Between my care and birth, taking into account I had basic care but a c-section birth (which is only about $3000 more than a reg birth), my portion was the entire $8000. I tallied up my total expenses including prenatal care, hospital care & the delivery and my total charges were over $30,000.

What you need to consider are 3 things. First, like I mentioned above, the baby will have thier own deductibles/maxs to fullfill because they are a new person on the plan. Immediately upon birth, they start charging expenses for the baby that are completely independant from your expenses - medicine, nursery care, doctor visits in hospital, etc. Second, when you mentioned that you checked with United and they charge $150-200 for an ultrasound. I think you may be confused by something. That's what your insurance ALLOWS for an ultrasound. Meaning that if your doctor's office/hospital charges $800 or $1000, your insurance will only allow (or in other words pay) $200. That will make a big difference in what you can afford. And third, you should apply to the hospital where you deliver for a discount. The financial department will have a form you can fill out that will take into account your financial and lifestyle situation. I recommend you attach a typed letter by you that personally outlines your situation. There may or may not be a discount avaialble to you. Then depending on what they determine, you can forward that info to your doctor's office and they too should allow a discount for you.

Looks like your total max for you is $7200. I would recommend that you should just count on that amount being what you pay, plus whatever else your child will cost. It stinks but that's how insurance is. Just imagine if you had to pay the entire $25-30K yourself!? At least you have insurance but these are major things to consider. Another point, my son is now 2.5 so that $30K I was charged has gone up from that time ago. I'm sure at today's rates it would now be closer to $35K.

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