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Pregnancy without maternity coverage?? Pay cash?? Add coverage??
Posted on 10/15/13 at 3:49 pm
Posted on 10/15/13 at 3:49 pm
So yesterday the OB clinic called to let us know that we don't have any maternity coverage. Well, apparently I dropped the maternity coverage for my wife when she got her iud, then forgot to add it back when it came back out. Now she is due in April. 
I talked to my insurance broker, and my options are to:
1) Add maternity to our current plan and our premium will probably triple.
2) Wait until Jan. 1 when maternity has to be included and get her her own new policy with a new carrier then at probably the same tripled up rate, or
3) Just keep our current plan (super high deductible 5500/11000 HSA plan), and negotiate cash prices for the hospital and OB.
After talking about these options with the insurance broker, she pretty much convinced me to choose option #3. We have plenty in the HSA to pay for the cash price, and she explained that any complications would not be considered part of the maternity coverage (my biggest worry).
So, can anyone tell me about their experiences paying out of pocket for a pregnancy? Would we be taking on any extra risk? Thanks.
I talked to my insurance broker, and my options are to:
1) Add maternity to our current plan and our premium will probably triple.
2) Wait until Jan. 1 when maternity has to be included and get her her own new policy with a new carrier then at probably the same tripled up rate, or
3) Just keep our current plan (super high deductible 5500/11000 HSA plan), and negotiate cash prices for the hospital and OB.
After talking about these options with the insurance broker, she pretty much convinced me to choose option #3. We have plenty in the HSA to pay for the cash price, and she explained that any complications would not be considered part of the maternity coverage (my biggest worry).
So, can anyone tell me about their experiences paying out of pocket for a pregnancy? Would we be taking on any extra risk? Thanks.
8
Posted on 10/15/13 at 4:28 pm to Kingpenm3
i can't even begin to fathom how expensive it would be to have to pay for each doctor's visit and then the birth of a child without maternity insurance.
my wife is due in december and we've already been to the doctor probably 10 times.
i don't know what you should do, but good luck.
my wife is due in december and we've already been to the doctor probably 10 times.
i don't know what you should do, but good luck.
Posted on 10/15/13 at 4:54 pm to theOG
According to my Open Enrollment package at work, the average hospital/doctor charges for a birth is $7,540. Now this is the negotiated contract price between insurance company and all medical partners involved.
I dont know if the doctors/hospital are going to give your that negotiated rate or try to screw you with something extremely inflated at which time you need to negotiate down.
Thanks Obama
I dont know if the doctors/hospital are going to give your that negotiated rate or try to screw you with something extremely inflated at which time you need to negotiate down.
Thanks Obama
Posted on 10/15/13 at 5:24 pm to Kingpenm3
We chose to not have maternity coverage as at the time you had to have it for 1 full year before "needing" it ... we ended up paying cash. Our hospital and doctors were great to work with. We paid it in installments.
Had anything "gone wrong" we then would have been under insurance. Now this was all almost 13 years ago ... discuss NOW with the MD office and hospital what the price would be for a "normal, uncomplicated delivery". Then you can compare that to the premium with the coverage.
Had anything "gone wrong" we then would have been under insurance. Now this was all almost 13 years ago ... discuss NOW with the MD office and hospital what the price would be for a "normal, uncomplicated delivery". Then you can compare that to the premium with the coverage.
Posted on 10/15/13 at 6:36 pm to theOG
I didn't have it for my wife, just our normal company provided coverage and it only cost me 3k for everything. This was 9 months ago.
Posted on 10/15/13 at 6:55 pm to MG
quote:That may be just for the birth, not all the visits/tests prior. That's probably another $3K.
the average hospital/doctor charges for a birth is $7,540
This post was edited on 10/15/13 at 6:56 pm
Posted on 10/15/13 at 7:30 pm to ell_13
quote:
That may be just for the birth, not all the visits/tests prior. That's probably another $3K.
I have a high deductible so I have to pay for the pre-birth doctor visits. The negotiated contract price is between 105 and 160 (depending on if we are having an ultrasound that visit). With lab work, visits, and ultrasounds, I would say an additional $1,200.
Again, I dont know if the doctors will give you the negotiated contract price.
Posted on 10/15/13 at 7:33 pm to MG
quote:What is your HD? We're going to hit it once we pay the hospital portion.
I have a high deductible so I have to pay for the pre-birth doctor visits
Posted on 10/15/13 at 7:38 pm to ell_13
When I was pregnant with #3 (almost 13 years ago), there wasn't a "per visit fee" .. it was a "fee" that included ALL office visits and delivery. There was the additional fee of ultrasound and lab work but I didn't pay each time I went .. I think it had to be paid out though by the end of the 6th month??
Check with your doc's office and the hospital .. tell them you have insurance but no maternity coverage. We got the insurance rate or close to it.
Check with your doc's office and the hospital .. tell them you have insurance but no maternity coverage. We got the insurance rate or close to it.
This post was edited on 10/15/13 at 7:39 pm
Posted on 10/15/13 at 7:39 pm to ell_13
quote:
What is your HD? We're going to hit it once we pay the hospital portion.
$3,000 but my premiums are $0.
Unfortunately, most of the pre-birth doctor visits are in 2013 and the birth is in early 2014.
However, I have been loading up my HSA at the tune of $5,000+ for 2013 and 2014. I anticipate the total cost of just the birth to be about $4,300. ($3,000 for deductible and 30% coinsurance on remainder).
Posted on 10/15/13 at 7:40 pm to tiger91
quote:
When I was pregnant with #3 (almost 13 years ago), there wasn't a "per visit fee" .. it was a "fee" that included ALL office visits and delivery. There was the additional fee of ultrasound and lab work but I didn't pay each time I went .. I think it had to be paid out though by the end of the 6th month??
This was the case for my first child (2011) when I had a Traditional PPO. We paid the first prenatal visit and didnt owe anything else until birth.
Posted on 10/15/13 at 7:42 pm to MG
Not far from ours. Congrats, btw!
This post was edited on 10/15/13 at 7:48 pm
Posted on 10/15/13 at 7:46 pm to ell_13
quote:
ell_13
Thanks, you too.
Posted on 10/15/13 at 8:45 pm to MG
ALSO, this was a long time ago BUT anything maternity did NOT go toward the deductible. Again, that was a long time ago BUT please check to make sure. It didn't go to the ded we were told as maternity coverage was an option that we opted to NOT have!
Posted on 10/15/13 at 9:10 pm to tiger91
We just had a baby back in June at womans hospital, had to do a last minute c section and we have insurance but I always like to look at the billing statements and they charges our insurance somewhere around 18 grand.
A buddy of mine had a baby just a few weeks ago (no insurance) and his wife had a vaginal birth and I want to say his negotiated price was around 4500.
A buddy of mine had a baby just a few weeks ago (no insurance) and his wife had a vaginal birth and I want to say his negotiated price was around 4500.
Posted on 10/15/13 at 9:48 pm to gsvar2004
Thanks for all of the good info. From pretty much everything I have found out so far, it's a no brainer, just go cash and don't worry about getting the maternity coverage/rider. Only thing I have found so far is that some insurances won't automatically add the new baby onto your existing insurance if you don't have the maternity rider and you have to shop for a new policy for them. I'll have to call the insurance company tomorrow to find out more about this.
Posted on 10/15/13 at 10:52 pm to Kingpenm3
quote:
it's a no brainer, just go cash and don't worry about getting the maternity coverage/rider.
Posted on 10/15/13 at 11:38 pm to Kingpenm3
I paid cash for both of my kids. The first one cost me 11k (2011) when it was all said and done. The second one that isn't even 4 months old cost me 13k. Both at Women's in BR.
Posted on 10/16/13 at 10:41 am to Kingpenm3
Honestly, you never know what can go wrong in a pregnancy. You may be thinking it'll be a regular pregnancy that may only set you back 15k, but you never know.
For instance, the latest baby (and last baby) my wife and I had rung up over half a million worth of charges.
What if the baby is premature and has to be in the NICU for months? That's hundreds of thousands of dollars and happens a lot more often than you think.
Option 3 is the dumb option. Go wtih option 1 or 2, unless you know for sure if your kid has to go to the NICU or any other complications can be covered under your current insurance.
For instance, the latest baby (and last baby) my wife and I had rung up over half a million worth of charges.
What if the baby is premature and has to be in the NICU for months? That's hundreds of thousands of dollars and happens a lot more often than you think.
Option 3 is the dumb option. Go wtih option 1 or 2, unless you know for sure if your kid has to go to the NICU or any other complications can be covered under your current insurance.
This post was edited on 10/16/13 at 10:44 am
Posted on 10/16/13 at 10:59 am to Moustache
Moustache all these years ago for my #3, had this happened our regular insurance would have been in play...Not the delivery or doctor costs but the "medical issues" would have been covered.
And yes I made sure of htat as I know that things can sometimes, very sadly, go terribly wrong.
And yes I made sure of htat as I know that things can sometimes, very sadly, go terribly wrong.
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