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Started By
Message
Baby on the way
Posted on 1/5/15 at 12:44 pm
Posted on 1/5/15 at 12:44 pm
Fiancé is pregnant. We are already getting married on 1/24/2015 and don't want to change that. However my current insurance will not cover the pregnancy and delivery unless it is an emergency delivery. She recently finished her degree and can't get on the schools insurance until the window is open so she is still on her mothers plan. That one will also not cover the delivery, only the baby.
How much does a typical delivery cost out of pocket? I'm working on purchasing a new plan so that should solve the issue, but I'd like to know what worst case will cost me. I can handle $10k-$12k but any more than that and it'll be tough without a payment plan or something which I assume will cost some interest?
Anyone went through this or something similar? I'm still learning all of this healthcare reform bullshite. TIA and I will laugh and upvote smartass remarks that I think are funny.
How much does a typical delivery cost out of pocket? I'm working on purchasing a new plan so that should solve the issue, but I'd like to know what worst case will cost me. I can handle $10k-$12k but any more than that and it'll be tough without a payment plan or something which I assume will cost some interest?
Anyone went through this or something similar? I'm still learning all of this healthcare reform bullshite. TIA and I will laugh and upvote smartass remarks that I think are funny.
11
Posted on 1/5/15 at 12:50 pm to tysonslefthook
So your insurance will not cover, even when you get married? When is the baby due?
Posted on 1/5/15 at 1:04 pm to OnTheBrink
Simple solution.....go get hitched in a civil ceremony at your local courthouse, asap. Put her on your insurance, then have your big wedding later as planned. Separate religious and civil services are commonplace enough.
Posted on 1/5/15 at 1:07 pm to OnTheBrink
quote:
So your insurance will not cover, even when you get married?
My current policy apparently only covers emergency deliveries. I'd have to purchase a new plan to have the delivery covered, which I will. That should cover her.
Also her insurance allows for enrollment through the school since a marriage is a qualifying situation to enroll early.
quote:
When is the baby due?
End of July
Posted on 1/5/15 at 1:15 pm to tysonslefthook
quote:
I can handle $10k-$12k
SHould not be more than this unless complicatons arise. Get prices from different hospitals. Look into natural birth with midwives also. Cheaper and many argue better for the baby.
Posted on 1/5/15 at 1:16 pm to tysonslefthook
Seems odd that her mom's policy covers the baby, but not the delivery. When we had our kids, the insurance covered the delivery, but we had to add the baby to the policy to have it covered.
There should be some remedy in the ACA for this situation. It's kind of why the law was written, but I don't know enough about it to say for certain.
Our last child the bill was around $25k, but that was via c-section which added a lot of costs. Our first was regular birth, and I forget how much the bill was. Around $10k I think.
There should be some remedy in the ACA for this situation. It's kind of why the law was written, but I don't know enough about it to say for certain.
Our last child the bill was around $25k, but that was via c-section which added a lot of costs. Our first was regular birth, and I forget how much the bill was. Around $10k I think.
Posted on 1/5/15 at 1:22 pm to The Spleen
quote:
Our last child the bill was around $25k, but that was via c-section which added a lot of costs. Our first was regular birth, and I forget how much the bill was. Around $10k I think.
This is what I was thinking. Thankfully my current insurance kicks in if their are any complications or if it is an emergency delivery. I'm sure I can get her added before then and have the delivery covered, but I just really wanted to see about what it costs out of pocket.
Posted on 1/5/15 at 1:40 pm to tysonslefthook
With insurance my first kid's doctor visits and delivery were about $3K.
While reading about how much it would cost, I read where a lot of people successfully negotiated with doctors and everyone else necessary. They were able to pay cash and in advance for discounted rates. The prices being thrown around were in the $5K range for a natural delivery with no complications.
While reading about how much it would cost, I read where a lot of people successfully negotiated with doctors and everyone else necessary. They were able to pay cash and in advance for discounted rates. The prices being thrown around were in the $5K range for a natural delivery with no complications.
Posted on 1/5/15 at 1:54 pm to tysonslefthook
Without endorsing this idea or judging anyone for doing it, state medicaid programs have maternity waivers that cover prenatal care and delivery. Its the reason they exist-so that cost is not a factor influencing the health of the baby and mother. I know this can open a whole other can of worms...Just presenting another option as a "worst case."
Posted on 1/5/15 at 1:56 pm to tysonslefthook
How old is your fiancee? Can she not be covered under her parents' insurance?
Posted on 1/5/15 at 2:37 pm to LNCHBOX
She will be 25 when the baby is born. She can stay under her mothers insurance, however it won't cover the cost of the delivery. Just the baby. It sounds strange but that's what it says.
Posted on 1/5/15 at 2:39 pm to AUjim
quote:
Posted by AUjim Without endorsing this idea or judging anyone for doing it, state medicaid programs have maternity waivers that cover prenatal care and delivery. Its the reason they exist-so that cost is not a factor influencing the health of the baby and mother. I know this can open a whole other can of worms...Just presenting another option as a "worst case."
I've learned this as well. I don't judge either, but I will be paying cash if for some reason I can't buy a new policy that covers her, or if she isn't allowed to enroll in her own insurance through the school board. She's a first year teacher
ETA: it's not that I don't think I can afford it. I'm just trying to figure out about what the typical costs are for both vaginal and caesarean delivery with no emergency or complications. My current insurance covers in the event of complication or emergency.
This post was edited on 1/5/15 at 2:42 pm
Posted on 1/5/15 at 3:25 pm to tysonslefthook
"No epidural for you, honey."
Seriously though, $10k should probably be enough if its a normal delivery with no complications. Had a buddy have to do it and it cost him around $8k.
Seriously though, $10k should probably be enough if its a normal delivery with no complications. Had a buddy have to do it and it cost him around $8k.
Posted on 1/5/15 at 3:42 pm to tysonslefthook
I thought one of the ACA reforms was coverage of dependent pregnancies, which this would be if she stays on her mom's policy. But I could be wrong.
You said she recently finished her degree... is she working? Is she going to work? Policies can't not cover preexisting conditions anymore.
I didn't know they still sold plans that excluded pregnancy. Pregnancy is one of the essential benefits under ACA that has to be included on exchange policies, and, to my knowledge, has to be included on insurance from an employer if it's going to count for the employer mandate.
I would also looking at getting her a plan on the exchange. Even though she can be covered under her mom's policy, if that policy doesn't include essential benefits, I think you can still get a subsidy.
Finally, as a last step, look at Medicaid. Medicaid is supposed to be a temporary thing for those "oh shite" times in life. Sounds like this is one of those times. Get on it, have the baby, eventually you all will be able to get traditional insurance, get off of it, and pay far more taxes than you ever got in benefits.
However, for the subsidy and for the Medicaid, it might be better for y'all to stay unmarried. Crazy at that sounds. And without maternity coverage on your plan... I'm not sure what benefit there is to joining your coverage, which she could do if you all married.
You said she recently finished her degree... is she working? Is she going to work? Policies can't not cover preexisting conditions anymore.
I didn't know they still sold plans that excluded pregnancy. Pregnancy is one of the essential benefits under ACA that has to be included on exchange policies, and, to my knowledge, has to be included on insurance from an employer if it's going to count for the employer mandate.
I would also looking at getting her a plan on the exchange. Even though she can be covered under her mom's policy, if that policy doesn't include essential benefits, I think you can still get a subsidy.
Finally, as a last step, look at Medicaid. Medicaid is supposed to be a temporary thing for those "oh shite" times in life. Sounds like this is one of those times. Get on it, have the baby, eventually you all will be able to get traditional insurance, get off of it, and pay far more taxes than you ever got in benefits.
However, for the subsidy and for the Medicaid, it might be better for y'all to stay unmarried. Crazy at that sounds. And without maternity coverage on your plan... I'm not sure what benefit there is to joining your coverage, which she could do if you all married.
Posted on 1/5/15 at 3:55 pm to tysonslefthook
quote:
She can stay under her mothers insurance, however it won't cover the cost of the delivery.
That seems odd.
Posted on 1/5/15 at 4:04 pm to LSUFanHouston
quote:
I thought one of the ACA reforms was coverage of dependent pregnancies, which this would be if she stays on her mom's policy. But I could be wrong.
So did I, and her mom works for the LSU Ag center so I figured for sure it would cover it. But apparently it doesn't include the pregnancy of a dependent. Mine also doesn't cover a pregnancy (I bought the plan in 2013 before ACA took full effect). It only covers the delivery if there are complications. It seems absurd to me that it won't cover a healthy delivery but will cover a complicated emergency.
quote:
You said she recently finished her degree... is she working?
Yes. She is a first year elementary school teacher at a public school. She had to wait until the June or July (I forget) enrollment period. The plan was to stay on her moms plan until the last enrollment period before she turned 26 as her moms coverage automatically covers her for no extra charge. However since we are getting married this month, that qualifies as a special circumstance where she can enroll in her own insurance through the school board outside of the normal window. Hence, I think it will cover her since they can't call it preexisting.
The wedding is 1/24/2015. There is only one appointment before the wedding and I already know I'll pay cash for it regardless as she can't get her own insurance until after the wedding and we don't want to move the date up. We just found out she was pregnant 2 days before Christmas. Hell of a Christmas present. I'm not overly concerned about costs. I just want a healthy baby.
quote:
However, for the subsidy and for the Medicaid, it might be better for y'all to stay unmarried
Which is part of the reason I weep for my child's future
Posted on 1/5/15 at 4:42 pm to tysonslefthook
quote:
She is a first year elementary school teacher at a public school. She had to wait until the June or July (I forget) enrollment period.
She started working in August? She should have been able to enroll during orientation with an Oct start date. What system, if I can ask? I find it odd that a public school system nowadays would have a year long waiting period to join a health insurance plan. Most new hires are eligible for coverage on the 1st of the month following 30 days of employment - but if she declined the coverage, then yeah, she would have to wait until open enrollment or have a life event.
Does that policy - at her workplace - cover maternity? If it does, have her join the plan the day after the wedding, coverage should be effective relatively soon, and most of the costs should be covered.
Posted on 1/5/15 at 5:04 pm to LSUFanHouston
quote:
She started working in August?
Yes
quote:
but if she declined the coverage,
She did because she could stay on her moms coverage for free for a year and save a few bucks. She was going to enroll this summer and since we would be married I would drop my insurance and join hers as it is a good plan for a good price. But we had our unexpected surprise Christmas present!
ETA: When she started working in fall 2014 the plan was to have the wedding summer 2015. But we already moved the date to January 24, 2015 as neither one of our grandparents are in good health...
This post was edited on 1/5/15 at 5:07 pm
Posted on 1/5/15 at 5:11 pm to tysonslefthook
quote:
She did because she could stay on her moms coverage for free for a year and save a few bucks.
Damn. Lost that bet. Sometimes, more options aren't a good thing.
Anywho, provided her insurance through work will cover pregnancy, I think your best bet is to get her on that and be done with it.
Posted on 1/5/15 at 5:15 pm to tysonslefthook
Had a baby last year. Without insurance, the price would have been around 10K, give her take a few hundred.
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