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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 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 10/16/13 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 3:14 pm to Kingpenm3
quote:You might be an Obamacare success story. Not kidding.
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
Your rates under a Jan 1 policy should not triple. Definitely check that out. You'll have to change policies anyway, if yours does not carry maternity.
quote:Your most prominent cost risk is C-section. Probability runs 15-25% depending on various factors. Would likely exceed your HSA.
So, can anyone tell me about their experiences paying out of pocket for a pregnancy? Would we be taking on any extra risk?
As with anything moneywise, leave no stone unturned. Talk with the hospital, but an ACA policy is going to be your best option.
Posted on 10/17/13 at 4:28 am to Kingpenm3
Kingpen, I have a good friend that has five kids. He and his wife do not have maternity insurance. What he did was go to the hospital and the OB doc and 'negotiate' the price of the hospital stay and delivery. He figured it out and with the discounts he got for cash (they screw you if you have insurance) was way better than if he had paid insurance premiums those years. So, I'd go with option three and know you can negotiate the price of your child's birth. Good luck and God Bless you and your family.
Posted on 10/17/13 at 6:51 am to Kingpenm3
My wife worked at the hospital our baby was born... They pay 100% for all employees and family members for services at that hospital though insurance. We paid zero out of pocket. 
Posted on 10/30/13 at 3:41 pm to Kingpenm3
Thankfully my wife had excellent coverage. We ended up paying $1300 on a bill > $500k.
She was perfectly healthy, had a great pregnancy, did everything she was supposed to to a t, but something happened at the 8 month mark and caused a host of problems leading to a pile of bills.
She was perfectly healthy, had a great pregnancy, did everything she was supposed to to a t, but something happened at the 8 month mark and caused a host of problems leading to a pile of bills.
Posted on 10/31/13 at 9:10 am to Kingpenm3
We have a high deductible that we meet every year. My wife regularly negotiates by offering up front cash payment the day the bill comes in the mail. 50% discounts are not uncommon.
Eta: if they offer nothing we say see you in 90 days.
Eta: if they offer nothing we say see you in 90 days.
This post was edited on 10/31/13 at 9:12 am
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