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Message
re: Pregnancy without maternity coverage?? Pay cash?? Add coverage??
Posted on 10/16/13 at 12:46 pm to Moustache
Posted on 10/16/13 at 12:46 pm to Moustache
quote:
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.
I just got off the phone asking our insurance questions about these scenarios. They said that the separate maternity coverage/rider is only related the cost of a typical pregnancy. Any complications past a normal delivery/c-section are covered under the main insurance policy. Any issues with the child are covered under the child's new policy. I asked her if there is any way that we would be responsible for some kind of large bill and she said no. She also said that being able to add the new child to our family policy is not affected by whether or not we have maternity coverage or not.
So it looks like option #3 for me.
4
Posted on 10/16/13 at 1:34 pm to Kingpenm3
Biggest expense risk is definitely if the infant has complications. So long as that is not an issue from an insurance standpoint, you are probably okay with any of the options.
Have seen more than one "million dollar baby" in my career (hospitalization costs for preterm/complicated infant)
Have seen more than one "million dollar baby" in my career (hospitalization costs for preterm/complicated infant)
Posted on 10/16/13 at 1:44 pm to Kingpenm3
quote:
I just got off the phone asking our insurance questions about these scenarios. They said that the separate maternity coverage/rider is only related the cost of a typical pregnancy. Any complications past a normal delivery/c-section are covered under the main insurance policy. Any issues with the child are covered under the child's new policy. I asked her if there is any way that we would be responsible for some kind of large bill and she said no. She also said that being able to add the new child to our family policy is not affected by whether or not we have maternity coverage or not.
Someone may have told you this already (didn't read whole thread), but DOCUMENT who said what and when (person's name and phone number whatever else). Record the call and get them to say it again. Call back and get another representative to come to the same conclusion. Then start you a folder and let the games commence. Fun times.
but seriously, good luck and congratulations!
Posted on 10/16/13 at 1:47 pm to Kingpenm3
We had our first without insurance (5 years ago), and a healthy, non-complicated C-section was about $19K total (prenatal and postnatal visits included). We planned on natural birth, but his heart rate kept dipping after contractions, so they went ahead and did surgery. I think the OR by itself was something like $7-8K, so that was a large part of the unexpected.
FWIW, our second was born 2 years ago, and we paid for insurance that time, and with the premiums included, it was about $10K, so insurance saved us about 50%. For the ones that are concerned about splitting maternity bills over 2 years (get pregnant in 2013, have the baby in 2014), Blue Cross will not apply any charges to your deductible until the baby is born. They call it "Global Billing" and it was nice.
FWIW, our second was born 2 years ago, and we paid for insurance that time, and with the premiums included, it was about $10K, so insurance saved us about 50%. For the ones that are concerned about splitting maternity bills over 2 years (get pregnant in 2013, have the baby in 2014), Blue Cross will not apply any charges to your deductible until the baby is born. They call it "Global Billing" and it was nice.
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 10/16/13 at 6:30 pm to kjacksonp
quote:
Biggest expense risk is definitely if the infant has complications. So long as that is not an issue from an insurance standpoint, you are probably okay with any of the options. Have seen more than one "million dollar baby" in my career (hospitalization costs for preterm/complicated infant)
This is good information. When my daughter was born, there were no notable risk factors until about 20 weeks into the term. After arriving several weeks early and spending about 3 weeks in the NICU, that bill was close to six figures. Fortunately, I had good coverage. I would advise some type of catastrophic coverage regardless. The delivery is usually part of a global fee, but if complications arise, things can get out of hand quickly.
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 10/17/13 at 3:39 pm to DaBeerz
quote:
We paid zero out of pocket.
Posted on 10/29/13 at 10:37 pm to NC_Tigah
quote:
You might be an Obamacare success story. Not kidding.
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.
I read this thread a few weeks ago and now find myself in this position of having a plan w/ no maternity. Tomorrow will be a 'fact' finding day wherein I call BCBSLA and see what I can do. It seems like I will pay cash for the next two months for these maternity issues while lining up a policy for Jan 1 wherein I will have the mandated maternity among other things. Ironic considering I am against the ACA for the most part. I'll report back in this thread for anyone who cares whenever I figure out which direction I go and what the $$ is.
Posted on 10/30/13 at 1:17 pm to rmc
Happened with my first. Paid Ocshner @6900 flat fee for everything. This was almost 12 years ago.
Posted on 10/30/13 at 2:15 pm to rmc
If payin cash, you got 2 options: 1- negotiate with the hospital and it'll run you b/t $10-20K.
2-Look into getting a midwife to deliver the baby. Will cost about $3K all-in, and they will deliver the baby in your home.
2-Look into getting a midwife to deliver the baby. Will cost about $3K all-in, and they will deliver the baby in your home.
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 10/30/13 at 9:39 pm to Kingpenm3
quote:
I just got off the phone asking our insurance questions about these scenarios. They said that the separate maternity coverage/rider is only related the cost of a typical pregnancy. Any complications past a normal delivery/c-section are covered under the main insurance policy. Any issues with the child are covered under the child's new policy. I asked her if there is any way that we would be responsible for some kind of large bill and she said no. She also said that being able to add the new child to our family policy is not affected by whether or not we have maternity coverage or not.
You should definitely double check this. Why would your premium triple when adding maternity if all the insurance company is on the hook for is the actual birth (minimal expense if everything goes well). The premium triples because the insurance company by law has to automatically pick up the baby on the policy; therefore, has to factor in the risk of the baby having a problem post birth.
Insurance professionals may correct me, but your agents logic makes no sense to me. I would definitely consider adding the coverage or see how Obamacare works for you.
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
Posted on 10/31/13 at 11:51 am to skidry
Unless BC has changed their policy, you can only add maternity at policy anniversary. Call BC member service number on your card and verify. So many changes going on, even us in the industry have to double check. ACA might be a better option. Remember, complications can blow up the bill to bankruptcy status in a hurry. Good luck.
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