sticker shock!

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waitingimpatiently614's picture
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sticker shock!

has anyone else figured out how much their pregnancy/delivery/etc. is going to cost them? of course it's impossible to put a price on having a precious new baby!!! but i'm feeling pretty stressed this morning after talking to our insurance provider.

we were spoiled the first time around because we had the most amazing insurance. it literally cost $250 total to have a baby. one $20 copay at the first OB appointment, no copays after that, and then a $230 bill from the hospital after baby was born. (the rest of the hospital bills, which were over $8000, were paid by our insurance.)

i knew our current insurance wasn't as good as before, but i hadn't really given it much thought until i started getting hefty bills for the screening i had recently. turns out we have to pay 100% of all maternity services until our deductible is met, and 20% after that. and the timing is bad...once i pay these bills i just got, we will have almost met our deductible for 2011, but then it starts over in january, so the maternity bills will start coming in full again for jan-march until we meet our deductible again! plus, 20% of everything is a lot of money when you're talking about hospital bills in the thousands. i asked the insurance lady if she could give me a guesstimate on how much we would end up paying when it's all said and done, and she said we could easily meet our out-of-pocket maximum for 2012 (by the time we pay maternity and pediatric hospital bills), which would be $4000! :eek: it could maybe be less if there's no need for c-section, baby has no special needs, i don't get an epidural, we get out of the hospital as soon as possible, etc. we don't have $4000! i'm kinda freaking out. anyone have any tips on ways to make having a baby more affordable? anyone know how much you have to spend on medical bills to get a break on taxes, for example?

i don't wanna stress anyone else out about this, but i'd appreciate any advice anyone can offer. i know i should still be thankful that we have insurance! Smile

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We are in EXACTLY the same situation as you are. We pay 100% of costs until our $800 deductible and then 20% once the deductible is met. We will easily meet our deductible AND possibly our out-of-pocket maximum this year, only to have it start all over in January. Ugh. My doctors office already informed me that the short 10 minute ultrasound I had at my first visit is $600 and the big anatomy scan is $1200!! I'm not really sure how we're going to pay for all of this, but I know that we will probably get our tax return just in time to cover all of the hospital expenses for the birth. I just really hope that the medical facility offers a generous payment plan cause money doesn't grow on trees over here!! The only benefit that I can see is that since I will meet our out-of-pocket maximum next year, I can probably go ahead and get my tubes tied for little or no cost to us. But, im sure there's some kind of catch to meeting that maximum...does it really mean that for the rest of the year I won't have to pay any co-pays or anything?

lmh101979's picture
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You might want to ask your OB if they will let your pay at the beginning of the year. Our Ob said it's going to be $525 for the estimate, but they don't bill until next year. As long as I pay for what comes due this year I can make the big payment next year and then all the hospital bills and the OB bill will be in the same calendar year. My DH's work also has medical flexible spending so we will get a card at the beginning of the year with however much on it we want and it comes out pre-tax of his check so it kind of helps both ways. I don't know if any of that helped, but there should definitely be some payment options. I don't think any dr, expects you to pay $4000 out of pocket right off the bat!

jenboucher's picture
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I was told -- by someone probably not the utmost reliable ... aka ... not the billing dept. -- that even though you are paying now, the BILLING is done when the birth happens -- so what you pay now goes towards the 2012 deductible. True or not -- idk. That's what I'm hoping!!

waitingimpatiently614's picture
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oh, the flex spending account is a good idea! anything we can pay pre-tax would really help. DH hasn't been eligible for that benefit til now (he had to be working at his new job for a year before he could get it) so we'll try to get enrolled in it for 2012. he thinks he can sign up in october.

and, yeah, i think you're right that all my OB bills will be totaled up and due in 2012. right now, it's lab and ultrasound bills i'm getting, which are separate departments. and then the hospital bills for the birth are separate, too (plus anesthesia, pediatrics, etc. etc.).

one friend told me to really look over the bills and check for errors. she got charged for a circumcision kit when she had a girl, and another friend got charged for the newborn nursery the day before her baby was born!

christybelle7's picture
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Okay, don't panic yet!

Check your "out of pocket maximum" for the year. Then call your insurance company and double check me. We've also recently switched to a (worse) plan that asks us to pay 20% coinsurance. But as I understand it, the most we can be asked to spend in any year, after deductible, is the out of pocket maximum amount. So you don't have to pay 20% of EVERYTHING. Just up to that amount.

Is that anyone else's understanding, or am I operating w/ bad information?

waitingimpatiently614's picture
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no, you're right! but our out-of-pocket maximum is $2000 per family member per year, so she explained it to me that that's $2000 for me and $2000 for the baby in 2012. and another $2000 for me for 2011 (which i don't expect us to meet...it would only be in a worst-case scenario, like i get admitted to the hospital for complications or something before january). so, she said the maximum we would be asked to spend on this pregnancy/birth is $6000, but more likely $4000 (since again, there shouldn't be any huge hospital bills for me in 2011). does that make sense? it is wonderful that the out-of-pocket maximum is there to protect us from out-of-control bills, but i just wish it were lower than $2000 per person per year! our last insurance paid 100% after deductible, so this is all new to me.

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Ok, I didn't realize that the baby counted as a separate person for the out-of-pocket maximum! Now I'm getting a little worried. Our maximum is $3000 per person! My doctors office handles things a little weird. I had to pay $405 at my first appt and then I have monthly payments of $150 until baby is born. I guess all of that is supposed to cover all of the OB fees for all of the prenatal care and delivery. So, the only thing I should have to pay for this year is any lab work, ultrasounds, testing etc. Honestly, the cost factor was part of the reason I opted out of the NT testing and additional testing due to my advanced maternal age. This insurance stuff stresses me out! I'm always having to haggle with them because they don't cover things like they should.

TyrantOfTheWeek's picture
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Find a good homebirth midwife. Mine charges $2,500 for EVERYTHING. The prenatal visits and the birth and postpartum.

abbyblack's picture
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Wow, I have terrible health insurance...My annual deductible is $5000 ($10000 for family)...I have met $859 of my individual deductible and family deductible before my insurance starts covering 70% of my pre/post and delivery expenses. Out of pocket I have paid about $350 so far. I didn't know once the baby is born he/she has her own deductible...YIKES! Sad

waitingimpatiently614's picture
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wow, abby! you have to pay $5000 before your insurance kicks in? hope your premiums are close to zero! that's not very helpful insurance!

and, yeah, our insurance lady explained that the baby has a separate out-of-pocket maximum and deductible (but our plan is all per person, no family maximums).

it sounds like my insurance is still as good or better than others, so i will just try to count my blessings. DH and i are gonna save all we can for a "worst case scenario" hospital bill situation, and then whatever we don't end up needing we will use for much-needed house renovations. we had hoped to do some of those renos before baby arrived (nothing fun...just stuff like replacing outdated electrical, plumbing, and hvac), but there's just not enough cash to go around!

good point about the home birth. DH wouldn't agree to it, but i think it's sounding better and better! Smile

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"TyrantOfTheWeek" wrote:

Find a good homebirth midwife. Mine charges $2,500 for EVERYTHING. The prenatal visits and the birth and postpartum.

I wish I was brave enough to consider that option. Natural childbirth scares me to death, so I'm scared to even try!

Dixiemom1st's picture
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Lurker from April- I have to say after reading about your situations, I am very glad to be in Canada. Even though the system has it's flaws it should cost us nothing to have our baby. I hope you get it all figured out.

brookie13's picture
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Lurker

I agree with the above poster..I was happy to be Canadian when I heard the cost of US Births. Both of my kids cost me a total of 175$.. $150 for my DS's circumcision and the rest was the cost if parking per day. And I had a c-section with my first. I was shocked when an American friend told me how much her c-section was. I didn't pay for any of my ultra sounds either

ange84's picture
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:lurk: It's the same in Australia. I did have some expenses with gp visits because the hospital won't see you until after 20 weeks in my town and one emergency ultrasound because there were no techs at the hospital that day so I had to go private but I got a percentage of those bills back and the rest of my birth was free and that included a c section and six day hospital stay

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**LURKER**

I wanted to post and say that if your insurance works like most, you shouldn't have to pay $4000. In the vast majority of cases, there is no separate hospital bill for the baby. (Unless, of course, they are admitted at the NICU or something, as then they are considered another patient by the hospital) The hospital generally bills for mom and baby together.

With my DD, the hospital actually messed up and tried to bill for her, but it was considered 'double billing' and the insurance rejected it, and the hospital retracted it. Mom and baby should be covered under one single charge, under mom's name. So, there are charges for the baby, but they are billed under mom's care.

So, while the baby DOES have a separate deductible, it shouldn't apply for the hospital charges. It might, as it did with my DD, apply for things like the pedi visit in the hospital (which was $150ish.)

And there are things you can do to make your stay cheaper. I'm actually thinking about doing some of these myself for the next LO in January. For example, you get charged every time you send the baby to the nursery, for every pill, pad, etc, you use. Rooming in with baby, bringing your own tylenol, pads, etc, can help reduced the charges by a few hundred dollars. (Hospitals will charge like $6.00 for a tylenol!)

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Lurker:

I know with my other 2 children we did not have a deductible for the babies until after we left the hospital. The baby usually has the mothers MRN until they are discharged.

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*Another Lurker!*

I have to agree with the PPs about Canada. I too can't believe how much you have to pay to have a baby in the US Sad

The parking was the most expensive thing about my deliveries. Especially this last time around, as I was going to the mat clinic at the hospital, so had to pay for parking everytime I went to see the dr.

I hope that you can get everything sorted out with insurance, and breathe a little easier!

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Oh yeah!
Here has been our history:
2007/1st baby- had decent insurance... just didn't realize it! Smile paid roughly $300 for maternity care and $1,000 or so for hospital bill (can't remember too well).
2008- tubal pregnancy and surgery. All in all paid 5,000 in medical bills (we made like 15,000 at that time!)
2009- had baby #2. Maternity care cost $2300 out of pocket. Hospital bill was another $2,500 at least. Baby had it's own deductible- joy, add on the costs. It took us 21 months to pay off our hospital bill (they have payment plan options that are interest free). Also, had an ER trip for my son, denied financial aid even though my husband was unemployed.
2010- Had fabulous insurance! $300 deductible for like $90 a month. No baby, no surgery, no ER trops.
2011- ER, get pregnant. Insurance deductible is back to $3,000. So we'll pay $2,300 out of pocket for maternity care and at least another $2,500 from the hospital bill. At least this time we have a family deductible. Have already paid for ultrasounds and labs out the wazoo... with another ultrasound in about a month and more labs coming before the end of the year.

Basically, we try to pay off our hospital bill before we try for another baby. Our hospital does have an option where if you pay in full you get 25% off of your bill! If we have the money this time I hope to do this as that will save a good $500! If not, we'll do payment plans again.

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I'm in the same boat. We pay 100% until we meet our deductible, then 20% after that. The total estimate I got was 2500. About half of what yours is though. Still, Ugh!

Jbaum2's picture
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Oh my - I feel for you ladies in the States. In canada, especially in Alberta our health care is covered. Meaning our provincial government pays for everyones health care. We are an Oil & gas province. They use the royalties form that to pay for it. There are the odd things that aren't (like medications - prometrium is EXPENSIVE). But considering, it's a small price to pay compared to what you ladies have to go through.

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With my husband's insurance, we will be paying $1200 total for all prenatal appointments/tests and the birth. It seems like a lot to me, but I know it could be a lot worse!!!

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This post makes me incredibly thankful for my usually thankless job. I am a public school teacher in very poor neighborhood. I put up with a lot of crap most days, for very little pay. However, we get excellent benefits. This is my third baby and I have never paid a dime out of pocket. I don't pay co-pays for appointments because they are considered preventative care. I have had 2 ultrasounds, including a nuchal translucency (sp?) scan and it was free. My second one was a c-section and I didn't pay for that either.
I am spoiled, and grateful for the school district for once. I feel for the rest of you, that is really frustrating.