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A friend of mine had no insurance and she is now payin off $72k in hospital bills because after being there for a couple days with a bunch of issues they gave her an emergency c-section which she then had complications with. Be careful!
@mwitter80: I have good individual coverage, just not maternity. I have spoken with my provider, and basically any emergency, including a non-elective (aka I didn't schedule) c-section, will be covered.
This is why I'm confused, I guess. If I have a totally uneventful preganancy and delivery, I could possibly be paying more to have coverage than if I didn't, but if I have a bunch of problems in delivery, it's already covered by my health insurance now.
@bree72: Ooh that's a tough one. Yikes. Are you a gambling kind of woman?
This is not going to help you at all, so I am sorry in advance, but I am posting just to give you the opposite extreme experience:
I work for the government and have BCBS. My entire pregnancy and delivery will be covered 100% (with no copays) if I use a preferred provider.
I have maternity coverage, and I also signed up for short-term disability, which in my state, allows me to get 60% of my salary, for up to six weeks, I think. So this will help when I am out on maternity leave.
What I would suggest is to find out the average cost of a regular vaginal birth at the hospital near you, as well as a c-section. Then, call your insurance and find out what it would cover, of those costs. And also what it would cover if you have the maternity rider. It seems like a lot of work, but getting actual rough dollar amounts will really help you.
If the maternity rider is going to save you $3000, but cost you $3600 ($300/month for a year) then it might not be worth it.
But let's say a c-section will cost 8k. Then paying $3600 for rider the year, plus $1500 for your deductible will still save you $2900 (assuming they would cover the full cost of the c-section). So once you have more realistic numbers, you'll be able to better determine if the extra coverage is worth it.
ETA- Just saw your post about how your regular plan covers everything if it's an emergency, but not if it is a schedule c-section, etc. That makes it a little harder. I personally opted for a higher co-pay and higher coverage, because paying the higher co-pay would STILL benefit me over paying for maternity care on the lower plan. So that's an easy choice, but this situation is a little harder to figure out. Good luck!
@LoveHappy: That is a great idea! We only have one hospital that delivers in my small-ish town, so hopefully I can get an idea from them. Thanks for the suggestion!
@bree72:I would just do the math if I were you - it seems really expensive to me! If you are likely to get most of your $ back though, I would do it so you are covered for unforseen expenses like a c-section or additional testing.
I was fully covered but if I wasn't I think it would have easily run us over $20K. Do you have to add the coverage before you get pregnant? what % of the hospital charges does it cover? how about if you have a c section?
I agree with checking with your hospital; a lot of doctors and hospitals have different charge amounts based on whether the person is insured or paying cash.
Also, just for comparison, my total bill for labor/delivery and 2 day hospital stay for me and the baby ran over 20k. And that was a very fast, uneventful vaginal birth with an epidural. ETA: I have no idea how much extra my total prenatal care costs above and beyond that 20k; that figure was just for labor and delivery.
One other thing to consider is AFLAC. I have never used it and sometimes feel like it's sketchy, but I know they pay for some of those random complications. And they pay you directly, not for the medical bills, so the money is more flexible. You just have to start it before getting pregnant. One of my friends mentioned it to me when I just started TTC but I have not looked into it further. If you do...let us know!
@Mrs Green Grass: as far as I know, you have to have it at least 3 months prior to it kicking in. Otherwise, it's supposed to be good, but I don't know. It didn't help my SIL with her pregnancy/delivery, but I don't know if the waiting period had ended before getting pregnant or not.
Hi! I have a self policy with a maternity rider too
I thing to consider- they usually have a 6 -12 month waiting period. Mine also has a cap- and its not much at all. What we ended up doing is talking directly to the hospital and my dr.s office. The Dr.'s office will then file our claim so we can be re-imbursed via the insurance policy - til we hit the cap. (which is $2000)
The dr is charging $1900 + $165 for the 20wk anatomy scan + labs (so far the labs have been $150, but I'm only half way through the pregnancy). The hospital offers a self pay maternity package for a routine delivery and it is ($3000). All of this I find super reasonable...the place I'm running into OMG! factor is the anestheioligist fee----he is way expensive BUT it does cap at $1800.
Also with my policy like yours an emergency c-section would be covered under my policy.
All in all I would forgo the rider, start stashing the money you would pay for it into a seperate account and pay out of pocket. (possibly even call your obgyn and hospital and ask what their self pay rates are).
Good Luck! Its all scary (and expensive) but there's always a way :)
If it's offered in your state/town and you are comfortable with it, you might look into midwife care. Just for example: The midwife practice we are considering charges $5500 for prenatal care and a natural home birth. That includes all your prenatal visits and basic lab work (if you want amniocentisis or something like that you have to go elsewhere and pay for it, but standard, uneventful prenatal is covered by that) all of your delivery costs and the post-natal visits.
I know that sounds like a lot of money, but if you have to pay out of pocket, maybe you can choose the kind of care you get, you know? Just something to think about.
oops- no my waiting period was 3 months....sorry I stated the wrong info.
I have nothing positive to say about health insurance, we're going to be paying around 4k for my hospital stay. :/
@Mrs Green Grass: I have BlueChoice, and if I were to get pregnant, I think I would be out of pocket about $1k total under my policy. And I will advocate for Aflac, cuz I am an agent for them, and they are anything but sketchy. If you can get a Hospital Idemnity Policy, it will pay $1200 for regular birth, $1700 for c section, $300 for epidural, and $100 per day for hospital stay, on top of some other things. But there is a 10 month waiting period on pregnancy, so you have to get it before you become pregnant
I also have BCBS, without maternity coverage, but like yours it does cover emergency c-section or complications for the mother with proper documentation on a case by case basis. So if you have any issues make sure to document them and that your doctor does as well. BCBS can be funny about stuff, especially on their individual plans. For instance, they cover well woman care pap smear one per year etc, but i had a pap smear at the first OB visit and they said becuase the pap was during an exam for pregnancy they would not cover it.....but had it been done sepaprate it could have been covered, the provider did not bill, and let it just be included with the regular cash fee.
The maternity riders i found were ridiculous anywhere from $300 to $500 per month with a waiting period and deductibles and after talking with a friend who sells insurance she suggested to save up and pay cash, medical bils are tax deductible to some extent as well.
We are in a semi small town and about 45 minutes from a city of approx 100,000. After i called the hospital i felt better, i guess it was a little better than what it could have been.
Total out of pocket if all goes well: ( i called my local hospital and if paid cash in advance by the 32nd week of pregnancy )
Vaginal delivery: $2750 + $99 per day private room fee (hospital fee)
C Section: $3500 (hospital fee)
OB: $3900 normal vaginal delivery this is paid as $2000 upfront and $200 each visit (i spoke with 5 providers and they were all within $300 of this fee) ultrasounds included.
OB c section $5500.
Epidural: $550 hospitals fee (paid in advance refunded if not done)
bloodwork $550
So if i have no epidural and no other complications i am looking at $7200.
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Because my husband and I have been discussing TTC lately, I have been researching the maternity riders available to me, since I am currently not covered under my individual plan. Holy crap are they expensive! I understand that I will have hospital bills and all, but I just can't see how it's even worth adding it when it'll be adding $300/month to my current bill, has a $1500 deductible itself, and only pays 50% of the doctor visits/tests.
Quite a few of the women I know who are pregnant now w/o group insurance are just paying for their pregnancies out of pocket, but that makes me nervous. I know that anything deemed "emergency" will be covered by my current plan w/o a maternity rider, though.
So ladies who are pregnant, have been pregnant, or are thinking about it; how are you managing your health insurance? I don't really want to discuss this with friends since we are not going to tell people about TTC, so I was hoping some of you might have some insight.
Thanks and sorry this is so long!