(Closed) How much is it going to cost you to have a baby in the United States?

posted 7 years ago in Pregnancy
Post # 47
Member
3460 posts
Sugar bee
  • Wedding: May 2012

Low income mothers have government help – it varies by state for what constitutes “low income.”  The regs for implementing the ACA changes to Medicaid categories for were published in March, effective Jan 2014.  Pregnant women qualify if their income is the higher of: 133% of FPL OR a higher standard set by State income standard.  My state is higher than 133% for example.  Hospitals also write off sums owed by indigent people (under charity care programs) because they won’t be able to collect.  If you are above the income limits, you can negotiate with them as well, and in my state at least, there are non-profit organizations which will assist you with this.  I volunteered at one such place for a few months.

US pays a lot in health care for many reasons, but one striking reason for me is that we are a leader in innovating new products.  So sure, you can get cheaper drugs in Canada, but often those drugs wouldn’t have existed without US support to US companies in developing them.  Drugs are *very* expensive to develop.  (Think of it as a lottery, you can play in a small game such as a disease affecting 100k people…or you can play in a big game and reap big rewards if you come up with something worthwhile.) 

Am I personally better off in CA or the US?  Since I only pay for my annual visit to the doctor each year, I’m personally better off paying lower taxes and getting few services.  That said, I do believe in a basic system of health care for all, which is why I’m pleased I live in Mass where we were the first state to try out that idea. 

***Disclaimer*** I am not your lawyer and this is not legal advice.  See your lawyer for legal advice.

Post # 48
Member
2065 posts
Buzzing bee
  • Wedding: December 2011

If I were to give birth under my current insurance plan, our deductible is $3K, so I’d be out that plus anything the insurance company decided not to cover along with all kinds of medication copays.

If I weren’t under an employer’s health plan I would be paying out of pocket for everything. Individual health insurance plans in Texas do not offer maternity riders and only cover complications from birth, not the actual birth itself. Thanks, Texas! 🙂

Post # 49
Member
9950 posts
Buzzing Beekeeper
  • Wedding: December 2012

Another Canadian here.

Ya we are lucky.

When I had my first baby (1980s), I remember the bill distinctly it was for $ 25 and that was to cover the Tv Rental in my room for the 5 Days I was in the Hospital (I had a C-Section)

EVERYTHING during my pregnancy… when it came to Medical Visits was covered.  All by OB-GYN Visits, Hospital Pre-Natal Course, Delivery, Hospital Stay for both Baby & I, and follow up care Post-Delivery (Doctors Visits)

My expenses were solely my Pregnancy Test (at the Pharmacy) and my Vitamins while I was pregnant.

Hubby’s Work had a Medical Plan that covered “extras” on top of the Canadian Medicare we all enjoy… fortunately I had no need to call an ambulance for example, but the Plan (Blue Cross comprehensive for Medical, Dental & Eye Care and Drugs) did cover off the expense for a Private Room vs a Semi-Private setting… which was nice, because I was in for quite awhile vs a regular delivery, and I enjoyed the privacy seeing as it had been a last minute complicated delivery and I had dressings that needed changing etc (and also I didn’t have to share a bathroom)

— — —

As outlined by the others, Canadian Taxes do seem a lot higher at first glance… and it does depend on what level of income you make (and we don’t get as many write-offs here)

BUT the benefits far outweigh the negatives IMO too… and as others have said you sort of get used to it all pretty fast, if you’ve never worked anywhere else or had things different

The nice thing is the “comfort” that comes with knowing that you don’t have to worry about Medical Expenses on top of everything else, at my age (50+) this is especially so for my own peace of mind… and the fact that I have Elderly Parents who need care from time-to-time

Nice to know you can get what you need without going bankrupt when tragedy strikes

And for the most part, unless it is deemed “Experimental” just about EVERYTHING is covered here.  So no Medical Insurance coming back and arguing about WHEN you contracted something, or what does and doesn’t qualify (which I hear is a HUGE issue in the US… even tho many have Insurance, they don’t actually end up paying for expenses that are incurred when needed.  This seems to be particularly the case for cancer treatments)

I admit I am truly spoiled having grown up in Canada, and knowing that I can get Medical Coverage whenever it is needed… without much thought about it.  Just make an appointment and go see my Family Doctor (such as Annual Check Up) … or call on the phone a 24/7 to speak with a Nurse Practioner for help / advice / consultation, or visit an Extended Hours Walk In Clinic, or if it can’t wait go to an around the clock Hospital Emergency Centre.

No complaints from me.  I quite willingly pay my taxes for these services and peace of mind.

 

Post # 50
Member
873 posts
Busy bee
  • Wedding: August 2010

@brandybelle:  This is not true.  Well, if by best you mean “cheap”, then maybe it’s tue.  But keep in mind that free healthcare for military dependants is at the military hospital only.  And the military hospital’s first priority is NOT family members.  You can see where I’m going with this…seriously, I’d never have a baby in a military hospital.  It might cost zero out of pocket, but you pay for it in other ways and your baby might as well.  I personally would never risk it.

I really don’t understand why people are ok with higher taxes that pay for healthcare.  I’d much rather pay as I go…and it’s cheaper!  Besides, when you involve the government in healthcare decisions…well, that’s why I pay out of pocket and don’t use military doctors.  I should be in charge of my health, not the military or government.

 

ETA: I AM thankful that Tricare Standard (the PPO version of military healthcare) covers CNM’s.  My employer’s insurance does not cover them except in hospital births and Tricare covers CNM in a hospital, birth center, or at home.  Granted, you pay out of network costs usually but the peace of mind and choice in healthcare makes a huge difference.

Post # 51
Member
9950 posts
Buzzing Beekeeper
  • Wedding: December 2012

TO – starrynight:  you said,

I really don’t understand why people are ok with higher taxes that pay for healthcare.

As an outsider, it would appear to me that the main reason would be that a health emergency could bankrupt you !!

Example, my Dad had a medical emergency when he was in the US, he was in the hospital a couple of days, and they did lots of tests to determine what the problem was (it was realted to his heart).  They stabalized him (adjusted his meds) and determined it wasn’t life threatening… and sent him home to his Florida Condo.  He then flew back to Canada (he lives here Spring, Summer & Fall). 

Once back here, he had the necessary treatment done.  Cost for his medical stay in Florida… close to $ 100,000… cost for his complete medical stay in Canada including operation = $ 0

He had travel insurance (again Blue Cross) so he paid $ 0 towards the US Bill.  If he was a US Citizen he may have had to have paid out that money himself.  Even if the expense was say $ 10 or $ 20 K out of his pocket, as an older person that would have been a HUGE burden for him

I’ve discovered as I’ve gotten older that when we are young we take our health for granted.  As we age, health becomes more precious (and expensive to manage).  It might make sense to say you’ll pay on your own when you are in your 20s or 30s, but by the time your 50s roll around you have more issues, then you might think differently.  And more so the older you get.

If it comes down to a family finding mega bucks to save / help / or prolong a loved one (such as with cancer) then it seems to me UNFAIR that that HUGE tragedy should be further enhanced by folks going into HUGE debt to do so.

How fair is it, that say someone dies, and still whoever is faced with a HUGE Bill (that must be financed) to remind them of such a tragic event.

Makes no sense in my mind.

 

Post # 52
Member
1695 posts
Bumble bee
  • Wedding: March 2012

@starrynight:  What free healthcare?  I live in Texas and I’m pretty sure that the only free healthcare is income-based (medicaid or city-based women’s health clinics and sliding-fee clinics).  You have to make very low income to qualify for that.  That’s very different than what they have in Canada.

 

OP, after my deductible, I’ll be paying around $2,500.  This includes delivery and all my doctor’s visits throughout my pregnancy. 

Post # 53
Member
1695 posts
Bumble bee
  • Wedding: March 2012

@starrynight:  Just saw your last post…you mean tricare.

As someone who had tricare growing up and then NO health insurance while in law school and then great insurance now…I guarantee you that Tricare is better than NO insurance. 

Post # 54
Member
70 posts
Worker bee
  • Wedding: November 2011

Never mind (:

 

Post # 55
Member
1249 posts
Bumble bee
  • Wedding: January 1992

@starrynight:  I’d rather have higher taxes and free healthcare because as an 18 year old college freshman with horrible insurance, I had emergancy room bills for over $5000… which ruined my credit to this day, since I couldn’t pay them.

Post # 56
Member
5009 posts
Bee Keeper
  • Wedding: April 2012

@rubyred605:  They actually give bills like that to students? That’s crazy! I would have been so deeply screwed with my health problems.

Post # 57
Member
1249 posts
Bumble bee
  • Wedding: January 1992

@SpecialSundae:  Yup!  I had 2 emergency room visits my freshman year, and I had to pay 50% of the cost.  I finally paid them off a couple years ago at a severely discounted rate, but my credit is still not good.

Post # 58
Member
9134 posts
Buzzing Beekeeper
  • Wedding: November 2013 - St. Augustine Beach, FL

My maximum out of pocket is $2500 but my costs should be much lower than that so long as I have a vaginal birth (C-sections can get expensive since they are surgery.)  I have to meet a $250 deductible first and then I have to pay 20% of insurance adjusted rates (my insurance will cover 80%.)  If you’re not sure of what your insurance covers you can speak with an insurance consultant during your pregnancy to outline your coverage in order to estimate your costs.

Women can always choose a birthing center and the ones in my area are pretty cheap since not many women choose them.  Some even accept insurance if your insurance has a birthing center option.  And doulas for birthing at home are even cheaper since they are self pay.

Post # 59
Member
5009 posts
Bee Keeper
  • Wedding: April 2012

@rubyred605:  $5,000 for two trips to casualty? That’s crazy! 

Post # 60
Member
966 posts
Busy bee
  • Wedding: October 2011

Zero dollars.  My insurance covers 100% of maternity care.  The benefits at work more than make up for the horrible pay.

Post # 61
Member
1396 posts
Bumble bee

Honestly, this is one of the reasons we’re not able to TTC yet. Darling Husband has insurance through his university as a student plan. We can’t rely on it to cover us past his graduation date. My insurance is through my employer and it is HORRIBLE. It’s an HSA (health savings account) with a super high deductible.

Deductible
$5500 Individual
$9900 Family

Out-Of-Pocket Max
$5950 Individual
$11900 Family

My employer contributes $2000 to my HSA each year, leaving me with a deductible of $3500. Just for myself.  I still pay monthly premiums of $130 for an individual. It would be $370 for Darling Husband to be on my insurance with. Add a baby and you’re at $490 per month. I have 100% coverage of preventative care, after the deductible is met, (75% for everything else) but only if I go to an approved primary care clinic. If my PCC can’t treat me, I have to get a written referral to another clinic/hospital that is also part of my insurance program. Last year my wellness visit wasn’t covered because I didn’t go to my PCC, but a child clinic of my PCC. That wasn’t good enough.

I have been covered by insurance for my entire life with no coverage gaps. I have no prexisting conditions and i don’t take any medication, but I have spent thousands of dollars anyway. I’ve had insurance deny coverage because of coding error and had a hospital send me to collections because of their mistake. Can you imagine how quickly I would have ended up in bankruptcy if I’d ever had a serious health condition?

Now, I rarely get treatment. I go in for my annual and request no bloodwork because it will cost me directly out of my HSA. I was stung by a wasp this weekend and my hand is swollen and painful but I haven’t gone in because I know it’s another cost that I’ll have to cover. I can go to a walk-in clinic and use the funds in my HSA, but every time I use them it’s a little less that I have saved up. We simply can’t have kids until we have that full deductible in the bank. Even then, that’s only good for one year. 

I ration my care because someday, I’d like to be able to afford to have a child. At this rate, I will be waiting a long time. It is a horrible, horrible feeling and if there were any way to get different insurance, I would do it. But since my employer offers me insurance, i’m not eligible to purchase it individually nor do I qualify for state insurance. Instead I’m stuck facing reality. If we had a child and were all on the health insurance available, we’d pay $5,880 a year in monthly premiums. Tack on another $11,900 for the maximum family in-network (out of network is $40,000!) and you’ve got a total cost of $17,780 for a family of three. We have two options – 1 pray that Obamacare helps our situation because we are horribly underinsured at this point or 2 – pray that DH’s first job out of college offers a much better rate of coverage.

 

I think I’d take the higher tax rate.

 

 

 

 

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