Post # 1
Hello there! First time thread poster, long time reader.
I’m here with a boring Insurance question. I am getting my IUD out the first week of June and then it will officially be TTC time! Hip Hip Hooray! DH and I are currently on a High Deductible plan ( I believe $3500 ). Obviously, it is safe to assume that we will hit the deductible in the year that we get pregnant and have the baby, but I’m curious about how that worked for those of you who have done this before. Did you pay for each visit piece meal until you hit the limit? If so, about how much did each appointment, etc. run you? Did you earmark these funds in your savings for baby deductible? Or just pay as you go? I’m just trying to plan in advance, so I’m not shell shocked by sticker prices when the time finally comes.
Also – have any bees switched insurance plans before TTC for this reason? If so, what did you change to? DH and I are both US attorneys and have a plan through the open market (both of our firms just provide stipends instead of group plans).
Any help is oh so appreciated!
Post # 2
I am wondering about this too. We also have a very high deductible but we have an HSA to supplement that. My DH’s work puts about $1500 of the $3000 deductible into the HSA and he has money come out of his check every week that is automatically added to the HSA.
Post # 3
If you do get pregnant, a lot of OB offices will set up monthly payments so you pay the full amount for delivery beforehand. I don’t have a high deductible plan but I would assume you’d be paying your copays and costs for ultrasounds, etc as you go.
Post # 4
We have a high deductible plan. I got pregnant in January and paid about $150 per visit out of pocket. Then we paid about $300 for each ultrasound. Then we had a miscarriage and the D&C caused us to totally exceed our deductible. When we get pregnant again, all visits prior to Jan 1 will be covered, then we get to blow through our deductible again.
We had the money in our HSA and just planned to use that. We didn’t change insurances, but we did try to time our pregnancy to make sure we got everything in one year. We were lucky– a Septemeber baby! That would have kept it to a single year. Then we had another MC with a late Decemeber baby, so all plans of maximizing insurance have gone out the door.
Post # 5
I have a high deductible plan as well.. as far as the monthly dr visits go I haven’t gotten a single bill yet (I’m 23w). From what I understand they wait & lump it all into one bill and bill you after the baby is born, which kind of sucks.. but that’s how they do it at my office. However I have gotten the explanation of benefits for each visit, and so far I owe less than $100.. $20 here, $30 there.. but nothing has shocked me yet. Even for our anatomy scan ultrasound I only had to pay the $20 co-pay, it was 100% covered (it actually cost $800). And as far as co-pays go, I paid it the first two visits and that was it, I won’t pay one anymore (I had to pay it for the ultrasound because it was with a different doctor).
Really I think every dr office and insurance company is different, so it’s probably best to contact your insurance and find out what they cover and how they bill things. Also if you know what dr you’ll be going to you can call & find out if they bill you monthly or can set up a payment plan or if they bill you all at the end.
Post # 6
Ok, so my husband has a great insurance plan thru work that we are both on. It is not an extremely high deductible plan, etc. With that said, you see doctors, get poked and prodded A LOT during pregnancy, and so far (6 months into it), I have paid a smaller out-of-pocket bill twice. I have never paid a co-pay at the doctor’s office (and we have one to pay), but they told me at my initial visit that with his insurance (or maybe all insurances), they ‘run a tab’ in essence, since you frequent them so much. So rather than paying $25/month, I will pay $200/every few months, etc…or whatever the cost to us is. It has been nice to not have to ‘worry’ about it.
I am certain we will hit our decuctible between the lab draws, co-pays and even labor and delivery this calendar year for sure!!!
Post # 7
So sorry to hear about your miscarriages, and the unfortunate timing re: your deductible. I’m sure dealing with insurance woes makes a frustrating situation even more upsetting. Wishing lots of positive baby thoughts to you!
I’m glad you mentioned the HSA – going to start dumping some more funds into mine shortly after the IUD removal.
Thanks for the info. It sounds like it just kind of depends on the office and the carrier. I plan to call BCBS and try to ask for the specifics. It is reassuring to hear that you haven’t had to pay exorbinant amounts along the way. It’s funny for me to be so clueless about all of this considering I practice insurance defense law. Haha! But health insurance is an entirely different animal!
Post # 8
I haven’t gotten pregnant myself yet, but two of my friends who did had to pay the entire deductible amount up front to the Ob/Gyn’s office.
Post # 9
It depends on the practice. Mine charges a global fee at time of delivery. I paid for copays, labs and ultrasounds throughout the pregnancy. Then, after delivery got a bill for the remainder of my deductible. I got pregnant in June (had baby in February) and because our plan year started over feb 1st I had to meet the deductible twice, which really sucked! So I would think about that With your tiMing! Also I kept track of every bill and payment because insurance doesn’t always keep the best records! Good luck!
eta – I had full genetic Jewish panel on visit 1 which was $1500. Ultrasounds were about $500 each if I remember properly. Those were the most significant costs alone the way until delivery.
Post # 10
I’m not pregnant yet, but we’ve been through a few insurance changes since starting TTC. We were on a high deductible plan (HDHP) with HSA, but recently switched to a co-pay plan since the premium cost was the same, but the out of pocket amount for health care was less.
One thing to check is what is covered as preventative care. For my current insurance company, I believe that any routine pre-natal care after the initial appt where they determine you’re pregnant is considered preventative care. So the pre-natal visits should be free. Routine pre-natal lab work might also be covered as preventative care (free!). If that’s the case, you’d just have to pay for the delivery itself and that can depend a lot on what kind of delivery you have and whether there are any complications.
Post # 11
We didn’t change plans specifically for TTC, but were picking new insurance a little before TTC and looked at the maternity coverage for the different plans. Once we were on a plan I called and got all of the nitty gritty details so that we’d know what to expect to be charged.
Post # 12
I have new insurance for my next pregnancy and I’m interested to see how it goes. My new insurance is a $750 deductible plus 20% up to $3000 (max out of pocket).
My old insurance with my first baby was $500 deductible and then covered 100%. I had to pay a $40 copay for my first OB visit, then $20 copay for each of 2 ultrasounds and blood work, and then my deductible for the birth.
Post # 13
With my OB I only pay for everything done at her office (just my copay), and the hospital will bill me for the delivery after birth. I overheard the receptionist explaining to a patient with a different insurance than I had that she would have to pay the full deductable amount to the OB 2 months before her due date or the OB would not deliver the baby. She said that she could either make a payment towards it at every visit, or just pay a lump sum as long as shepaid by the deadline. I guess it really just depends on theinsurance you have. I would talk with all the insurance reps before you pick a new plan.