(Closed) Possibly Pregnant? Help!

posted 11 years ago in Babies
Post # 47
Member
4122 posts
Honey bee
  • Wedding: October 2010

I too would love to know what happened.

The unfortunate thing, is most “private” insurance coverage that does cover pregnancy, actually requires 6-18 months of coverage BEFORE they will cover your pregnancy. i.e. you need to sign up and use them for 6-18 months before they’ll cover any costs. 

My FI’s work insurance will be just a “get on and go” kind of thing luckily, because while I have insurance, it doesn’t cover pregnancy. So, I totally understand how the OP may feel. 

Post # 48
Member
365 posts
Helper bee

Wow, congratulations.  I see you’re humming along nicely.  That’s wonderful 🙂
 

Can someone explain the US health system to me?  Do you have to pay to go to the hospital for an emergency or a surgery or birth?

Post # 49
Member
1937 posts
Buzzing bee
  • Wedding: July 2010

@tobin – The US health care system is pretty complicated.  In short, yes, you generally have to pay for the services/ products you receive unless you go to a free clinic.  I volunteer every week at a free clinic and patients must apply for a spot and only so many patients are accepted every 3 months.  Usually all the spots for the next 3 months are filled within 48 hours.  We generally see these patients for years – either until they find a job with benefits or they reach ~65 and qualify for Medicare (which costs money, but everyone over that age is eligible automatically).

For example, my husband has insurance through his work.  He recently had to go to the ER.  We had to pay $175 at the ER because that was the co-pay.  In addition, we have to pay 10% of the total cost (and his insurance pays the other 90%).  So between the lab work, a few other tests and medication, the bill was almost $7000.  That bill will get sent from the ER to his insurance company.  The insurance company has a contract with the hospital where they pay so much for each item.  So for example, if you have a CAT scan, the hospital might charge $3000 but in their contract, the insurance company agrees to pay only $2000.  So, my husband and I will get an “explanation of benefits” in the mail soon that details these costs.  We will pay 10% of the contracted cost (i.e. instead of $700 it might be $450).

And that’s just one example – every plan is different.  If he were admitted as an “in patient” to a hospital, we would be responsible for paying a deductible first.  The deductible is $4000.  So we know if I were to become pregnant, we would be responsible for the $4000 deductible before the insurance would pay anything.  

One of the many issues to me is that if you have insurance, you pay a lower cost because of “contracted rates.”  People without insurance (the people who often have jobs that don’t offer insurance, they can’t afford insurance, etc) are charged the full price.  These people often can’t afford what is charged and it can result in bankruptcy… all from becoming ill or being in an accident.  It happens to people with insurance too.  

Let me know if you have any other questions 🙂

Post # 50
Member
2236 posts
Buzzing bee
  • Wedding: September 2011

@rabbit: Are there any updates?  I know your OP was a few weeks ago…

Post # 51
Member
293 posts
Helper bee
  • Wedding: March 2011

Bump!  Update pleaseeee! 🙂

Post # 52
Member
1432 posts
Bumble bee
  • Wedding: November 2013

Yes, update please!

 

View original reply
@EvaBostonTerrier:  Boy, the US health care system sounds terrifying!  I don’t care how high my taxes are, I’m just glad that I won’t go bankrupt if I ever break an arm or something.  I always took it for granted that when I walk into an ER and hand over my health card, I will walk out those doors never having received a bill.

 

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