(Closed) TTC and Health Insurance

posted 7 years ago in Babies
Post # 3
Member
7587 posts
Bumble Beekeeper
  • Wedding: December 2010

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!

Post # 5
Member
7587 posts
Bumble Beekeeper
  • Wedding: December 2010

@pinky44: Ooh that’s a tough one. Yikes. Are you a gambling kind of woman?

Post # 6
Member
1820 posts
Buzzing bee
  • Wedding: August 2010

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.

Post # 7
Member
325 posts
Helper bee
  • Wedding: May 2009

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!

Post # 10
Member
2695 posts
Sugar bee
  • Wedding: February 2008

@pinky44: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?

Post # 11
Member
6009 posts
Bee Keeper
  • Wedding: May 2009

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.

Post # 12
Member
2538 posts
Sugar bee
  • Wedding: November 2009

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!

Post # 13
Member
3866 posts
Honey bee
  • Wedding: April 2012

@JaneyD: 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.

Post # 14
Member
601 posts
Busy bee
  • Wedding: April 2018

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  🙂

Post # 15
Member
751 posts
Busy bee
  • Wedding: May 2010

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. 

Post # 16
Member
601 posts
Busy bee
  • Wedding: April 2018

oops- no my waiting period was 3 months….sorry I stated the wrong info.

 

The topic ‘TTC and Health Insurance’ is closed to new replies.

Find Amazing Vendors