Insurance Help!!!! — The Bump
Babies: 0 - 3 Months

Insurance Help!!!!

I live in California and was just informed that as soon as dd is born she will have her own deductible. So I could potentially pay up to $12,000. $6300 for me and up to 5700 for her. This wasn't the case for my son 2.5 years ago but the rep said this was a new change this year. Anyone have an idea on how much newborn care in the hospital goes for?
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Re: Insurance Help!!!!

  • I'm in FL and babies stay in hospital is covered under moms insurance not her own for delivery
  • I would call and speak to someone else for clarification.  You aren't even required to provide proof of them until max of 30 days after birth so it seems unlikely she'd be considered her "own person" right away for normal care.
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  • i'm in NJ and I have Aetna.  As soon as LO was born she was billed as an individual with her own deductible.  I just filed away my claims yesterday so here is what I have.

    For her care alone the hospital billed roughly $3500.  The pediatricians billed an additional $500 for their services. Your insurance likely has a set member rate meaning despite what you are billed from the hospital/doctor, the insurance adjusts/pays a set rate.  For instance for the $3500 the agreed upon payment from my insurance is $2300 and the pediatricians agreed payment is $140.  

    Hope this helps.  I would call your insurance to clarify.  It is true that you do have 30 days but still your LO is filed separately (at least in my case/state)

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  • Does your insurance have a maximum family deductible too?  If i had a child, they'd be an individual right away, but my family deductible is like another 1000 total. 
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  • jenn43jenn43
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    My LO's hospital bills were billed to his policy. I also had another nasty surprise: my COPAY for the delivery was $3000. Ridiculous.

  • Does your insurance have a maximum family deductible too?  If i had a child, they'd be an individual right away, but my family deductible is like another 1000 total. 
    This - you should have an out of pocket max per family per year.  

    Also, I am always getting confused about the relationship between the deductable (as in "you met your deductable"- mine is $1,500) and the co-insurance (a DIFFERENT 20% of our stay that does NOT apply for me to the deductable) that both add up together to apply to the out of pocket max per family per year.  I find that many insurance people tend to not do a good job of differentiating these when explaining on the phone.
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