Anyone else paying for u/s b/c they apply to your deductible??

NicoleWI

I have this crappy insurance that I am SOOO annoyed about. I left my job in spring and DH is self-employed so we bought what we thought was a very good policy for the family (for upwards of $15K/year).Tried hard to get something comparable to what I had (which was great). Turns out that the maternity coverage is AWFUL. Totally bare bones. I didn't think we'd need it, but had made sure it was there just in case, and apparently I couldn't have really gotten anything better even if I'd tried. I couldn't do first trimester screen as i would have paid 100% out of pocket without it applying to my deductible at all. I paid $300 or so for the Quad screen. I have now paid $1600 for the 20 week u/s and am paying $800 for the 32 week that they want to do. $800, b/c now I have hit my deductible and am in the "50% co-insurance stage" until I would hit my out of pocket max. I'm SOOO annoyed by our stupid health care system! I am happy I can GET basic maternity coverage now for the appointments and birth, but I think it's CRAZY that they can make it so totally bare bones...and that I didn't even have the option to get better coverage unless it was through work! 

Is anyone else paying for this stuff? This seems SOO extreme but there's nothing I can do. Age doesn't matter, either. Same coverage no matter what whether I am 24 or 44 (am 39). 

Had I known I'd be getting pregnant I should have TOTALLY done COBRA from work, despite the higher per-month fee for premiums...but we decided to do this a month after I had to decide about COBRA. Hindsight. Oh well.

mandyreads

Yikes. I thought me having to pay $60 per u/s was a lot but apparently not.
I don't understand how your 20 week u/s cost that much. Ours was $250 & when the HR did it again for their measurements it was $650. I guess these ppl can charge whatever they want....but it is highway robbery if you ask me.

harmonicbabe26

We have insurance through MH's work as usual and yes, I had to pay about $550 for my anatomy scan and $680 for the detailed us/fetal echo they did at 26w. Can't remember how much the 1st tri screen was.

It is in line with the policy we chose (higher deductible but lower monthly pmts). It sucks but I think it's pretty standard these days. A lot different from how things were (really low co-pays etc) when I first started working straight out of college.
It seems like they keep dropping coverages, raising rates and in general getting worse and worse each year.

Not much you can do about it though.

Next year we're being switched from Cigna to Anthem (BCBS) and coverage will get even worse and monthly fees higher. At least now maternity is covered 100% after deductible. We're up to about $2,200 so far. That means we still have about $1,800 out of pocket coming up. Next year they cover 80% after deductible, so I'm glad we're having a baby under Cigna, this year.

anonymousmotley

Girl...I share your frustration with insurance!!  I have a low monthly premium but high deductible plan ($4800ded/$8400oop) for 2014.  My girl is due in February, which means I get a fresh deductible to meet for the birth (YAY ME!).  We have paid for every sonogram, every blood test and every urine test since becoming pregnant.  So far, we're up to $1510 this year in sonograms, tests etc.  But I've actually paid $3598 because I'm paying my OB fee of $2088. And to top that all off, we just enrolled in 2015 benefits that start over on Jan. 1 and my ded/oop will be even higher!  $5550ded/$9975oop!!!

My best guess is that this baby will cost me close to $15,000, not including premiums because I'd be paying the premium regardless!  Sad, considering that 5 years ago it only cost me about $1500 and 18 years ago a $20 (yes, twenty dollars!)!

I have been trying to offset the birthing bills by buying everything I can, for the baby, 2nd hand and I've saved about 75% off retail.  I've gotten some really great deals at resale shops and Craigslist.  Just bought a 4moms MamaRoo the other day for $125 that's less than a year old.  Those things retail for $270 (including tax). Believe it or not, it's taken my mind off the stress of the medical bills.   Shopping is always therapeutic for me...lol...and if I'm saving money...all the better!!

Hopefully your baby is due before your deductible starts over.  Best of luck to you!!

NeonNoon

Is that with some sort of maternity coverage @anonymousmotley?  I'm about the same, (don't have an exact number though because we still have to negotiate the NIPT bill) except we're self-paying for maternity at the moment.

We got a cancellation notice for our current plan.  We were gonna add maternity for 2015 anyway but luckily H's employer is offering an awesome new plan with an HSA that gives us a lot of flexibility.

anonymousmotley

@NeonNoon - Yes, Maternity care is covered and this is an HSA plan that I'm on.  I have to pay 100% of it until I meet my deductible, then 70% thereafter until I hit my cap of $9975 for 2015.  My portion of the NIPT bill is $823.50, which is 100% of the contracted rate with BCBS and Sequenom (the original bill was $2762 and I about had a heart attack)!!  They won't negotiate down since this is a contract rate with BCBS.  It seems that some people are able to get the price to $250 but I had no such luck!   I hope this is the case for you!!

Glad you get insurance with maternity coverage just in time for baby and hope that you get better deductibles that I do!

ewenner

NicoleWI - Thank you for posting this!  I have been feeling the same way, and it's good to know lots of others are dealing with the same frustrations.  We also have a high-deductible plan ($5000 individual, $10000 family) and we have to pay 100% of everything until we meet that deductible.  Fortunately, because my OB is in-network, we get lower contracted rates, which helps, but I am very nervous to find out how much the MaterniT21 is going to cost me (just had blood drawn for it this week).  

Overall, what's most frustrating is that I would never have chosen this plan for myself, but it's all that my employer offers, and the DH is currently out of work, so we really have no other options.  I would much rather pay a higher premium and have better coverage throughout the year, because at least you know what to expect every month when you know your premiums and then your actual medical bills are limited to co-pays and co-insurance instead of hundreds or thousands of dollars for every little service that you receive.  

topaz7777

anonymousmotley said:

@NeonNoon - Yes, Maternity care is covered and this is an HSA plan that I'm on.  I have to pay 100% of it until I meet my deductible, then 70% thereafter until I hit my cap of $9975 for 2015.  My portion of the NIPT bill is $823.50, which is 100% of the contracted rate with BCBS and Sequenom (the original bill was $2762 and I about had a heart attack)!!  They won't negotiate down since this is a contract rate with BCBS.  It seems that some people are able to get the price to $250 but I had no such luck!   I hope this is the case for you!!

Glad you get insurance with maternity coverage just in time for baby and hope that you get better deductibles that I do!

Wow, my NIPT was the Panarama.  The bill was $2700 or so and my insurance only covered 90%.  The people at Nitera told me that they had an agreement with my doctor that they would only charge me $25.  So I just had to endorse the insurance check over to them, and send them a check for $25 instead of the $270.  I sure was happy about that!

anonymousmotley

topaz7777 - Hmmm!!  I have an appointment with my doctor, next week.  I'm going to ask them about this 'agreement' thing, perhaps he has one too. 

This girl I work with (she's about 10 weeks along) told me just last week that she's getting the NIPT for free!!  That info, coupled with yours, makes me curious if I can be so lucky.

Thanks for the info!!  It's most useful as I'd never have asked my doctors office about it. 

NeonNoon

I wanted to let everyone know that it is worth calling to ask for assistance/discounts.  We got a 40% discount on our labs across the board.  In just one phone call, we saved a little over $900.  It's such a racket.

@anonymousmotley our main insurance is BCBS TX too, and I think we did the same NIPT.  It says informaSeq on my bill?  It was supposed to be Verifi but Progenity screwed it up.  Anyway, we were billed $954 and got it reduced to $667.80, but when we asked for help with our other big invoice, the NIPT got reduced to $572.40.  Not sure if it helps you but I thought you'd like to know.

anonymousmotley

Thanks @NeonNoon! 

Mine is a different company, Sequenom, which is the MaterniT21 test.  I think the girl I work with is having Panarama test and she's getting it for FREE!  

It IS a racket, considering the prices are so varied from person to person!! 

ewenner

NeonNoon!  I recently received my EOB for the MaterniT21, which says we will owe about $875 (of the roughly $2500 that was billed!), but we haven't received an actual bill yet.  Once we get the bill, I will definitely call to see if we can get it reduced at all.  I'm not sure if they will do anything, because I think the $875 is the Blue Cross and Blue Shield contracted rate, but it never hurts to ask, right?