Insurance FYI

erkyoung

I just had a baby in April and found out about a little hiccup in our insurance I thought it would be good to share in case there are others of you who didn't know about this. When I got pregnant, I asked my insurance rep all about labor and delivery costs and what would be covered. After the delivery we got our bills and paid up to our deductible of $500 (a total of $16,000 without insurance...wow). Now, three months later we have gotten a bill for $5,000 with no insurance coverage. We noticed the patient's name was my son's whereas on the other bills it was mine. After doing some calling we found out that because we went on my husband's family insurance plan instead of mine (because his has much better benefits) after the birth, any bills under our son would restart the new deductible. Of course we knew the first office visits would fall under this, but what shocked us was from the very minute he was born, he was being billed separately than me at the hospital. So, when I had asked about labor and delivery costs the insurance people only told me about mine, not my son's. I had just assumed we were covered as one for those few days in the hospital. Some parts of the bill are super silly as well, like we are both charged $3,100 for room fees when we were in the same room!

I just wanted to get this out there so that when moms-to-be are talking to insurance people, make sure to ask about the baby's coverage from the moment they're born, especially if you're switching to a spouse's insurance.  

DaisyTortilla

Oh no! Insurance can be a pain in the butt! I hope they can work something out with you. Nice to know though! Good luck!

VitaLuna

Almost all insurance companies will start a new individual deductible from day baby is born, since they're a separate person. It makes sense, since some babies require a lot of medical interventions, NICU, etc.

My insurance has an individual deductible, an individual OOP max, and a family OOP max. Our insurance will roll over mid-pregnancy.. Which will be fun having to pay the dang deductible twice.

NoelBird

For my insurance, as long as the baby is discharged the same day as mom, it all comes out of the mothers deductible. Even with insurance having a baby is expensive so it's definitely better to research your costs.

robinj716

So thankful you posted this because I have a high deductible of $1500 for myself and $3000 for family and I'm willing to bet my insurance is going to make me pay the additional deductible. I called and asked about costs but never though to ask about adding baby and having the deductible increase. Ughhh!!!

Miss Lilac

As a Canadian all these costs really boggle the mind! Good info to share though.

bredoll

More fun things to consider, my deductible is $3000 with $6000 family max...I'm going to go throw up. 

inomniaparatus

I've never had a deductible with my insurance, is that common?

robinj716

@inomniaparatus My office pays 100% of our insurance premium. In turn, they get cheap rates which allows them to offer that to us, so we have high deductibles. So either way, I'm pretty much paying a monthly fee. they always find a way to get ya!

4N6s

inomniaparatus said:

I've never had a deductible with my insurance, is that common?

Extremely common.

ecmb

A lot of insurance companies will consider the baby and mom as one deductible if the baby leaves the hospital when mom does. The only time two deductibles would apply us if the baby stays in NICU after mom is discharged.

If you want to put your LO on insurance that is not yours (your husband's if you have different coverage), do not do so until you are home from the hospital! This exact thing happened to my friend.

MrsJG3

I didn't add my babies until we left but HR back dates them to their DOB. The year I had DD2 we had 80/20 and even though I had maxed out my oop hers started over bc we hadn't met the family oop max.

mrs riva

bredoll said:

More fun things to consider, my deductible is $3000 with $6000 family max...I'm going to go throw up. 

Mine is similar with a $6k OOP max. We have a high deductible plan, but it has a lower monthly premium and an employer-funded HSA. We figured for something major, like having a baby, we'd max out anyway and the price comparison was equal, if not better than a plan with a lower deductible.

Knottie08171795

Wow. I feel so blessed to live in Canada. But I thought with the new healthcare in the states things would get less expecive?? But either way you'll be glad you paid to have your baby somewhere safe and that money will be paid off by your LO in lists of love and kisses

DizzyMom1

Thanks for the info, insurance make me cry We were signed up for the wrong plan at the beginning of this year, HUGE deductible and they had the audacity to claim that's what we signed up for. We thought we had a semi-reasonable deductible and by the time we found out we had paid quite a bit towards it and we would have lost what we paid if we switched plans. BCBS sucks! Doesn't help that we all have medical conditions. Not looking forward to the bills from this pregnancy!!

Sorry for the Rant, lol

RN0107

inomniaparatus said:

I've never had a deductible with my insurance, is that common?

I don't have one either. I consider myself extremely lucky.

CuriousKiddosMama

Knottie08171795 said:

Wow. I feel so blessed to live in Canada. But I thought with the new healthcare in the states things would get less expecive?? But either way you'll be glad you paid to have your baby somewhere safe and that money will be paid off by your LO in lists of love and kisses

Yeah, that is so no where near true to what the bill actually read. They promised lower health care costs, the average family's cost went up by a couple k. Our monthly cost has risen significantly over the past few years. And it's basically because of all these things that are required by law to be covered now that the insurance company either could or could not cover before. Things like preexisting conditions, birth control, breast pumps, etc.

Knottie08171795

Well that's silly. We have coverage for hospital and doctors. We don't have free perceptions, Breast pumps, we do have birth control. But only pills, shots and Nova ring. You can get extended coverages for that sort of thing, and for dentist, eye doctor, ciropractor ect. I don't have that tho. I only have basic through government funding as I got laid off in December and haven't found work. So I get eye exams, perception (no name only pills ) doctor and hospital. And if I get a tooth that needs filling they extract it, which sucks. I couldn't imagine having to pay like 3000$ for hospital bills each for me and baby. I would cry. Between me and my husband we make less than that a month! I don't think that's far at all for them to expect people to pay that for having a baby! Don't they know that money should be used for things like safety gear for the baby. A crib? I mean a Breast pumps only 3-400$ I would rather buy one than pay the extra insurance cost!