@bettybonsomethingstein I agree. I'm a person who doesn't want an epidural (if I can avoid it), so considering my insurance plan, the potential cost-saving seemed like a perk. But I hope I didn't make anyone feel like they should re-think their whole birth plan to save cash --- it's ultimately not the most important piece of all this, and I wouldn't trust an internet article as the law of the land. Just wanted to make a space to mull through all this, which is unfortunately one reality of giving birth in America.
@antoto My fertility clinic offers payment plans and they also have a system where if you can show severe economic hardship you can apply to have your IVF costs reduced by a few grand.
@antoto My fertility clinic offers payment plans and they also have a system where if you can show severe economic hardship you can apply to have your IVF costs reduced by a few grand.
Really cool to hear that lots of places offer payment plans! Somehow I just never noticed/had the option lol.
@orbmaker - yeah ours offers a discount to pay it all at once too, which is nice but I know we will end up paying into taxes again next year so I don't want to spend ALL of our savings
we may just do the payment plan and pay out of my HSA! My DH doesn't have an HSA anymore, which sucks but they baby will be on my insurance and the bank I work for will put more in the HSA once we add him/her to our insurance. I'm just looking forward to everything being covered AFTER baby is born since we'll hit the deductible so early on in the year!
@crossfitbabybump I would still look into it if you're interested! One group in my area seems to offer a sliding scale. I think we might pay $180 for my husband and I to take a local class together, so that he'll/we'll have a better idea of how to support me during labor.
@orbmaker - I sure will! I follow doula wisdom on Instagram and it makes me want to research more. They seem just so amazing and helpful! Our hospital offers free birthing classes and I am excited to take the course! Do you know how far along you should be when you start taking them?? My poor DH will probably be in a slight panic so I know a doula would be so handy!!
@crossfitbabybump I think they recommend the last trimester! But also say it's a good idea to register in advance. Here, classes haven't been added for 2018 yet.
@orbmaker - I will ask my OB at my next appointment! I wish you all the best of luck with the insurance crap! If I could give one positive note, at the end of all of this, we'll be holding our babies close, think about that, let it help take your mind off this insurance non-sense (for now) lol
@orbmaker mostly just lurking here as I am also in Canada like @mountain_girl ... and your right - the difference in price really emphasizes how much private health care inflates prices. the differences you posted in prices are insane.
I am not trying by any means to insult/ offend or be insensitive.... but it makes me so angry that so many of you ladies will have to pay anything out of pocket to have your LO's and even more frustrating that you have to compromise your comfort and wellness in order to "save money". our healthcare in Canada is by no means free - we pay higher taxes- but I've never in my life met anybody who had took pay money to birth their babies. this is infuriating. you are creating life! this is species basic reproduction ... you shouldn't have to PAY it go into debt for it.
@bb3vj3n it's infuriating! I think there's this prevailing cultural attitude that women do things "from the goodness of our hearts," so therefore women's work needn't be fairly compensated, and we should be happy to pay some corporation a good chunk of our family's income for the privilege of bringing the next generation into the world. It drives me nuts when male politicians go on these rants about how they shouldn't have to pay for someone else's pregnancy. Well, what magical never-birthed young people do you think are going to be caring for you and paying into the system when you're elderly? So short-sighted.
I pay more from each paycheck toward my insurance premiums than I do for taxes! I don't think taxes are twice as much in Canada, are they?
@bettybonsomethingstein I agree. I'm a person who doesn't want an epidural (if I can avoid it), so considering my insurance plan, the potential cost-saving seemed like a perk. But I hope I didn't make anyone feel like they should re-think their whole birth plan to save cash --- it's ultimately not the most important piece of all this, and I wouldn't trust an internet article as the law of the land. Just wanted to make a space to mull through all this, which is unfortunately one reality of giving birth in America.
I don't think anyone should be faulted for taking it into consideration, by any means. It's the fact that anyone is confronted with this scenario at all that disgusts me. I never knew this before, and it is giving me all the feels and all the rage.
***March '18 October Siggy Challenge: Halloween Costume Fails***
@bb3vj3n it's infuriating! I think there's this prevailing cultural attitude that women do things "from the goodness of our hearts," so therefore women's work needn't be fairly compensated, and we should be happy to pay some corporation a good chunk of our family's income for the privilege of bringing the next generation into the world. It drives me nuts when male politicians go on these rants about how they shouldn't have to pay for someone else's pregnancy. Well, what magical never-birthed young people do you think are going to be caring for you and paying into the system when you're elderly? So short-sighted.
I pay more from each paycheck toward my insurance premiums than I do for taxes! I don't think taxes are twice as much in Canada, are they?
Preach! Yeah, seems like a lot of 'family' sort of stuff isn't fully recognized for how difficult and important it is. Like how clearly maternity/paternity leave time isn't seen as important because if it was, we'd be able to take more time and have more ways to support ourselves financially during that time. It's crazy how some parents have to go back to work after just a few weeks. I know though there are people on differing sides of opinion there though...as there are with the discussion of insurance (privatized vs. single payer).
@orbmaker ....it depends on your income bracket. the more $ you make, the higher your tax rate. Low income (# ranges from province to province but generally sites around 12k/yr) does not pay tax on their income. I pay around 40% of each paycheck in incline tax, unemployment insurance and the Canadian pension plan.
our sales tax also ranges be province but in general sits around 12-13% on most purchases.
what do your tax rates look like in the US? I imagine they vary depending on each state - but is there an average federal tax?
@bb3vj3n Our federal taxes are also divided into brackets. This is over-simplifying, but say I make 50,000. The first 10,000 would be taxed at 10%, the next 20,000 at 15%, the final 10,000 at 20% and so on. In my bracket, my state taxes are another 5.5%. A few states don't have state taxes at all -- I can't really speak well to how state taxes vary.
Last year I made about $60K and was the only earner in my home while my husband was in grad school. I paid what looks like 21.6% of that to federal/state taxes, medicare, and social security. Another 6.5% of my income went to my insurance premiums, but if you factor in the usual medical expenses/copays/deductible on top of that it's more like 7.3% (on a "normal" year with no hospitalization/pregnancy/major illness). So all this adds up to maybe 29% (not including property tax). And at least 25% went to student loan payments, but that's another story
Sales tax is 6.35% in my state.
ETA: So, yes, looks like you do pay more (tho maybe you're in a higher bracket?). I think I'd rather pay more in taxes and rest easier knowing that me and all of my fellow citizens were spared the threat of destitution due to illness or injury.
How are you managing your baby bills so far? What are you worried about? We have health insurance through my DH's work. It's a version of Blue Cross. In terms of managing, I have spent hours on the phone, logged into our insurance website to try to figure things out. We got a bill for the first ultrasound for $350. (I've posted about this elsewhere.) But, when I found and red our actual policy booklet this weekend it says " you may continue
to receive follow-up care which includes prenatal visits, medically necessary and
appropriate sonograms, delivery, postpartum and newborn care in the hospital..." Which implies to me that sonograms would be covered. It looks like it was billed as diagnostic radiology. So...another round of phone calls is on my to-do list. How are you planning to pay for your hospital delivery, if you plan to have one? I was bolder in my youth and believed in the beauty of home births, but we've been through so much to get PG if anything bad happened I don't know if I'd forgive myself. So we're definitely going to the hospital, though I plan to do as much labor at home as I can. With a doula. Anyway, our policy says In-network hospital birth is covered 100% after deductible. Of course, our policy turns over on 4/1 and I'm due 3/25 but measuring a few days behind. So it's possible we'll be paying the full deductible twice for one birth. I'm basically assuming we will be and saving for that, just in case. If you live in the US, aren't you frustrated with our healthcare system? :P Absolutely. One thing that really gets me is even if, hypothetically, we all had Blue Cross, our companies each negotiate their own coverage policy. So basically some person in HR is practicing medicine by deciding in advance what healthcare we're allowed. It also seriously annoys me when people are against single-payer health care because "It's socialized" and anything "socialist" is bad. Insurance IS SOCIALIZED MEDICINE. We all pay in as we're able (so to speak, we pick a plan we "can afford") to a centralized fund, and we take out only what we need.* The big difference between our system and a truly socialized one is that corporate insurance companies make a profit off of it. It's an entire industry. We have corporatism without the free market. Which leads to inefficiency and injustice, so no one is happy. (holy cow, sorry for yelling. This kind of political illogic really makes my blood boil.) What about affording maternity clothes and baby stuff? Well, I also work for myself and am trying to build a client base (I'm a freelance editor). So my income is low and unpredictable. We've decided a doula is worth paying for, so maybe I'll be foregoing cute maternity clothes. I can just wear leggings and DH's shirts right? This will be the first grandchild for DH's parents and mine, so I'm not too worried about baby stuff. Pretty sure this one's gonna be spoiled. I think our parents will help out with the big ticket items and I'll stick to mostly necessary things on the registry. Also plan to do cloth diapers. Edit to include * "From each according to his ability, to each according to his needs," is often attributed to Karl Marx.
The guy at Blue Cross told me it depends on how the hospital bills it and that determines how the Ins Co receives it. So the hospital could be coding the billing a different way that would technically be screwing you over on something that may be covered at 100% or a little less by the insurance company. I got screwed over a blood test that cost me over $600 because of the way the hospital billed it, after I paid it to find out that had I called them and had them change the way it was billed to BCBS, I wouldn't have paid that much for it.
ASK QUESTIONS! Demand to know how they're billing your company!
-your 29% to my approx 41% (I also didn't include property taxes in that number but mine are approx 4k a year..) -our sales tax is approx double yours ... - I still pay a monthly insurance premium but we don't have deductibles and honestly... the cost is so low (I pay maybe $50 bucks a month for full benefits, disability & life ins).
at the end of the day I would say with the difference in taxes we probably come out pretty close to equal when you consider your out of pocket expenses versus what we pay in advance. and I only say this strictly regarding having babies....i know that your system can cost did much more for some other types of care that pre existing or not covered...
I personally like my healthcare included in or taxes as it doesn't matter what type of care you need, or add on (like for instance an epidural) as you know it will be covered. I also find that you can't spend money you never had - so not getting hit with a large bill is easier for me than having to save the money myself and pay it later.
During my first delivery / hospital stay, I had no idea every single thing was costing money. You need some more giant-ass pads? Sure, and you'll see it on your bill / estimation of benefits. More mesh underwear, ready for your next pain pill? Sure, and it'll be added to the bill. For me it was my first hospital stay, so I didn't realize and no one presents anything to you as if there's an extra cost. So while I know I wouldn't be in the frame of mind of trying to save money while in delivery, post-delivery you may want to be mindful of the 'extra' stuff the nurses provide/offer (with the exception of pain meds...not skimping on those (I ended up having to have a C-section)) ********************** [box got all crazy on me] I was wondering about this because I've heard the other side of the coin too - that you are charged for everything in the room or on the cart or whatever anyway so you might as well scoop it all up even if you're taking some of it home. Like they put out new stuff for the next person and charge you for it whether you take it or not so you might as well. But if it's that they charge you based on what you use that's a whole 'other story. I guess every hospital could be different so you probably have to ask. And if you ask you probably won't get a direct answer so the truth is you're probably screwed either way so just use what you need right?
And seconding @crossfitbabybump, @bb3vj3n, we need a president with views like you so bad. Our healthcare is so infuriating and shameful. And the whole reason is not that we can't afford to change it, it's insurance companies and old dudes in gov't. don't want to compromise for the welfare of everyone else in the f***ing country.
@fatstagnation also a freelancer, and literally working right now in a coffee shop in my husband's t-shirt and [eta: my] leggings. lol. *insert emoji with monkey covering his eyes* I ordered a few maternity pieces like jeans (mine are hurting to sit in now), but I'm trying to maximize on loose and stretchy clothing, and taking advantage of the fact that I don't need to really dress nice for work.
@crossfitbabybump I don't understand how you would know how to tell them how to bill? I mean for the $600 lab work, how would you even know what was billed wrong and how it should have been billed or what the other options are? Is it something that was obvious and stood out on your EOB? Honestly that stuff mostly looks like abbreviated gibberish to me. I'm not trying to doubt your advice, I just don't understand how to apply it.
@orbmaker and @alice0218, maybe my understanding of how I was charged for those various items is backwards. Or maybe it's both though, because they 'gave' me an SNS contraption (supplemental nursing system...lets you 'breastfeed' while also supplementing with formula) because it took a while for my milk to come and I ended up seeing that on the estimation of benefits (same with a belly bandit thing they offered/gave me). But then again, I can't see how the amount of pads and panties you use can be really tracked, so maybe what @alice0218 said, they just automatically charge.
But anywho, those charges are like a drop in the bucket compared to the actual delivery cost and cost to just exist in the hospital.
One thing I wanted to mention to anyone in the US with employer coverage, like others have been saying, don't be afraid to question the charges on your bill (pain in the butt) and if you don't know if your employer offers a 'health advocate/advocacy' service, definitely find out. The extent of what they'll do can vary by employer, but generally speaking they may be able to help confirm if all is well or not with how you were charged and they can help you file appeals with the insurance company. They don't have the power to tell the insurance company what to do, but they know all the in's and out's and.
I guess I just don't understand all of the insurance stuff. We have good insurance I know that much, but I don't plan on having some large bill. My office visits are all covered not even a co pay. My dr does ultrasounds in the room during my appointments that I don't pay for, my lab work is covered, and when I do my anatomy scan I just have to pay a small $10 co pay. The booklet we got says in network pregnancys are completely covered and just have to pay the co pay for the hospital stay. Am I missing something? Is there going to be a huge bill waiting for me in to end? With my first we had government insurance so we never saw a bill for anything but this time we have insurance through my husbands work.
God bless military insurance. My first (non military) baby we paid close to $2k out of pocket when it was all said and done. My second (military insurance) I think I paid like $20 total. Lol This is why military families can be so big! Haha
@kforbes14 if that's what your plan says, that's what you'll pay. You're lucky! If you're worried, call the number on the back of your card and talk it through.
There is little consistency among plans in our country, except now at least they must include what the ACA mandates (thank goodness).
@alice0218 it'd be a (possibly long, annoying) phone convo with your insurance company. i.e., please help me figure out why I was charged X while my plan says it should be covered. Then they might tell you, doctors office coded this as a blank, it should have been Other Thing, and then either you or they call the doctor and have them recode it.
@enigmaticjj we're supposed to code/charge for "big ticket" items we give out, like crutches/canes etc. My hunch is that things like toiletries/pads are "assumed" costs and those other things are manually entered.
We have to pay our deductible twice because baby is due in March. They bill as they go, I wish they did global billing and billed everything after the baby was born. But they have a payment plan where we can pay $350 a month and it "should" cover most estimated expenses. I'm sure they estimated me doing a vbac because my OB wants me to try, but I'm having a repeat cs so I'm sure it will be more expensive. I plan on filing financial assistance after the baby is born with the hospital. I think we will be at the cut off for the remaining bill to be cut 50%.
As for maternity clothes and baby items I have quite a bit left from baby #1. We need a few small things, nipples for the bottles, a new rock and play, spring baby clothes and I need maternity clothes for wintertime. I've been hitting end of season sales and buying small things here and there.
ETA we're managing bills well so far. We moved to a home with cheaper rent because it's tiny back in march to save, so we have a good cushion of savings and we've been adding to that. The $350 we pay every month covers the monthly costs and the rest is credited for future use. We've been cutting back and I've been working what extra hours I can to save more for maternity leave. I'm in school, so it isn't easy. But I think we will be able to save enough for me to take 12 weeks and DH to take 4 and still be comfortable.
alice0218 said: @crossfitbabybump I don't understand how you would know how to tell them how to bill? I mean for the $600 lab work, how would you even know what was billed wrong and how it should have been billed or what the other options are? Is it something that was obvious and stood out on your EOB? Honestly that stuff mostly looks like abbreviated gibberish to me. I'm not trying to doubt your advice, I just don't understand how to apply it.
@alice0218 - the insurance company told me it was the way that the hospital billed it. I guess they can code it a certain way to the insurance company as to whether it was routine lab work or something else, so they can determine how I pay for it and whether or not the insurance company covers it a certain way. Does that make sense? Insurance is so confusing! So, had the hospital billed it as routine lab work, I wouldn't have had to have paid so much. But they billed it as something different that my insurance didn't cover it at a certain cost. Same as my prenatal care. If I was a high risk pregnancy, all the ultrasounds in the world I could get and they would be covered 100% because the hospital would bill it to BCBS that way. But I'm not, so only one is covered and the rest I have to pay for. But the hospital will bill EVERYTHING at the end of my delivery so about a month after giving birth, the insurance company will send me the final bill after the deductible is taken into account. Does that make sense? I had to have them explain all of it to me and I even asked my mom about the billing since she's an expert on all of that, considering she's had 8 back surgeries, a double mastectomy and 3 different kinds of cancer treatments.
I talked to insurance again today, and the bad news is that ultrasounds are billed as radiology and not maternity. So we have to pay for that. But the good news is that we're close to my deductible, so everything from now on I will only pay copays. So now I'm like, 'I'm going to all the doctors!' I haven't seen a dermatologist in a while, and I should, for example.
@fatstagnation - thank you she is! She is officially cancer free as of this June! And she's so excited to be a grandma! If I can be half the mom she is, then we'll be okay
So since this is my third time doing this I know it will be expensive. I carry the insurance through work for my family (the one my husbands company offers is crap) so because there's already 4 people on it we have a high deductible, plus my employer only offers HDHP, thankfully with a HSA along with it. Our deductible is $2600 but one person can't use all of it, I forget how much one person can use so even though I by myself would have met it in March it won't count. I don't know if anybody else has this but with Aetna there is also an out-of-pocket maximum so even once the deductible is met (which it already was for this year because DD had oral surgery with anesthesia in March and all of my different appointment with rheumatologists etc) but our out of pocket maximum is $5200 which means I only have to pay 10% of what is billed but things are still not covered 100% until after I reach that out of pocket maximum. It's very frustrating that I pay so much just to have health care and then I constantly have to keep paying. For example, I have to pay $1300 to my dermatologist for seeing him back in June which is ridiculous and I probably need to look into how they billed the services to my insurance company like @crossfitbabybump said.
Also, have any of you every looked closely at the EOB for a hospital stay? I've never had a broken bone or anything like that so the first time I stayed overnight in the hospital was for DD. When I looked at the EOB for that I almost fell over. The base amount that they billed for the room was over $8K A NIGHT. Just for the room, not the dr's or nurses, not the equipment or medicine, just the room. Now that was not the amount that was finally billed because there is an "in network agreement rate" which is what they actually billed the insurance for but the base amount is crazy. I'm thinking I'll probably have to pay a little over $2500 for this one which is about what I paid for my last one which was 2 years ago, barring any complications. I did get the epidural and I'm planning on it again, DH thought that maybe I wouldn't get it because while the belts were showing that I was having contractions, I couldn't feel any but I told him not to get too excited haha.
Wow, i remember the insurance i had with my first wasn't really good, as in we had to pay like 10k for my baby to be born and his month long stay in nicu, but all of my other babies and maternity care have been covered 100%. After him, we knew how expensive birth could be and we wanted a large family. I can't imagine having to decide whether or not to grow your family or not based on of you could afford the birth, and i kinda thought Obama care was supposed to help eliminate that problem.
I also feel bad for families that have to decide whether or not to have 1 or 2 or more children based on daycare costs. A good friend of ours is going through that now, and decided that can't afford to have a 2nd because of how expensive day care is.
Good point @mamaof5already on the day care mention! Day care is very expensive and honestly after we had DD it didn't make sense for me to go back to work because all I would have been working for would be to pay her daycare. Thankfully, we are very blessed and my mom stepped in and said that she would watch her for us so that we could both work and not have to worry about finances. She now watches both so we've never had to actually pay for daycare. 3 might be a little much for her but since I will have off (assuming baby comes when they're due!) until mid July she will only have to watch all 3 of them until school starts again for DD in September and then she'll be in school all day, and the year after that DS will be in Pre-K half day so she'll just have the one then. I know not everyone is as lucky as we are to have family close by that's willing and able to watch kids and I can't imagine how they do everything!
@mamaof5already Honestly the daycare thing is more stressful IMO than the cost of the birth (at least for us/our insurance situation). We live just outside the city of Atlanta (still inside the perimeter) and the daycares we're interested in cost over $1000/month for ONE child. It's nuts. We're lucky enough that we can afford it, with some budgeting, but it is so out of reach for so many people. I'm sure there are cheaper daycares but these are the ones recommended by friends/coworkers/etc so they're the ones I trust.
Bumping this thread because I need to vent about money and medical stuff. Man does it stress me out!
@orbmaker and @crossfitbabybump I actually got my first medical bills from this pregnancy in the mail yesterday and spent like half the morning on the phone trying to see if everything was coded properly and trying to have them review it (which they say should take about 2 weeks). Thank you for explaining some of that coding stuff! On my coverage and benefits of maternity the website for my insurance says 100% of prenatal preventative care is covered and deductible waived. So not having had any bills yet (I'm just about 5 months in) I assumed I was scott free for the prenatal stuff. Apparently, most of the blood panels and lab work that was performed at my first two appointments totaled about $3,200 in all, my portion of which is about $750. I was so upset and confused thinking it would be covered. $750 isn't the most outrageous bill I've heard of but it's a hell of a lot more than $0. And I haven't even had an ultrasound or any elective testing, it's just all regular panels the doctor ordered. Turns out it's all billed under "diagnostic" and not "preventative" so I have to pay for it, or at least part of it (I am still trying to have them review it though). I have my first ultrasound in 2 weeks (at 21 weeks) and confirmed that that's not covered by insurance either (radiology, not preventative care). So I spent the other half of my morning calling all over this hospital system trying to get a code for it and an estimate. Finally got the code. Still don't have the estimate. I honestly think I'm going to flat out refuse to pee or give blood anymore until they tell me exactly what codes it will be billed under and have a chance to find out what portion of it I'll have to pay after insurance. I can't deal with $200-$750 every time they want to look at my blood and piss (which seems like it's been pretty much every appointment). Not to mention, the things that weren't covered were testing for sickle cell, drugs, syphilis, and HIV, all of which I could've told them I don't have if they would've told me what the tests were for, but they don't do that do they?
I effing hate this country's healthcare. Oh btw, you guys heard about non-mandatory coverage of BC now right? Brilliant! SMH
eta: I think I'm extra stressed over it because this week we also found out my husband's crown can't be replaced but instead the tooth needs extraction and an implant which altogether might be anywhere from $2,000-5,000. We are still gathering estimates but fuck me.
alice0218 I feel your rage! The amount we pay for insurance just to get billed for important and standard care makes me furious.
and I also think it's not right for them to test us for things without telling us what it is. I was tested for STI's and HIV too, and was like, why didn't we do that at my regular annual exam? That's when I've had it done before I was married. WFT? and just, you know, patient consent requires that we know what we're consenting to. I used to work in healthcare so that one really annoyed me.
Also, coincidence, my husband is in the exact same dental situation. and dental stuff gives me anxiety so I couldn't even listen to him tell me about it. hahaha poor guy.
@alice0218, if you're coverage is through an employer, find out if they have an 'advocacy' group. At least for bigger companies I believe it's somewhat common to have, and they usually can help do the leg work you're doing now as far as getting carriers to double check how they reviewed the claim, etc. $750 is a big bill, so I'd be shocked as well! That's so stressful.
And regardless if coverage is through an employer, see if your or your partners employer (assuming not self-employed) has an 'employee assistance program' (more common for bigger employers) you can call just to see if they have any resources for your money/bill situation or for you being pregnant. I figure it's worth a shot just in case.
@alice0218 for some of the things you said they tested you for and the insurance company is charging you for, I don't think they can under the ACA (except for a few narrow circumstances with the insurer). You might want to follow up with your insurer and challenge them on that, or even appeal with a letter explanation (I've done that before and got them to cover it).
also ask your insurer if there are any diagnosis codes or location specifics associated with the procedure code that might affect how much they cover of a certain service. My last pregnancy, my anatomy scan was not covered because the office it was done in was in the hospital (that is, it was a separate location from my OB GYN office). But, if it had been done in "a physician's office" instead, like my doctor's office, it would have been covered 100%. Thankfully this time around my doctor's office does in-office scanning so I don't have to worry about that, but I learned the hard way after pouring through all my insurance fine print.
Re: Payin' for It
@orbmaker - yeah ours offers a discount to pay it all at once too, which is nice but I know we will end up paying into taxes again next year so I don't want to spend ALL of our savings
we may just do the payment plan and pay out of my HSA! My DH doesn't have an HSA anymore, which sucks but they baby will be on my insurance and the bank I work for will put more in the HSA once we add him/her to our insurance. I'm just looking forward to everything being covered AFTER baby is born since we'll hit the deductible so early on in the year!
I wish I could afford a doula, though.
any day, dude, any day!
I am not trying by any means to insult/ offend or be insensitive.... but it makes me so angry that so many of you ladies will have to pay anything out of pocket to have your LO's and even more frustrating that you have to compromise your comfort and wellness in order to "save money". our healthcare in Canada is by no means free - we pay higher taxes- but I've never in my life met anybody who had took pay money to birth their babies. this is infuriating. you are creating life! this is species basic reproduction ... you shouldn't have to PAY it go into debt for it.
I pay more from each paycheck toward my insurance premiums than I do for taxes! I don't think taxes are twice as much in Canada, are they?
our sales tax also ranges be province but in general sits around 12-13% on most purchases.
what do your tax rates look like in the US? I imagine they vary depending on each state - but is there an average federal tax?
Last year I made about $60K and was the only earner in my home while my husband was in grad school. I paid what looks like 21.6% of that to federal/state taxes, medicare, and social security. Another 6.5% of my income went to my insurance premiums, but if you factor in the usual medical expenses/copays/deductible on top of that it's more like 7.3% (on a "normal" year with no hospitalization/pregnancy/major illness). So all this adds up to maybe 29% (not including property tax). And at least 25% went to student loan payments, but that's another story
Sales tax is 6.35% in my state.
ETA: So, yes, looks like you do pay more (tho maybe you're in a higher bracket?). I think I'd rather pay more in taxes and rest easier knowing that me and all of my fellow citizens were spared the threat of destitution due to illness or injury.
We have health insurance through my DH's work. It's a version of Blue Cross.
In terms of managing, I have spent hours on the phone, logged into our insurance website to try to figure things out. We got a bill for the first ultrasound for $350. (I've posted about this elsewhere.) But, when I found and red our actual policy booklet this weekend it says " you may continue to receive follow-up care which includes prenatal visits, medically necessary and appropriate sonograms, delivery, postpartum and newborn care in the hospital..." Which implies to me that sonograms would be covered. It looks like it was billed as diagnostic radiology. So...another round of phone calls is on my to-do list.
How are you planning to pay for your hospital delivery, if you plan to have one?
I was bolder in my youth and believed in the beauty of home births, but we've been through so much to get PG if anything bad happened I don't know if I'd forgive myself. So we're definitely going to the hospital, though I plan to do as much labor at home as I can. With a doula.
Anyway, our policy says In-network hospital birth is covered 100% after deductible. Of course, our policy turns over on 4/1 and I'm due 3/25 but measuring a few days behind. So it's possible we'll be paying the full deductible twice for one birth. I'm basically assuming we will be and saving for that, just in case.
If you live in the US, aren't you frustrated with our healthcare system? :P
Absolutely. One thing that really gets me is even if, hypothetically, we all had Blue Cross, our companies each negotiate their own coverage policy. So basically some person in HR is practicing medicine by deciding in advance what healthcare we're allowed.
It also seriously annoys me when people are against single-payer health care because "It's socialized" and anything "socialist" is bad. Insurance IS SOCIALIZED MEDICINE. We all pay in as we're able (so to speak, we pick a plan we "can afford") to a centralized fund, and we take out only what we need.* The big difference between our system and a truly socialized one is that corporate insurance companies make a profit off of it. It's an entire industry. We have corporatism without the free market. Which leads to inefficiency and injustice, so no one is happy.
(holy cow, sorry for yelling. This kind of political illogic really makes my blood boil.)
What about affording maternity clothes and baby stuff?
Well, I also work for myself and am trying to build a client base (I'm a freelance editor). So my income is low and unpredictable. We've decided a doula is worth paying for, so maybe I'll be foregoing cute maternity clothes. I can just wear leggings and DH's shirts right?
This will be the first grandchild for DH's parents and mine, so I'm not too worried about baby stuff. Pretty sure this one's gonna be spoiled. I think our parents will help out with the big ticket items and I'll stick to mostly necessary things on the registry. Also plan to do cloth diapers.
Edit to include * "From each according to his ability, to each according to his needs," is often attributed to Karl Marx.
The guy at Blue Cross told me it depends on how the hospital bills it and that determines how the Ins Co receives it. So the hospital could be coding the billing a different way that would technically be screwing you over on something that may be covered at 100% or a little less by the insurance company. I got screwed over a blood test that cost me over $600 because of the way the hospital billed it, after I paid it to find out that had I called them and had them change the way it was billed to BCBS, I wouldn't have paid that much for it.
ASK QUESTIONS! Demand to know how they're billing your company!
so to put that into comparison
-your 29% to my approx 41%
(I also didn't include property taxes in that number but mine are approx 4k a year..)
-our sales tax is approx double yours ...
- I still pay a monthly insurance premium but we don't have deductibles and honestly... the cost is so low (I pay maybe $50 bucks a month for full benefits, disability & life ins).
at the end of the day I would say with the difference in taxes we probably come out pretty close to equal when you consider your out of pocket expenses versus what we pay in advance. and I only say this strictly regarding having babies....i know that your system can cost did much more for some other types of care that pre existing or not covered...
I personally like my healthcare included in or taxes as it doesn't matter what type of care you need, or add on (like for instance an epidural) as you know it will be covered. I also find that you can't spend money you never had - so not getting hit with a large bill is easier for me than having to save the money myself and pay it later.
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[box got all crazy on me]
I was wondering about this because I've heard the other side of the coin too - that you are charged for everything in the room or on the cart or whatever anyway so you might as well scoop it all up even if you're taking some of it home. Like they put out new stuff for the next person and charge you for it whether you take it or not so you might as well. But if it's that they charge you based on what you use that's a whole 'other story. I guess every hospital could be different so you probably have to ask. And if you ask you probably won't get a direct answer so the truth is you're probably screwed either way so just use what you need right?
And seconding @crossfitbabybump, @bb3vj3n, we need a president with views like you so bad. Our healthcare is so infuriating and shameful. And the whole reason is not that we can't afford to change it, it's insurance companies and old dudes in gov't. don't want to compromise for the welfare of everyone else in the f***ing country.
@fatstagnation also a freelancer, and literally working right now in a coffee shop in my husband's t-shirt and [eta: my] leggings. lol. *insert emoji with monkey covering his eyes* I ordered a few maternity pieces like jeans (mine are hurting to sit in now), but I'm trying to maximize on loose and stretchy clothing, and taking advantage of the fact that I don't need to really dress nice for work.
@crossfitbabybump I don't understand how you would know how to tell them how to bill? I mean for the $600 lab work, how would you even know what was billed wrong and how it should have been billed or what the other options are? Is it something that was obvious and stood out on your EOB? Honestly that stuff mostly looks like abbreviated gibberish to me. I'm not trying to doubt your advice, I just don't understand how to apply it.
But anywho, those charges are like a drop in the bucket compared to the actual delivery cost and cost to just exist in the hospital.
One thing I wanted to mention to anyone in the US with employer coverage, like others have been saying, don't be afraid to question the charges on your bill (pain in the butt) and if you don't know if your employer offers a 'health advocate/advocacy' service, definitely find out. The extent of what they'll do can vary by employer, but generally speaking they may be able to help confirm if all is well or not with how you were charged and they can help you file appeals with the insurance company. They don't have the power to tell the insurance company what to do, but they know all the in's and out's and.
With my first we had government insurance so we never saw a bill for anything but this time we have insurance through my husbands work.
There is little consistency among plans in our country, except now at least they must include what the ACA mandates (thank goodness).
@alice0218 it'd be a (possibly long, annoying) phone convo with your insurance company. i.e., please help me figure out why I was charged X while my plan says it should be covered. Then they might tell you, doctors office coded this as a blank, it should have been Other Thing, and then either you or they call the doctor and have them recode it.
As for maternity clothes and baby items I have quite a bit left from baby #1. We need a few small things, nipples for the bottles, a new rock and play, spring baby clothes and I need maternity clothes for wintertime. I've been hitting end of season sales and buying small things here and there.
ETA we're managing bills well so far. We moved to a home with cheaper rent because it's tiny back in march to save, so we have a good cushion of savings and we've been adding to that. The $350 we pay every month covers the monthly costs and the rest is credited for future use. We've been cutting back and I've been working what extra hours I can to save more for maternity leave. I'm in school, so it isn't easy. But I think we will be able to save enough for me to take 12 weeks and DH to take 4 and still be comfortable.
I talked to insurance again today, and the bad news is that ultrasounds are billed as radiology and not maternity. So we have to pay for that. But the good news is that we're close to my deductible, so everything from now on I will only pay copays. So now I'm like, 'I'm going to all the doctors!' I haven't seen a dermatologist in a while, and I should, for example.
So since this is my third time doing this I know it will be expensive. I carry the insurance through work for my family (the one my husbands company offers is crap) so because there's already 4 people on it we have a high deductible, plus my employer only offers HDHP, thankfully with a HSA along with it. Our deductible is $2600 but one person can't use all of it, I forget how much one person can use so even though I by myself would have met it in March it won't count. I don't know if anybody else has this but with Aetna there is also an out-of-pocket maximum so even once the deductible is met (which it already was for this year because DD had oral surgery with anesthesia in March and all of my different appointment with rheumatologists etc) but our out of pocket maximum is $5200 which means I only have to pay 10% of what is billed but things are still not covered 100% until after I reach that out of pocket maximum. It's very frustrating that I pay so much just to have health care and then I constantly have to keep paying. For example, I have to pay $1300 to my dermatologist for seeing him back in June which is ridiculous and I probably need to look into how they billed the services to my insurance company like @crossfitbabybump said.
Also, have any of you every looked closely at the EOB for a hospital stay? I've never had a broken bone or anything like that so the first time I stayed overnight in the hospital was for DD. When I looked at the EOB for that I almost fell over. The base amount that they billed for the room was over $8K A NIGHT. Just for the room, not the dr's or nurses, not the equipment or medicine, just the room. Now that was not the amount that was finally billed because there is an "in network agreement rate" which is what they actually billed the insurance for but the base amount is crazy. I'm thinking I'll probably have to pay a little over $2500 for this one which is about what I paid for my last one which was 2 years ago, barring any complications. I did get the epidural and I'm planning on it again, DH thought that maybe I wouldn't get it because while the belts were showing that I was having contractions, I couldn't feel any but I told him not to get too excited haha.
I also feel bad for families that have to decide whether or not to have 1 or 2 or more children based on daycare costs. A good friend of ours is going through that now, and decided that can't afford to have a 2nd because of how expensive day care is.
older siblings: ds 16 dd 14 ds 13 dd 11 dd 7
@orbmaker and @crossfitbabybump I actually got my first medical bills from this pregnancy in the mail yesterday and spent like half the morning on the phone trying to see if everything was coded properly and trying to have them review it (which they say should take about 2 weeks). Thank you for explaining some of that coding stuff! On my coverage and benefits of maternity the website for my insurance says 100% of prenatal preventative care is covered and deductible waived. So not having had any bills yet (I'm just about 5 months in) I assumed I was scott free for the prenatal stuff. Apparently, most of the blood panels and lab work that was performed at my first two appointments totaled about $3,200 in all, my portion of which is about $750. I was so upset and confused thinking it would be covered. $750 isn't the most outrageous bill I've heard of but it's a hell of a lot more than $0. And I haven't even had an ultrasound or any elective testing, it's just all regular panels the doctor ordered. Turns out it's all billed under "diagnostic" and not "preventative" so I have to pay for it, or at least part of it (I am still trying to have them review it though). I have my first ultrasound in 2 weeks (at 21 weeks) and confirmed that that's not covered by insurance either (radiology, not preventative care). So I spent the other half of my morning calling all over this hospital system trying to get a code for it and an estimate. Finally got the code. Still don't have the estimate. I honestly think I'm going to flat out refuse to pee or give blood anymore until they tell me exactly what codes it will be billed under and have a chance to find out what portion of it I'll have to pay after insurance. I can't deal with $200-$750 every time they want to look at my blood and piss (which seems like it's been pretty much every appointment). Not to mention, the things that weren't covered were testing for sickle cell, drugs, syphilis, and HIV, all of which I could've told them I don't have if they would've told me what the tests were for, but they don't do that do they?
I effing hate this country's healthcare. Oh btw, you guys heard about non-mandatory coverage of BC now right? Brilliant!
eta: I think I'm extra stressed over it because this week we also found out my husband's crown can't be replaced but instead the tooth needs extraction and an implant which altogether might be anywhere from $2,000-5,000. We are still gathering estimates but fuck me.
and I also think it's not right for them to test us for things without telling us what it is. I was tested for STI's and HIV too, and was like, why didn't we do that at my regular annual exam? That's when I've had it done before I was married. WFT? and just, you know, patient consent requires that we know what we're consenting to. I used to work in healthcare so that one really annoyed me.
Also, coincidence, my husband is in the exact same dental situation.
And regardless if coverage is through an employer, see if your or your partners employer (assuming not self-employed) has an 'employee assistance program' (more common for bigger employers) you can call just to see if they have any resources for your money/bill situation or for you being pregnant. I figure it's worth a shot just in case.
this has a short summary of the things that must be covered by insurance without any cost-sharing (i.e., no copays or deductibles): https://www.healthcare.gov/preventive-care-women/
also ask your insurer if there are any diagnosis codes or location specifics associated with the procedure code that might affect how much they cover of a certain service. My last pregnancy, my anatomy scan was not covered because the office it was done in was in the hospital (that is, it was a separate location from my OB GYN office). But, if it had been done in "a physician's office" instead, like my doctor's office, it would have been covered 100%. Thankfully this time around my doctor's office does in-office scanning so I don't have to worry about that, but I learned the hard way after pouring through all my insurance fine print.