Does anyone have private health insurance?

aegrimm

I'm curious as to how much you per month for your premium and what kind of benefits you have.

Without getting into too much detail, I have an HSA through work. For myself, DH, DS and our LO it will cost me $360 a month. ($180 a paycheck, so two months I will have to pay 3 times as we get paid bi-weekly).

We are required to pay for EVERYTHING out of pocket until we hit our deductable of $2400. (Pedi appts are $60 a pop (well child visits and immunizations are free), DS's asthma medicine is $200 a month, etc) After the deductable is met we have a co-insurance of 10% until we meet our out of pocket maximum of $3300. We'll hit the deductable early next year due to LO being born, but I'd like to see about less expensive options. I'm also concerned about maternity coverage as we want to have more kids.

(DH's health insurance through his employer is worse, so that's not an option.)

murfygirl

I don't but my sister does. She has Kaiser since her husband is self employed. She right now pays 720 a month for her 4 kids and herself and husband. However right now their coverage isn't great no maternity (BIL had a vasectomy their done) and a deductible of 4k a year. But when she was having babies I believe they paid as much as 1100 a month for health insurance.

aggielauren

I have private insurance through Blue Cross Blue Shield, but I can't be any help on the maternity coverage aspect. BCBS in Texas doesn't offer maternity coverage and there are actually only two health insurance companies here that offer maternity coverage and they have a HUGE deductible to start covering anything.

As far as cost, we pay $249 for DH and I but it will add $95/month when we add LO to it. However, we have no deductible  (that was really important to me) but we do have a prescription deductible of $200. It's a $25 co-pay per office visit, generic prescriptions are $10 after you meet the deductible and brand-names are $30 for preferred and $45 for non-preferred.

That's all I can think of off the top of my head. The no maternity coverage is a big bummer for us (we want to have 3 more kids after this one) but, like I said, it's really not an option on private insurance in TX.

jescgrl

we pay about $300 a month for our insurance. That covers everyone. Our deductable is $250(I think) and we only pay our Copay's and anything left over. They cover 80% we pick up the remainding 20%.  Regular checkups and OB/GYN visits are a $20 copay, Specialists are $40, Urgent Care visits are $50, ER visits are $100, and Rxns are on a three tier options $4/$25/$40. We have Cigna

amdicl

I do.  I have a private plan for myself and my daughter because I am a Realtor and self employed and my husband's plan with his office is wonderful for him, but completely unaffordable for us (free for him, as soon as family is added it jumps to $13-14,000 a year w/ a high deductible!).  My daughter's is with Aetna, it's an HMO and it covers everything and is $181 a month (this is not a state sponsored plan based on income, we make too much for those).  Mine is with Geisinger Health Plan (which may only be offered in PA) and is $304 a month with a $1400 deductible and 10% copay, max. out of pocket is $2200 and this includes the optional maternity rider.  I have been told that in some cases, it is better to have each member of the family on their own insurance, if you do go the private route, just in case someone is high risk insurance wise, the whole family isn't effected by that.  Not sure how true that is. 

I will be doing some adjustments once the new baby comes. 

sarajo317

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

sarajo317

aggielauren:

I have private insurance through Blue Cross Blue Shield, but I can't be any help on the maternity coverage aspect. BCBS in Texas doesn't offer maternity coverage and there are actually only two health insurance companies here that offer maternity coverage and they have a HUGE deductible to start covering anything.

As far as cost, we pay $249 for DH and I but it will add $95/month when we add LO to it. However, we have no deductible  (that was really important to me) but we do have a prescription deductible of $200. It's a $25 co-pay per office visit, generic prescriptions are $10 after you meet the deductible and brand-names are $30 for preferred and $45 for non-preferred.

That's all I can think of off the top of my head. The no maternity coverage is a big bummer for us (we want to have 3 more kids after this one) but, like I said, it's really not an option on private insurance in TX.

So what do you do? Just not have maternity coverage? So you have to pay for everything, or how does that work? Im thinking about switching after I give birth - and was thinking about BCBS.. but we will see!

aggielauren

sarajo317:

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

Yeah, that's what I meant about a really high deductible for the ones that do offer maternity coverage. And that's a really high amount per month!

My entire OB bill for the whole pregnancy would be barely half of the deductible.

aggielauren

sarajo317:

aggielauren:

I have private insurance through Blue Cross Blue Shield, but I can't be any help on the maternity coverage aspect. BCBS in Texas doesn't offer maternity coverage and there are actually only two health insurance companies here that offer maternity coverage and they have a HUGE deductible to start covering anything.

As far as cost, we pay $249 for DH and I but it will add $95/month when we add LO to it. However, we have no deductible  (that was really important to me) but we do have a prescription deductible of $200. It's a $25 co-pay per office visit, generic prescriptions are $10 after you meet the deductible and brand-names are $30 for preferred and $45 for non-preferred.

That's all I can think of off the top of my head. The no maternity coverage is a big bummer for us (we want to have 3 more kids after this one) but, like I said, it's really not an option on private insurance in TX.

So what do you do? Just not have maternity coverage? So you have to pay for everything, or how does that work? Im thinking about switching after I give birth - and was thinking about BCBS.. but we will see!

Yea, I just don't have maternity coverage and we pay out of pocket. It seems like it would be crazy, but so far it hasn't been bad. My doctor gave us a 30% discount for not having maternity coverage (it was $2700 for our entire OB bill) and the hospital is giving us a 35% discount for not having maternity coverage and I've heard they may give more than that once we get the final bill. We did have to pay $3500 to the hospital by the end of the seventh month, though.

We actually looked into other insurance and we apparently are getting a good deal and couldn't find anything less expensive with the same coverage.

amdicl

Another thing that you would want to take into account is a guaranteed issue plan or a medically underwritten plan...a guaranteed issue plan will be more expensive, since there is little or no health review.  A medically underwritten plan takes a little bit of time and energy to apply for, but in most cases, you will have a lower premium payment that is based on your past health, weight, etc.

sarajo317

aggielauren:

sarajo317:

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

Yeah, that's what I meant about a really high deductible for the ones that do offer maternity coverage. And that's a really high amount per month!

My entire OB bill for the whole pregnancy would be barely half of the deductible.

It almost doesnt even seem worth it.. I know our Dr and hospital would have worked out something with us if we didnt have coverage.. we did have to make a $1,000.00 OB deposit by the end of the 7th month - they also wanted the rest of the deductable that I hadnt met (which seems INSANE to me!!!)

aggielauren

sarajo317:

aggielauren:

sarajo317:

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

Yeah, that's what I meant about a really high deductible for the ones that do offer maternity coverage. And that's a really high amount per month!

My entire OB bill for the whole pregnancy would be barely half of the deductible.

It almost doesnt even seem worth it.. I know our Dr and hospital would have worked out something with us if we didnt have coverage.. we did have to make a $1,000.00 OB deposit by the end of the 7th month - they also wanted the rest of the deductable that I hadnt met (which seems INSANE to me!!!)

They would definitley work something out with you if you decide to have more kids and want to change insurances. Our OB didn't care when we paid, we just paid whatever we wanted whenever we wanted - we just had to be paid up by the 28th week of the pregnancy and, with hospitals, I'm pretty sure as long as you pay SOMETHING each month after you get a bill, they won't try to get anything specific from you (other than having to pay that initial deposit I mentioned).

sarajo317

aggielauren:

sarajo317:

aggielauren:

sarajo317:

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

Yeah, that's what I meant about a really high deductible for the ones that do offer maternity coverage. And that's a really high amount per month!

My entire OB bill for the whole pregnancy would be barely half of the deductible.

It almost doesnt even seem worth it.. I know our Dr and hospital would have worked out something with us if we didnt have coverage.. we did have to make a $1,000.00 OB deposit by the end of the 7th month - they also wanted the rest of the deductable that I hadnt met (which seems INSANE to me!!!)

They would definitley work something out with you if you decide to have more kids and want to change insurances. Our OB didn't care when we paid, we just paid whatever we wanted whenever we wanted - we just had to be paid up by the 28th week of the pregnancy and, with hospitals, I'm pretty sure as long as you pay SOMETHING each month after you get a bill, they won't try to get anything specific from you (other than having to pay that initial deposit I mentioned).

I think we are DEF going to switch. So DH, me and baby can all be covered - thanks for the tips

fellesferie

We currently have United, but we're about to switch to my husband's insurance.. which is BCBS.

With my plan, we pay about $50 per month for the whole family. We have a per person deductible of $1k and a per year out of pocket max of $2k. Our copays for pediatrician appointments or other doctor's visits is $20, and doesn't get counted towards the deductible. 

Once I'm a SAHM mom and we move to my husband's insurance, it will cost us about $190 per month to cover the whole family. Our per person deductible will go down to like $300, but the out of pocket max will still be like $2k or $2.5k.

Between the deductible and out-of-pocket max, both insurance plans pay 80% and we're responsible for 20%. 

jennype

aggielauren:

sarajo317:

aggielauren:

sarajo317:

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

Yeah, that's what I meant about a really high deductible for the ones that do offer maternity coverage. And that's a really high amount per month!

My entire OB bill for the whole pregnancy would be barely half of the deductible.

It almost doesnt even seem worth it.. I know our Dr and hospital would have worked out something with us if we didnt have coverage.. we did have to make a $1,000.00 OB deposit by the end of the 7th month - they also wanted the rest of the deductable that I hadnt met (which seems INSANE to me!!!)

They would definitley work something out with you if you decide to have more kids and want to change insurances. Our OB didn't care when we paid, we just paid whatever we wanted whenever we wanted - we just had to be paid up by the 28th week of the pregnancy and, with hospitals, I'm pretty sure as long as you pay SOMETHING each month after you get a bill, they won't try to get anything specific from you (other than having to pay that initial deposit I mentioned).

 

I am in the same boat.  I have maternity private insurance $330 a month.  We have been trying for our first baby for 10mos and I have been paying maternity insurance for a year.  I was just informed my premium is going up to 450 in January and I don't know if I want keep paying.  I can switch to nonmaternity insurance for 140 a month.  We dont mind paying out of pocket for the birth but I am concerned about what would happen if there are complications.

jennype

aggielauren:

sarajo317:

aggielauren:

sarajo317:

Im from Texas - and I have Assurant Health - it has a maternity option but my deductable is $5,000.00 - once I reach that they pay 100% - not 80/20 (that's only the maternity option - regular medical is 80/20)

I pay $300 a month for JUST ME.

Yeah, that's what I meant about a really high deductible for the ones that do offer maternity coverage. And that's a really high amount per month!

My entire OB bill for the whole pregnancy would be barely half of the deductible.

It almost doesnt even seem worth it.. I know our Dr and hospital would have worked out something with us if we didnt have coverage.. we did have to make a $1,000.00 OB deposit by the end of the 7th month - they also wanted the rest of the deductable that I hadnt met (which seems INSANE to me!!!)

They would definitley work something out with you if you decide to have more kids and want to change insurances. Our OB didn't care when we paid, we just paid whatever we wanted whenever we wanted - we just had to be paid up by the 28th week of the pregnancy and, with hospitals, I'm pretty sure as long as you pay SOMETHING each month after you get a bill, they won't try to get anything specific from you (other than having to pay that initial deposit I mentioned).

 

I am in the same boat.  I have maternity private insurance $330 a month.  We have been trying for our first baby for 10mos and I have been paying maternity insurance for a year.  I was just informed my premium is going up to 450 in January and I don't know if I want keep paying.  I can switch to nonmaternity insurance for 140 a month.  We dont mind paying out of pocket for the birth but I am concerned about what would happen if there are complications.