July 2012 Moms
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***OUKatie*** and anyone else on insurance question

OUKatie, I seen that you mentioned this on another one of my posts so I thought maybe you would be able to answer my question or someone else could.

You had mentioned that some insurances dont cover you if you deliver at a different hospital. I replied on my other post but wasnt sure if you would see it so I thought I would make a new post. Sorry for posting again.

I am wondering if anyone knows if their insurance covers you at a different hospital? I also wondered, if I meet my deductable with the bill from the hospital (if I would by some chance deliver at a different one) would it still count as my deductable? Im not sure if that really is understandable so just to throw out a simple example. If I had 300 towards my deductable and then got a hospital bill for 400 and my deductable was 500, would they pay the rest of the bill like if I delivered at my hospital. So basically as long as I meet my deductable it doesnt matter where right?

ah, sorry these get so lengthy!

Re: ***OUKatie*** and anyone else on insurance question

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    oncoRNoncoRN member
    I have to be "In Network" (I have a PPO plan) meaning there are certain hospitals that are covered more than others...if I go to an out of network hospital, then I pay much more!
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    Sounds like a call to the insurance company might give you the best answer.  So much about insurance is different from company to company, state to state, etc.  That even if lots of women on here reply with the same answer, it could be different with your specific insurance company or policy.  If it is an emergency I think there is a number on your insurance card you can call, or wait until monday. 

     My gut tells me that the deductible is the deductible and it doesn't matter how or where it gets met, as long as it gets met.  But I could be totally wrong.

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    Well right after I got pregnant I called my insurance to ask a similar question. They said (and as someone above me said it can vary from state to state and company to company and PPO vs HMO) that once I meet my deductible (I will use your example) of $500 that they will pay 70% of the bills up to $700 then pay 100% after that amount. But I also know of some companies that once you reach your annual deductible of $500 that you wont pay any more then that out of pocket for the rest of the year. You should really call your insurance company to see what they say about YOUR specific policy, or check the website and see if you can get a detailed copy of your policy details.

    As far as delivering at a different hospital, it would probably have to be an "in-network" hospital for your insurance to cover it. What I would do is most insurances have a place on their website where you can search for "in-network" hospitals and providers. Try to find one that is closer to where you are going to be that weekend (I read your other post before) that way you know which one to head to JIC you go into labor while you are away from home. I hope this helps!!

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