Does your insurance deductible carry over?
shesthetoast
member
I just called our insurance company and found out that we have no carry-over for maternity coverage, so we have to pay a deductible for both 2012 and 2013. We have a high-deductible HSA plan, so that means a minimum of $2,400 each year out of pocket. (We had carry-over in previous years when I had claims due to back problems, so I wasn't expecting this!)
I have an AFLAC hospitalization policy, so I'll get ~$2,300 from that. When we signed up for AFLAC, the rep said it usually works out that you end up paying the family deductible when you have the baby.(which is $4,800), so that will mean $7200 out of pocket for having a baby. (I need to check with my insurance company on that but I'm not in a mood to call back today.)
We can afford it, but I'm a little peeved. I had been planning for a lot less than $7,200. 
If you have good insurance, it's worth more than you think. Ugh.
Re: Does your insurance deductible carry over?
Well, I feel a little better that I'm not the only one. I just have one small claim from the derm for this year, so the majority will be maternity care.
My friends seem to be split - some of them have said they ended up paying an additional deductible for procedures billed for the baby. Fingers crossed that we'll not end up with that. I'll have to call back again tomorrow and figure that out.
I'm probably also mildly irked because I have a few friends who have (on purpose) gotten pregnant without insurance and ended up paying about the same out of pocket as I am with insurance. Irrational annoyance for the day, I suppose.
I thought it was pretty standard for deductibles not to roll over. It would make sense because (at least for our policy, which is also high deductible HSA) the in-network deductible is for the whole family (both MH, myself, and any dependents). It would be difficult to sort out which is for "maternity" and which is other medical costs since it's all rolled into one deductible.
You know that anything you pay from the HSA goes towards fulfilling your deductible, so you don't have to pay for the deductible "out of pocket," you pay for it with the money already set aside in your HSA.
Paying $2400 for 2012 and 2013 is not mandatory. It's not like you automatically get charged that money. You have to pay the full cost of all your medical bills up to $2400, after that the insurance kicks in a starts paying more (sometimes 100%, sometimes 80/20). So far this year, if you haven't had that many medical costs, it is likely that you won't have $2400 worth of expenses related to pregnancy between now and the end of the year. I know most practices charge the whole bill after the birth, which means most of your medical costs will come in 2013.
I hear you, though, on the expense. Our deductible is $2800. Because of medications I've been on and dr's visits for my medication, previously this year we've already paid over half of that. We'll easily meet the $2800 by the end of the year (and drain our HSA) and then have to pay another $2800 (2013's deductible) by the beginning of Feb 2013. After we meet our deductible we still have to pay 20% of all other medical costs for the rest of the year, which includes newborn care, vaccines, circumcision, dental work, eye appointments, etc. We're saving like crazy now, so that we can deposit a big chunk into the HSA at the end of the year to be ready for the bill in Feb 2013. With that said, we know we can pay all the medical costs out of the HSA, so we don't need to pay for them "out of pocket," we just need to plan our HSA accordingly. We DO want a doula and placenta encapsulation, which we cannot pay for out of the HSA, so those costs will be at least $800 actually out of pocket.
I don't know when your due, but I'd sit down and look at the information you have and come up with a list of very specific question for both your OB's (or midwife) billing office and your insurance company (right down to "how much are u/s; how much is newborn care in the 1st 30 days; how much after the first 30 days). Get specific information so that you can sit down and plan your costs and plan you HSA. MH and did this just last week. He spent almost an hour on the phone with our insurance company asking questions about everything. In 2 weeks at our first appointment we'll do the same with the billing people at the birth center. I'm sure they'll find it annoying, but at least we now have a better idea of how much money we need to budget for and there are less likely to be surprises.
And yes, I am wicked jealous of my friends with Blue Cross Blue Shield. My best friend paid $30 throughout her entire pregnancy, which included a week long hospital stay for her and baby since her LO came a month early.
This is a really good suggestion. Thank you. Based on what I know from my friends who've gone to the same practice, payment in full was due at 24 weeks.
I'll have to discuss with them and see if we can arrange it so that most everything falls onto one plan year.
We put money into the HSA pre-tax weekly, but like you said, it's constantly being drained. We still have a pending claim from last year for some of my back issues/injections and we're working with the doctor, but it's going to end up costing somewhere between $1,400 and $6,000. (I had already met my deductible, then some of it fell out of network, etc.)
I've heard about other employers who put some $ into the HSA for their employees. I don't know how common that is, but H's does not contribute anything so it's all on us. It just kind of sucks.
My deductible doesn't roll, but fortunately my plan year starts in April!
And I agree, your Ob's office will most likely be willing to allowing you to make the payment in January to use your HSA. And full payment by 24 weeks seems kind of crazy to me, the norm is usually 36 weeks.
Just a suggestion. I will be putting my first paycheck in 2013 toward my HSA - so basically using pretax dollars to fund as much as I can per IRS regulations. That way I will have used all my pretax dollars toward pregnancy early on.
One more thing. There is no point in "funding" your HSA after you have met the IRS limits. I believe but am not positive that the 2012 limit is around $3,100. After you have maxed out your HSA contribution, any money withdrawn from your paycheck going into your HSA will be taxable to you. You may as well put it in a savings account and use it on medical or other expenses as necessary.
$3100 is for a single plan. If you have a family plan, the limit is $6250. (just in case anyone here has a family plan and an HSA but didn't know the limit.)
In 2013, those limits are changing to $3250 single, $6450 family.