NICU cost and insurance coverage

kelliwill · December 2009

During this whole pregnancy I have had double coverage insurance. I get free insurance coverage for myself through work and because DH and I had just gotten married (found out we were expecting the day after the wedding) I was added to his as well. It has been great to have this and as a result we have ended up paying very little out of pocket. We feel very fortunate that this is our situation. I am not set to go back to work until June and my insurance coverage thru work will be dropped in March. I am not concerned since I will still be under Dh's.

Hopefully our babies will be fine and require no NICU time, but I also want to be prepared. With both insurances if we want the babies added we just have to tell them within 30 days of their birth. I am wondering how expensive NICU stays are (I assume very) and if in fact one or both babies require NICU time if we should add them to both of our insurances or stick to our original plan and just add them to DH's since mine will be dropped in March anyway.

I am curious what your experience was with NICU time and cost as well as insurance. I don't know what it will cost us to add them to mine, but it will cost something. Did anyone have double coverage for your babies and was it worth it, or those of you who didn't, would you recommend it if we can do it.

TIA!

keg · December 2009

My DDs were in the NICU for 5 and 6 day and I think we were probably billed about $15,000 for each baby once we accounted for the neonatologist bills. And they were basically in a step down unit. One DD had a feeding tube for a day or two, and one had an IV and some antibiotics for a day or so. My insurance covered maternity at 100%, but since the girls were in the NICU, they were covered under the medical portion of the plan, so we were responsible for 15%. Honestly, I don't know how it works having babies on two plans. I guess I would check with both insurances as to how they cover NICU stays and what additional benefit yours would pay over your DH's.

lisa&andy · December 2009

DS stayed for 26 days and his bill was $136,000 and some change. However, he was on a vent and about 80,000 was room and board and 30,000 was medicine. If I'm reading your explaination right, I would plan on adding the kids to just DH's, you will know within 30 days if the babies will need NICU and if they do, add them to your insurance, if not I would stick with DH's.

kimarino13 · December 2009

I don't have double insurance, and never really considered it. I am just planning to spend my OOP Max (for the whole family) which is $3,000. We'll be covered at 90% up to the OOP Max, but I am guessing if NICU time is involved, plus the cost of the c-section, we'll get to that amount.

blossom · December 2009

You should check your DH's insurance plan to see how much NICU care is covered. I called mine a while ago and it's covered 100%. The only thing I have to pay is $500 for the hospital admission.

lgurian · December 2009

i just got all my bills.....baby a was in the nicu over night and his bill was $6400, baby b was there for an extra 2 days and his bill was $11,000. this does not include MY hospital bill for being there 3 days ($15000) or my OB surgery fee. each of us had to meet our deductible and out of pocket max. but all told we ended up paying out of pocket only $1600 for the birth (i reached my max out of pocket going to the peri so much). thank god for insurance is all i have to say. i would add them to both, no harm in having double coverage while they can!

dulcinea03 · December 2009

We're just budgeting to hit our $6,000 family out of pocket maximum for the year. After we hit that (at 90% coverage) everything is covered 100%. Call your ins and find out what your benefits are.

laceymb · December 2009

I believe after all was said and done for us each baby racked up about $150,000 worth of medical bills with an 11 day stay for both. I would just plan on paying whatever your OOP max if there is any extended hospital stay for you or your babies.

na24 · December 2009

My daughters were in the NICU for 11 days each and their bills were each around $54,000. We ended up paying our family deductible for the year, which was a total of $3,000 for all three of us (two girls and me).

I can barely wrap my head around regular insurance situations, so double coverage is even more of a mystery to me.

carder0716 · December 2009

One of mine was in the NICU for 8 days, with charges of $18,000. She was not on a feeding tube, received no medications, and had IV access for 1 day only. My other child was in the nursery for 5 days, and the NICU for 3 days to receive antibiotics. Her bill was $11,000. I had to pay $500 for each (insurance copay is $100 per day, up to $500 total). My girl that was in the nursery was still classified as "sick baby," so this is why I had to pay the $500.

fallbride110406 · December 2009

kimarino13:
I don't have double insurance, and never really considered it. I am just planning to spend my OOP Max (for the whole family) which is $3,000. We'll be covered at 90% up to the OOP Max, but I am guessing if NICU time is involved, plus the cost of the c-section, we'll get to that amount.

Ditto this, only our total family deductible + OOP expense should be $2k next year, which my insurance said we will hit between delivery and their NICU if they need it. NICU is counted like any hospital stay as far as my insurance is concerned since it's technically them being admitted for something medically necessary.

I would guess that you would just need to add them to your husband's insurance since yours will be up in March. I would just double check his insurance to see how much it is to add them or do the family cost (ours is just a set "family" price when there's any children involved, not per child) and if your deductibles or anything else go up.

Soon2beMrs.Sivert · December 2009

Our babies weren't in long. 4 & 7 days and their bills were approx 20K and 40K. It seems like the NICU I was at seems to be charging more than others? I don't know. They didn't need too much, just an iv with antibiotics & one was a little jaundiced. Anyhow, we have great insurance and only had to pay the $300 hospital admission. I would call your benefits coordinator and ask about a coordination of benefits. That's what it is called when you have multiple insurance.

PianoPlayingSarah · December 2009

Anna was in the NICU for 3 weeks. She had three surgeries. We paid nothing for it - it was all covered under our medical insurance. I never saw any bills so I have no idea what the grand total was.

You should probably check with both insurance companies now b/c I thought (and I could be completely wrong) that some companies won't cover you if you are covered by another insurance plan.

mmbench · December 2009

The girls' NICU stays were about $60K each (we were in for 16 days). With the total cost of my prenatal care, c-section, and NICU being $170K.

We paid out of pocket about $2500. They were only on my insurance.

If DH's policy is good, that one should be fine.

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