3rd Trimester

Insurance Issues and just found out at 33weeks...almost in tears.

So last year I had awesome insurance, $25.00 co-pay for my intial OB appointment, 100% covered after that.  I only had a $250.00 per day deductible up to $1000.00.  No big deal, thought we were getting off pretty good.  So, the first of the year our company changes our plan due to the economy and now I have a $1000.00 deductible with 20% co-insurance up to a $2500.00 out of pocket maximum.  So I am thinking $3500.00 will be the most I pay for delivery and that we would be able to work out a payment plan with the hospital and pay it over the course of a couple of months in the event that we don't recent out tax refund. 

Well now, I get a call from my OB that since my plan changed on 01/01/2010 that I have to pay the 20% for thier charge before they will see me again...which in 1 week.  So, I have to come up with $460.00 within 7 days or I don't have an OB and they won't see me.  I am stressed...not that $460.00 is terribly difficult to come up with but 7 days isn't a lot of time to work with...I am stressing and almost in tears...DH is going to lose it! 

Is this typical with OB's to request thier charge to be paid before delivery? 

 

Re: Insurance Issues and just found out at 33weeks...almost in tears.

  • I've heard of the entire payment to be due up front.  Sorry your stressed, that stinks about the last minute notice. 
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  • I'm not sure about all plans, but with mine, no doctor/hospital is allowed to ask for money up front.  They can only bill after services have been rendered...i'd call your insurance maybe.
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  • It varies by practice. 
    Mine I pay at the end ($500 lump sum) and I know people who have paid it all upfront or in installments
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  • We paid our doc's fee monthly up until the 28th week.  That includes a "normal" vaginal delivery.  I haven't heard, however, of them asking for a huge chuck of change like that.  Expecially if your insurance is the thing that changed.  GL!!
  • Not sure if this is what you're asking but I had to pay all of my deductible to my OB before 28 weeks (they let me know that at 26 weeks, right before Christmas...nice, eh?)
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  • WOW! I would cry too! ...that SUCKS.

    ...and no, I have not heard of a dr demanding payment like that.

  • YES, I had to pay for my delivery in global payments.  I paid a little bit each visit up until the vaginal birth was paid for.  Now if I end up having an emergency c-section or something, then that will be added on after we get out of the hospital.
  • Move to Canada.  It is all free here!
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  • I had a 10% deductible for my OB and they were going to let me make payments.  Since it was only $200 and some odd dollars I just went ahead and paid it.  Some doctors do require it up front however.
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  • My OB has a sign in his office that all payments are due upfront.
  • This same thing just happened to me.  It sucks and DH was pissed, however our office was willing to work with us.  Ours was around 400 too and my OB office said they would give us until delivery to pay it but we just got it over with.  
  • It is normal.  I paid mine in one lump sum because it was just easier, but when my OB's office sent the letter they had it set up for 4 payments...$100 something each month.

    Now the difference with mine is that it was from the time I was about 24 weeks and would have been completely paid well before my due date.  I could see with your situation that they wouldn't be able to take 4 months, but they should still give you some sort of option of payment plan...divided into 2 payments, paid once a month, or 3 payments made every 2 weeks...if I were you I'd call them back and ask about that.

    Good luck

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  • I have to pay installments every month up to delivery, making my last payment next month before I deliver, I would talk to your Dr. himself if you have built a relationship with him and at least ask if you can pay it in a couple payments, if that would help...?
  • imagejknallen:
    Move to Canada.  It is all free here!

    WOW!  That is so nice of your government to pay for your medical without asking for anything like taxes in return!  I've never heard of 100% government funded health care before.

    To the OP: I'm sorry you're going through this.  I cry on a weekly basis over how much this is (unexpectedly) costing us. 

  • Well I feel better knowing that this is typical.  With my DD, I didn't have to worry about it and didn't at the beginning of this pregnancy so now it's all hitting me at once.  I guess I am jsut concerned that this $460.00 is going to get lost in the shuffle and that it won't be applied to my out of pocket maximum.

    Also, on a side note, my OB won't do a payment plan since I am 33 weeks.  They would've done a payment plan from the beginning up to 28 weeks.  What hurt me is that my insurance changed during my pregnancy...URGH!

  • We had to pay ours (554.00) by the fifth month of pregnancy. They set up monthly payments for you if needed. Our insurance (up until January, Thank goodness) had a 6000.00 deductible which would have carried over in January, which would have meant even though we had "insurance" everything would have been out of pocket at the end of the day. Luckily we were able to switch in December. Still sucks! 

    The one thing about your situation that I am not sure about is how they could deny you as a patient at 33 weeks... Where I am, that's illegal and as long as you are making a monthly payment (even if it is 10.00) they cannot deny you service.

    Good luck!  


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  • imageelidav2007:

    Well I feel better knowing that this is typical.  With my DD, I didn't have to worry about it and didn't at the beginning of this pregnancy so now it's all hitting me at once.  I guess I am jsut concerned that this $460.00 is going to get lost in the shuffle and that it won't be applied to my out of pocket maximum.

    Also, on a side note, my OB won't do a payment plan since I am 33 weeks.  They would've done a payment plan from the beginning up to 28 weeks.  What hurt me is that my insurance changed during my pregnancy...URGH!

    You've got 2 months left.  I would still ask if you could divide it into 2 payments...pay one by Friday and then do the other 4 weeks later, and you'd still have plenty of time.  Hopefully they won't be asses about it. I mean...it's circumstances.  It's not like you were hiding something from them, this was sprung on you too! 

     

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  • I call BS - its not your fault that your insurance changed the rules unexpectedly.  The office needs to work with you or sue them for neglect or something.
    TTC since 2005. DS via IVF - 02/10 Baby #2 - due 10/16/11
  • Whatever you do keep your reciept when you pay the insurance. The hospital won't see that when you go in because it won't have hit yet but the hospital can't make you pay up front. Just tell them when they ask at the hospital to bill your insurance because you have already paid towards the OPM and they will bill insurance then you. As ling as you keep reciepts then you cover yourself if something gets lost in the shuffle gets
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  • imageseniah_05:
    I call BS - its not your fault that your insurance changed the rules unexpectedly.  The office needs to work with you or sue them for neglect or something.

     I LOVE this!  We are just going to pay it and be done, but I tell you what, I'd liek to have spent that $460.00 on somethng else....that's for sure! 

  • imagemrs.oz:

    imagejknallen:
    Move to Canada.  It is all free here!

    WOW!  That is so nice of your government to pay for your medical without asking for anything like taxes in return!  I've never heard of 100% government funded health care before.

    To the OP: I'm sorry you're going through this.  I cry on a weekly basis over how much this is (unexpectedly) costing us. 

    I am an American living in Canada, and yes we pay a ton of taxes, but we are taken care of so much better up here. If I get sick, I am taken care of, no questions asked. Same for everyone- if you are sick, you need the hospital, you have a baby, etc-it is covered. I'd much rather my taxes go toward something I can actually use instead of paying taxes and seeing nothing from it. I love being American, but wish for so many things for my country to improve on, healthcare being one of them.

    To the OP: I am from Orlando, and 3 of my friends there had kids in the past year. All had the same situation as you- had to pay in full before due date.

  • We had to pay the OB's fee (deductible + the 10% not covered) before 28 weeks, but they did it in four installments so I owe nothing at this point.  I also picked up secondary insurance that covers the extra 10% OOP for the hospital otherwise we would have owed another 600+ to the hospital before delivery.

  • The EXACT same thing happened with my insurance this year as well.

    What sucks is my OB charges for all the office appts after the baby is born, so I'll have a hospital bill (which was $20K with DS) and an office visit bill ($3600 with DS) come May. I am responsible for 20% of that (after my deductible) up until my out of pocket max (I think around $3000). Once you hit that, everything is covered 100%.

    For me, the light at the end of that tunnel is that I plan to have an IUD placed (Mirena) at 6 weeks pp and it will be covered 100% since I'll have already met my out of pocket max.

    As for the paying up front, I haven't run into that. I'm guessing its a policy that your doctor's office has?

    GL hun!! You're not alone!

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  • I have to pay by 36 weeks.  But mine is $1900, plus the costs of ultrasounds, this DOES NOT include what my hospital payment will be.  I hate HSA's
  • My max out of pocket is $3200. I had to make 4 monthly payments of $625 to my OB because their policy that patients have to be paid in full before 28 weeks. So at least I know I only am liable for $700 of all other charges.
    DD(14),SD(13),SS(11),SS(9),DS(3)

  • imageNFL_Wife:
    imagemrs.oz:

    imagejknallen:
    Move to Canada.  It is all free here!

    WOW!  That is so nice of your government to pay for your medical without asking for anything like taxes in return!  I've never heard of 100% government funded health care before.

    To the OP: I'm sorry you're going through this.  I cry on a weekly basis over how much this is (unexpectedly) costing us. 

    I am an American living in Canada, and yes we pay a ton of taxes, but we are taken care of so much better up here. If I get sick, I am taken care of, no questions asked. Same for everyone- if you are sick, you need the hospital, you have a baby, etc-it is covered. I'd much rather my taxes go toward something I can actually use instead of paying taxes and seeing nothing from it. I love being American, but wish for so many things for my country to improve on, healthcare being one of them.

    I was just being sarcastic.  I hate the term "free" when talking about healthcare in another country because it's not "free".  Free would imply that you're getting something for nothing when in fact like you said, your taxes go to help pay for healthcare.  There's nothing wrong with taxes helping to fund healthcare but to say it's free...that is not accurate.  Perhaps the person getting the care is jobless or (like in the United States) gets more money back in tax returns than they paid into the system but someone is paying for it. 

  • We had to do something similar.  I think that we paid $400 or so upfront and that covered all of the co-pays for the entire pregnancy plus any L&D co-pays.  They gave us until our third visit to pay, but maybe because you are further along, they need to have it all now?  I would ask them if they can give you another week or so.  It doesn't seem right that they can just kick you out this far into your pregnancy!
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