2nd Trimester

Curious about medical care....

I live in Canada and here- everyone has the same medical care and is entitled to a year of maternity leave.  After reading so many posts, I was wondering how it works having a baby in the states.  Is it really expensive?

Here we all have health cards and I just go to my appointments and U/S as directed.  We don't have a lot of choice for Doctors and OBYN because we have a shortage here.  But I don't think I have to pay for anything.  I know if I was to have a boy and chose to have him circumcised we have to pay $300 for that.   I just wondered how it works in the states? 

Re: Curious about medical care....

  • Health insurance is privatized right now.  I have really good insurance through Kaiser and I don't have to pay for any copays or anything for prenatal care because they consider prenatal care preventative medicine.  I may have to pay 100 bucks for the hospital stay but I don't think it'll be much more than that.  
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  • Everyone is different.  Some have insurance and some don't.  Different insurances cover different things.  It isn't as cut and dry. 
  • It's not cheap =D (def jealous of canadian health care!)

    & circumcisions cost more because they're considered cosmetic surgery. 

  • Every plan is totally different and costs a different amount of of the employee's paycheck.  For example my policy has a $3500 annual out-of-pocket deductible so by the time all my appts & the birth are said & done that is how much I will have paid.  Other people pay nothing out of pocket or $100 out of pocket & some pay more than I'll owe.

    DD1 born 5/24/10.

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  • I read yesterday that the hospital cost for a vaginal deliver varies from $5000-$9000. And a cesarean can run $10,000 to $20,000. How m uch of this is covered by insurance really varies by person. I am fortunate that all I have to pay is $100 co-pay under my insurance (if we had DH's it would be $1000). For my prenatal care I paid one $10 co-pay. Some people who have PPO insurance have to pay 20% of all expenses.

    As for maternity leave, most employers have nothing compared to Canada's plan. I qualify for up to 6 weeks of short term disability (2/3 of my pay) and the other 6 weeks is unpaid - for a total of 12 weeks that they will guarantee my job. Canada has it GOOD in this regard. I'm jealous of my Canadian friends. 

  • DH has a really good plan and we are only going to have to pay $100 when we go in and as far as leave, per the state of CA I can collect disability for 16-18 weeks. There are some restrictions to that like how long you have been with your company but I will have been with my company long enough I wont have to worry about any of those restrictions.
  • they consider circumcision cosmetic here as well...  which seems really strange to me... 

    i think there may be some additional costs for the hospital stay.  But i don't think it is a lot of money. 

    I can't believe that you guys have to go back to work after 6 weeks.  But i guess it was the same here not so long ago.

  • I have Kaiser medical through my office and DH has a blue cross medical plan through his office along with dental and vision coverage, both are paid for by our employer as part of our compensation package.  To add me to DH's dental and vision plan was about $500 for the year.  To add baby to my plan it will be around $300 per month pre-tax and if we go with DH's plan, it will be closer to $500 per month pre-tax.  All my co-pays for maternity visits are $20. None of my maternity leave will be paid, but I am a partial owner at my office, so I have made arrangements to defer some bonuses and use them as salary during my leave and/or to keep some salary coming in during the months I am off, but agree to take a reduced salary for a 12-24 month period to make up the difference.

  • For my insurance I have to pay $1500 before insurance coverage and that pays only 80%.  With my plan though I get $500 a year to go towards my $1500 deductable and whatever is leftover rolls over every year.  So I have about $1200 to go towards my $1500 and then it's just 20% after that. 

    If you meet certain requirements you are entitled to 3 months maternity leave.  My company offers 6 weeks half pay.  Some companies offer more pay and some offer none. 

  • I paid one co-pay for first appointment and $500 to the doctor office for services and delivery.  The hospital will be $250 per day.  So probably about $1,250 total. 
  • We don't have to pay anything because DH is in the military.  Military = free babies!
    Adrian 7.6.07 - ADHD, Disruptive Behavior Disorder, Learning Disability-NOS
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  • We have to pay up to our deductible of $3,000 per year and extra for circumcision and anything that isn't considered in the insurance plan.  As far as maternity leave goes...it's unpaid unless you use any accumulated sick pay.  So my plan is to take 6 weeks, but 1/2 of that will be unpaid.  :(
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  • My healthcare cost with insurance:

    I basically have to pay the entire out of pocket deductible for me: $2,500.00 since the insurance covers 80% and I cover the other 20%, but capped at $2,500.00.  I will probably pay the whole thing.

    Oh and the baby has it's own yearly deductible as does the DH of course.  So the "plan" is that my husband won't get sick at at all this year and have no other injuries or medical expenses.  And the baby won't have much of it's own costs either :) 

    Worst case scenario is we pay out of pocket deductibles in full in one year for each person under the insurance plan= $2,500 X 3= $7,500.00.

     And maternity leave obviously varies from employer to employer.  Mine is a small private employer not covered by FMLA so I get 6 weeks paid because my boss is nice.

  • I guess a really basic way to explain American medicine is like this:
    You can either.

    1. Not have insurance and pay out of pocket (if you are rich, if you are poor there are government sponsored programs that pay your medical costs like medicaid so please don't think American's are dying on streets not getting treated, hospitals cannot refuse to treat anyone based on money).

     2. Pay a premium (fee) every month for health insurance and whatever plan you have tells you how much it pays for what.  Most pay 100% for preventative services (like a checkup every year, mammogram, etc) but every plan is different and you have to verify with your carrier what is covered and at what rate.  The most common plans are 80/20 or 90/10 where there is a dedictible you pay first then after that the insurance company either pays the 80 or 90% of the costs and you pay the leftover amount up to a maximum amount specified by your plan (for instance my plan is 80/20 and my deductible is $500 and max out of pocket is $3,000 after that my company pays 100%).  It can be very confusing but again it is based on the plan you pay for.  The higher amount the insurance pays typically the higher your monthly premiums.

    A LOT of Americans get their health insurance through the plans their work offer.  A lot of employers pay for a portion of their premiums to lower the cost and as a benefit to the employees to help attract better employees.

    This can seem like a lot to people from countries with socialized medicine but our taxes are a lot lower than socialized medicine countries.  We also get to make more decisions (like we pick our doctors, hospital we deliver at, etc)  I even get a say so in what meds are used on me (when I was sick they wanted to give me a zpack and i said no as I don't find them effective on me so I was given a different antibiotic).  Also for non emergency medicine we get very good/fast service.   For things like hip replacement/knee replacement or other non emergency type surgeries you get in within a week or two typically- whereas I know in England you can wait up to six months depending where you are what procedure.  It may not be that way in Canada.

    Anyway, hope that clarifies somewhat.

     

    eta- my insurance actually states that circumcision is included in the maternity coverage, thus we owe nothing over what we owe for the entire maternity care for it.

    image Momma to Ms. C age 16 months and Mr. C age 3 months!
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