Babies on the Brain

Question about pregnancy medical costs.

DH's insurance is changing and we need to make a decision.

We're trying to do the math to see which plan is better for us, but I need to know about how much a healthy pregnancy costs (not delivery, just prenatal care).

If you've figured up the cost for your pregnancy it would be greatly appreciated.  Google isn't helping much right now.

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Re: Question about pregnancy medical costs.

  • My office charges 3000 for prenatal care.  This is standard office visits, two ultrasounds and vagnial delivery.  Of course c-section, any complications, extra visits, NST's, and ultrasounds like the NT scan are extra.  I would hate to see my total bill.
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  • Mine comes down to the Out Of Pocket (OOP) maximum. Once I reach OOP ($2000) I don't have to pay any more than that. So if my delivery would cost $10,000 I only have to pay $2000 for everything the rest of the year. If I had to have my appendix out in October, I wouldn't have to pay anything due to having met my OOP. Does that make sense? 

    You will have sit down and look see if you have a deductible and an OOP (I have both as well). 

  • One plan is a $500 deductible and I pay 20% of all costs after I meet it.

    The other plan has a $3000 deductible and I pay 10% after it is met.

    The lower deductible plan costs $250 a month while the higher costs $50.  The other $200 we'd save on the lower costing plan would go into a Health Savings Account (we'd get a debit card and all medical expenses could be paid with it immediately).

    All well-child visits and immunizations are covered in full regardless of whether or not we've met the deductible up to age 19.  Annual physicals and Gyn visits are also covered in full.  Nothing is automatically covered on the higher priced/lower deductible plan.

    I just don't know what to do.

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  • I guess another thing I need to look at is the hospital stay after I have a baby.

    $250/month plan: I have to meet the deductible if I haven't already ($500) and pay $250, plus 20% of the charges.

    $50/month plan: After I meet the deductible, I pay 10%.

    A birdie told me my OB's prenatal plan is $3000.  That's the deductible right there.

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  • When my DH and I were discussing which health plan to move to last year, I was able to find a report online that detailed all the hospitals in my state and how much a vaginal vs c/s delivery would cost on average at each one. Where I live a vag birth averages $7k and a c/s averages $13k.
  • imagecrownedbee:

    One plan is a $500 deductible and I pay 20% of all costs after I meet it.

    The other plan has a $3000 deductible and I pay 10% after it is met.

    The lower deductible plan costs $250 a month while the higher costs $50.  The other $200 we'd save on the lower costing plan would go into a Health Savings Account (we'd get a debit card and all medical expenses could be paid with it immediately).

    So let's say that delivery costs $10k. If you get Plan A, you pay $500+$950= $1450 +12*250 (cost per month) which is $4450 total. With Plan B, you pay $3000+700 = $3700 + 12*50 (cost per month) which is $4300 total. So you really need to find out whether to expect a delivery cost of over $10k or under $10k to know if the math works out for you. I hope this helps.

    ETA: Also, make sure you also take into account how much "newborn care" costs on average at your hospital. At my hospital, it means factoring in an extra $3k into my formula.

    Don't be afraid to call your hospital to see if they can direct you to their cost of services reports, if you can't find them online. They're supposed to be public information.

  • I see your dilemma. It's all kind of confusing. You might want to talk with your Dr and the hospital you would plan on delivering at to get estimated cost.  That might be able to help you figure out cost wise how much it might cost you. Run it both ways, vaginal delivery and c-section.
  • I can offer you zero help.  Mine is all paid for through my insurance.  I think you should move to CA and have Kaiser :-)
  • TW, if I didn't love you so much I would hate you right now.
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  • Neither of these insurance plans have maternity coverage separated from other care? The reason I ask is because all the insurance plans that I have reviewed in the last 7 years have maternity separated from other illness/injury coverage. So- all in all, I paid $25.00 from start to discharge.
    One Beautiful Gift Delivered 11/08 One Beautiful Angel 8/10 4 Clomid/Ovidril/IUIs= Negative 2 Gonal F/Ovidril/IUIs= Negative Please Lord, I love this baby already, we are ready when You are.
  • No, iowa.  There is a line on the benefits summary that specifically says 10% after deductible for the high deductible plan and 20% after deductible for the lower deductible plan.

    I'm going to make a list of questions for the rep tonight and one of them is if they have a separate rider we could add--because I'm sure it'd still be cheaper than the $250 premium for the low deductible plan.

    If DH and I weren't TTC and dealing with IF right now, my decision would be made.  Neither of us go to the doctor enough to justify a $250 premium per month when we can save $200 of that a month in a tax free account to pay for the visit when we randomly go to the doctor.

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  • Crownedbee, check out page 8 here. It is breaks down average costs in your state. I interpret "billed net charges" as the actual amount paid by patients (ex-insurance).

  • imagehopeful:):

    Crownedbee, check out page 8 here. It is breaks down average costs in your state. I interpret "billed net charges" as the actual amount paid by patients (ex-insurance).

    Erm, thanks but I live in North Carolina.

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  • imagecrownedbee:
    imagehopeful:):

    Crownedbee, check out page 8 here. It is breaks down average costs in your state. I interpret "billed net charges" as the actual amount paid by patients (ex-insurance).

    Erm, thanks but I live in North Carolina.

    LOL, I thought you said you lived in Iowa. Sorry.

  • imagecrownedbee:

    No, iowa. 

    critical reading FAIL

  • imagehopeful:):
    imagecrownedbee:

    No, iowa. 

    critical reading FAIL

    I forgive you.  This time, anyway.

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  • Smile

    Look what I found. It also looks like the person who wrote this up ended up calling around and asking hospitals in her area. I know you have insurance but she talks about average costs. Not sure if you are in Central NC but hopefully this helps.

  • Thank you!
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  • I never totaled up my bills. I just paid them and didn't pay much attention. Embarrassed

    I know I should be more aware. 

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  • Prenatal care = $40 copay at the beginning.  Everything else was covered for us.  The delivery was 80/20.  Insurance paid 80% (after our $500 deductible) and we paid 20%.
  • For a traditional, non-issue pregnancy, with 2 u/s and a vaginal un-medicated delivery my OB charges just over $3,000.

     Add in my additional 5 u/s, 3 NST's,  additional charge for being high risk, hospital stay, Epi, and emergency surgery (not a c-section) total cost for just me came to $15,000.

     Then add an additional $7,000 or so for a 5-day NICU stay for M.

     

    I paid $20 for my first hospital visit. $20 for each additional u/s. $500 when I was admitted and $500 when M was put into the NICU (and she became her "own" person instead of under me for insurance.

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