Insurance vent AKA: This sh*t is expensive!
jfischer1115
member
I work for a tiny charter school with limited cash flow. For that reason, we have some of the worst benefits on the planet. We pay about $50 a month plus a $2500 deductible just for the employee (if we add a spouse or dependent we have to pay full-cost, which would be about another $125 a month, plus another $2500 added to the deductible). We don't have "co-pays," instead the insurance company just pays some arbitrary amount depending on the type of service given at the appointment.
Well, in the last 11 weeks I have already racked up $1800 in out-of-pocket expenses. I'm so close to reaching my deductible, which should make me happy... except for the fact that our "year" ends in mid-October! By the time I have my next appointments and ultrasounds, I'm going to hit that deductible just as the plan is renewing, and then I'll have to spend another $2500!
I know it could be much worse: I could have no insurance, my deductible could be higher, I could be spending all this money trying to get pregnant... But, darn it, I want to vent!
Re: Insurance vent AKA: This sh*t is expensive!
He just graduated from law school in May and took the Bar last week. He has a full-time job waiting tables, but it doesn't offer benefits. Between the two of us, we make a decent of money, so the baby itself isn't a financial burden to us... I just want better benefits.
If you don't mind me asking... what was the $1,800? That seems like a lot for 11 weeks?
I'm also on a high-deductible plan and my doctor doesn't bill our insurance for the entire cost of prenatal care AND L&D until the day the baby is born. So, even though I'm seeing my doctor this calendar year, my insurance will show all of my doctor's costs, plus the hospital charges in 2012. Maybe it's too late for that, but all I pay out of pocket for 2011 will be bloodwork and my first ultrasound, which is only a few hundred dollars.
Can you talk to your doctors office about their billing plan?
Have you talked to the ins company? We'll be crossing plan years as well, but we only have to meet one deductible for the pregnancy/L&D. They carry it over and we only have to meet the 3K once.
That's a good idea; I'll ask when I go in for my next appointment.
As for where the money is going... I'm not kidding when I say the amount they choose to pay seems truly arbitrary. The bill from my labs itself is $2000 (I paid $800), but office visits range anywhere from $9 to $100. They bill me once to pay the doctor, then again for the service. For example, my ultrasound got one bill paying the office for $104 (I paid $50), then the ultrasound itself has a bill for $750 (I paid $500).
In order to make sense of it, I have to have both bills out next to each other with a highlighter.
Unfortunately, I asked our insurance rep this exact question. He said I definitely have to pay both deductibles.
Ouch. I'm sorry, I can't imagine how stressful that would be. Our insurance definitely has some crappy points, but thankfully maternity coverage isn't one of them. At my first visit, they confirmed my insurance and told me that all of my prenatal care, including either vaginal or C-section delivery, is included in one price, and I get to pay it off as I go. I think it was just over $300 for everything. Obviously that doesn't cover the anesthesiologist, pediatrician, etc. fees that will be racked up in the hospital. We also have to pay a portion of lab work as it's done, but so far I think it's only come to just over $50.
You may want to double check with your Doctors office because I just got a bill for my prenatal lab work and it only totaled $400. This cost was without insurance, I need to go back to my PCM and have them resubmit it to my insurance since I know for a fact my insurance covers all 100% of prenatal and labor/deleivery but just wanted to give you that heads up. I don't understand how lab work can cost $2000--I also checked that with my MIL who used to work in the lab until she retired. (about a month 1/2 ago)
You should ask your Dr. if they offer a cash discount. You won't use your insurance so it costs the office less money b/c they don't have to worry about billing the insurance company and having to pay the biller.
I have really good health insurance, but on my first visit I didn't have my insurance card so they said they would bill me as self pay and then I could call to give the insurance information to be resubmitted.
The bill was 50% off. I was supposed to pay $345.00 and that was for the ultrasound, dr., and urine pregnancy test.
If the self pay or cash price is cheaper, you can pay that and then still submit the bill to your insurance to go against your deductible.