I knew having a baby was going to be expensive. ...

celestialnyte · February 2012

but our insurance is 100% coverage. MH gets amazing insurance at his job, and that has helped us a LOT. Imagine my surprise when I walked into my OB appt this morning and the woman at the desk said "You know you have a $730 maternity fee?" Um .. NO I didn't know that. Then she says, "And it has to be paid in full by 34 weeks. And you have to sign here to say that you know you have to pay it and it will be paid by 34 weeks." I gave them $100 to start a payment plan .. and called the billing dept (conveniently in another office) to figure out why the insurance hadn't paid it ... and also why the HECK have I been going to you since October and I haven't heard about it til now? I'm 23 weeks along, so I have 11 weeks to pay this, and I'm unemployed. What're they gonna do? Not deliver him?

MH was awesome and said, "I don't want you to worry about it. I will take care of it." But I can't help worry. And be aggravated that after 18 weeks of being under their care this is the FIRST time I'm hearing of this.

MrsJerseyJets · February 2012

We had full coverage for my daughter's birth and maternity...just the hospital costs alone for the C-section and 3 days stay ended up being roughly about $45k, and we had no complications!!! I don't know how anyone has children in hospitals without some sort of coverage!

Heartcease · February 2012

And what is that fee for exactly? My husband's insurance is supposed to cover all of those fees, so I'd be very angry at having that sprung on me. I'd find out more about it and then check with my insurance to see if it's something they cover. Maybe the office doesn't turn it in and it's something you have to be reimbursed for?

celestialnyte · February 2012

Heartcease:
And what is that fee for exactly? My husband's insurance is supposed to cover all of those fees, so I'd be very angry at having that sprung on me. I'd find out more about it and then check with my insurance to see if it's something they cover. Maybe the office doesn't turn it in and it's something you have to be reimbursed for?

I don't know what its for yet ... the lady at the desk didn't have that information because the billing dept is elsewhere. The billing dept sends them who owes money, and then the front desk tells them. Any questions, the patient has to call the billing dept (which I called and left a message when I got home). I'm super aggravated by this. The fact that I've been there since October and haven't heard anything about it til NOW, the fact that they couldn't tell me WHAT it was for ... and then when I got home I went through ALL the insurance paperwork that we get (we get it every time we go to an appt) and in each and EVERY instance, it says that they paid in full, and we owe NOTHING.

MsMommyDoc · February 2012

MrsJerseyJets:
We had full coverage for my daughter's birth and maternity...just the hospital costs alone for the C-section and 3 days stay ended up being roughly about $45k, and we had no complications!!! I don't know how anyone has children in hospitals without some sort of coverage!

DH and I both have our own small businesses so we don't get group coverage here in Texas., which means that i have zero maternity coverage. It sucks but I negotiated payment plans with both my OB and the hospital and have been paying along the way. It will cost about $2,000 for the OB (for the entire 9 months of care and delivery) and about $4,000 for the hospital (assuming a normal delivery and 2 day stay).

I basically went in and said this is what I make and can afford to pay, I am willing to pay in advance. I realize that if things were to get complicated it could cost us more but I insisted they give me a pricing structure in advance for most anticipated costs. Plus a complicated delivery is covered by my insurance because they consider it to be an "emergency".

All in all we are doing well with the whole thing, it can be done. Definitely is not as good as having full coverage, but its worth it to have a successful business on my own.

jlgregory75 · February 2012

Same thing happened with us at out 20 week appointment. We do have a co pay though. Had pay our doctor's fee of $250 for normal delivery, more if we want a tubal sterilization as well, and we were told that we have to go to the hospital before 28 weeks to pay their portion of the fees as well and give them our insurance information. Don't have a clue how much that will be.

Josie22 · February 2012

You really should not have signed, or paid a thing before fully understanding what it was for. Even if that meant missing your apt. It could be a screw-up on their part. Which now could hold you responsible for something you shouldn't be.

aprillle · February 2012

Oh, I would be ticked!

I would just call the insurance company and make sure that the office knew what it was talking about - I used to work in my company's HR benefits department and we saw mistakes like this all the time.

kimmyg000 · February 2012

I understand you being upset with an unexpected expense like that, but it could be a lot worse. We have a family deductible of $7,500 with my DH's insurance, which we will most certainly reach since I have to have a c/s. Plus all the co-pays. Does that make you feel any better?

Daisy22 · February 2012

A lot of OB offices charge up front for deductibles and coinsurance percentages of their patients. My office calls your insurance after your confirmation appt to find out exactly what you owe. My insurance covers everything 100% except a $100 global OB fee. I dont' pay any copays, deductibles or coinsurance. I had to have the $100 paid to them by 24wks along. My office not only calls you to explain your benefits but has a sheet outliining everything that they send you before your next appt.

I would be a little upset they just sprung this on you and with no information on what the fee was for.

celestialnyte · February 2012

kimmyg000:
I understand you being upset with an unexpected expense like that, but it could be a lot worse. We have a family deductible of $7,500 with my DH's insurance, which we will most certainly reach since I have to have a c/s. Plus all the co-pays. Does that make you feel any better?

Nope because while ours is 100% covered, it is that because our deductible we have taken out of an account we created with the insurance company. So it is covered with money that we put in there, so that it doesn't come out of our pocket every visit - it comes out of that account. And then the insurance kicks in after that.

But thanks for trying.

amoerizzle · February 2012

Grrrr!!!! Who does that anyway? I feel like that's something that should have been discussed at the very beginning. Springing things like that on a family getting ready to welcome a new baby into their home is crappy. Luckily, our insurance is 100% coverage as well, other than about $20 per day in the hospital (which I will gladly take!) I hope your DH is able to get a hold of the insurance company and they take care of it for you.

hecallsmecat · February 2012

That totally sucks. I would be mad too that they waited so long to tell you. I get why they make you pay in advance though. When my parents had me they had no money and couldn't afford the hospital bills after I was born. They paid some of it and then never paid it off. The hospital never came after them so it remains unpaid to this day. It was always the joke in our family that I still belonged to the hospital. They always threatened to send me back there when I misbehaved.

mamameg11 · February 2012

I had something similar happen to me at my 16 wk appointment. My OB's office informed me I had a $250 fee to pay by 32 weeks, so I pay $50 a visit. They said it was a fee from my insurance. I did not have a fee like this during my last pregnancy, so I called the insurance company. Sure enough, I do need to pay it. I did confirm that after I pay the $250, I will owe nothing else, including at the hospital. When we went to the hospital for DD delivery, we had a $300 insurance fee to pay. So from what my insurance explained, I am basically paying the same fee (less for some reason!) before we get to the hospital.

travnicek · February 2012

Usually, even if you have 100% coverage, you still have to pay your deductible. I'm sure you know this, but each year, you have a deductible of a certain amount (low, like $730 or high, like $7000). You can have full coverage for appointments, etc. but for hospital visits and emergencies you have to reach your deductible first before they pay the rest. So, if a typical birth costs $45,000, the max you are going to pay is $730; The max someone with a deductible (for the same birth) of $7000 will pay, is $7000.

Most clinics have you pay them the remaining balance of your deductible for that year when you are midway through your pregnancy, so that it's already taken care of when you go into labor. So, if you were to go into labor at 32 weeks, you wouldn't have to worry about the bill later. After you pay the $730, you won't have to pay anything else for your hospital stay, food, delivery, and all of the thousands of extra dollars that add up when you have a baby (as pp have said). If you weren't paying your clinic the $730, you would be paying the $730 to the hospital - either way, they have to cancel out your deductible first before your insurance will pay for the rest.

Does that make sense? I promise you, even with 100% coverage, it is completely normal.

snickersforeveryone · February 2012

Our pregnancy coverage is pretty awesome too, but we have a similar fee to pay. The OB's office called up our insurance company and found out what our co-pay structure is, what fees we may have to pay them after the insurance has covered their portion, etc. It came to roughly the same amount as yours. We were told pretty early on, however, in case we wanted to do monthly payments as opposed to a lump sum. Do you have to pay any co-pays or fees whatsoever under your coverage? Could they be lumping them like they are mine? I would definitely call your insurance broker or insurance company for some clarification!

travnicek · February 2012

I just read something you wrote above:

Is the account you took out with your insurance company a health savings account? Is that why you are saying you are !00% covered?

kimmyg000 · February 2012

travnicek:

I just read something you wrote above:

Is the account you took out with your insurance company a health savings account? Is that why you are saying you are !00% covered?

I would assume not since HSA usually have high deductibles. 100% coverage applies AFTER you pay a deductible. I don't know anyone with a $0 deductible for health insurance. You can't assume insurance will pay for every single cost. Your DH may have a cafeteria plan that he may plan on using to pay the deductible. In that case you would pay your Dr. and then get reimbursed. I would talk to your DH and have you both talk to your insurance company. We have talked to ours numerous times each pregnancy so we understood what we would have pay and what they would.

amberlynnr7 · February 2012

We have to meet a deductible before the insurance will pay. I'm really nervous about it. I don't know the procedures or anything. Suuuper frustrating.

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