Insurance question

bellamatson · December 2013

My insurance doesn't cover my LO, so we are going to put him under DH's insurance who his BCBS....
His deductible is either 6 grand or 4 grand a year...
With that said, did the hospital charge your babies insurance for them to sit in the hospital while you were recovering from birth? I'm so confused with this new insurance stuff. The birth is completely covered through my insurance, but once he is out of me, it's on him. Maybe I am not understanding how it works? Lol

Sorry if this doesn't make sense. I'm confused and Bcbs can't answer my question! Lol

ChuggingWater · December 2013

Yes, my son had a bill from his birth--- nursery, monitoring, testing, pedi visits, etc.

ashybear · December 2013

Baby is covered under my plan and deductible for 6 weeks, but I was just talking with a friend who's baby had his own set of bills to immediately apply to LO's deductible. So, it certainly seems insurance-dependent, and like something BCBS should be able to answer - how frustrating!

bethughknee · December 2013

I didn't deal with insurance for my son since his adoptive parents covered him from the moment he was born but this LO will go on my H's insurance because mine is just astronomical to add anyone to.

Anyway, I was asking my mom about this because she works in the hospital where I will deliver. It might depend on the hospital but she said that from moment one, baby's get their own patient number and account. She asked someone in billing who said newborn hospital stays range form about $500 on the low end up to tens of thousands for NICU stays. (H's insurance covers a certain percentage after a deductible so we were trying to get a ballpark estimate. We couldn't really. There are just so many variables.)

I don't think most hospitals itemize things like how many diapers they put on your kid or if they have to bring you an extra pacifier, but there is a charge for all the "things" they do. Like if they give you formula and then there's the usual battery of tests.

Sorry to ramble but to answer your question, yes. Once he's out he's his own patient with his own separate bill that YH's insurance will start to cover. And yes it costs money for him to be at the hospital too.

thegosiers · December 2013

My Blue Shield plan covers baby under me for first 30 days. After that he needs his own insurance card. (not sure I actually answered your question, just offering my details for comparison?)

nbbride06 · December 2013

It depends on your specific plan. Call them.

bellamatson · December 2013

Lol! I had figured he would have his own little bill for tests and what not.
I called my hospital billing, and they told me that I'd be fine. I was just going to have a fit if I had to pay 6 grand right away for him to stay in a room with me while i recover.
But yes it's super frustrating when by even Bcbs can answer my question! Lol

brideandbreve · December 2013

bellamatson said:

Lol! I had figured he would have his own little bill for tests and what not. I called my hospital billing, and they told me that I'd be fine. I was just going to have a fit if I had to pay 6 grand right away for him to stay in a room with me while i recover. But yes it's super frustrating when by even Bcbs can answer my question! Lol

I've got a question --

Do you mean that you're required to stay in the hospital, but your son is in a "boarder" status, meaning he's not being held at the hospital to receive care himself, but they're allowing him to stay because he needs to be with you?

'Cause in that case, the hospital can bill the insurance for him being there for basic stuff like room charges and such.

SunflowersBride · December 2013

I'm confused about all of this, because I was under the impression that the baby is automatically covered under the mother's health insurance for the first 30 days, because you need a SS number and other information in order to sign them up or add them to your insurance. And once all that comes in, you can either add them to your insurance or put them on your DH's. Is this incorrect, or does it vary by provider? I can't figure out another way it could work without needing certain documentation.

Jackapatamus · December 2013

For us, even though DS will not have a ssn, he will have a separate bill- and be billed separately from me. We had 30 days from birth to add him to my plan (making it a family plan vs. individual). But his medical expenses were not covered under me/my plan. It sounds like all plans vary on this. But just an FYI- I had a c-section, stayed 4 days 3 days @hospital. My bill was around $8000. DS was in the NICU- his bill was about $55,000. We both had deductibles to meet, as well as an out of pocket max.

HappyDoc · December 2013

@SunflowersBride said:

I'm confused about all of this, because I was under the impression that the baby is automatically covered under the mother's health insurance for the first 30 days, because you need a SS number and other information in order to sign them up or add them to your insurance. And once all that comes in, you can either add them to your insurance or put them on your DH's. Is this incorrect, or does it vary by provider? I can't figure out another way it could work without needing certain documentation.

This is how my insurance works. I have BCBS of NEPA, FWIW. All of LO's costs, including visits to pediatrician in the first 30 days, are billed and covered under me. After 30 days, she must be officially added to my policy. So for my policy, my member number is XXXXX01, LO's member number will be XXXXX02.

I had assumed that all insurance companies worked this way, but I guess I am wrong.

COgirl29 · December 2013

HappyDoc said:

@SunflowersBride said:

I'm confused about all of this, because I was under the impression that the baby is automatically covered under the mother's health insurance for the first 30 days, because you need a SS number and other information in order to sign them up or add them to your insurance. And once all that comes in, you can either add them to your insurance or put them on your DH's. Is this incorrect, or does it vary by provider? I can't figure out another way it could work without needing certain documentation.

This is how my insurance works. I have BCBS of NEPA, FWIW. All of LO's costs, including visits to pediatrician in the first 30 days, are billed and covered under me. After 30 days, she must be officially added to my policy. So for my policy, my member number is XXXXX01, LO's member number will be XXXXX02.

I had assumed that all insurance companies worked this way, but I guess I am wrong.

I have United (but I know plans under the same insurance company can even be different) - but this is what mine does:

Once LO is born, I have 30 days to add her to my insurance. However, as soon as she is born, she is her own person as far as insurance is concerned and will have her own deductible (since my plan is a per person deductible even under the family plan). So all of my prenatal care and my time at the hospital will be covered by my $400 deductible. LO will also have a $400 deductible once she is born that will need to be paid before I leave the hospital. If she is born in 2014 though, then her deductible will then be covered for the entire year.

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