Hospital delivery bill

laurajj031 · October 2014

I've heard that by not taking certain "extras" you can save a lot of money - like the socks with the rubber stuff on them, they are $20. Then I have heard some moms say take everything and ask for more. I have a grandfathered in health insurance plan that doesn't cover stuff like breast pumps, etc. Can any offer advice?? Money is tight and I am not saying I won't use what I need but if I can bring slippers instead of buying $20 socks then it just seems smart....

ordinary1 · October 2014

I don't ever remember being asked if I wanted slippers (or much anything else), it was just given. When people say take everything they offer, it is in reference to what is on the cart. They put diapers and such in the cart. You pay for the pack of diapers whether you take one or the whole bag.

jmcgra06 · October 2014

I had a $200 copay, but I never saw an itemized bill so I'm not sure. I'm actually pretty sure the nurses put the socks on me after the c section and then put these compression devices over top.

Our hospital has a birth advisor who can answer questions like this - maybe yours does, too? Or even calling the billing department?

Irishcurls · October 2014

There should definitely be someone you can sit down with and hammer out the costs beforehand. I know some people even start paying before the birth. If it is going to be that tight, I suggest knowing what you're getting into as best you can.

CatLadyTX · October 2014

If you have insurance, then you should be subject to a copay. I'm sure the hospital charges your insurance for every single item, but once you pay your percentage or copay amount, you should be fine. When you pre-register, they will go over all of the billing information you will need to know. That is a good time to ask questions.

mrs&mrsk · October 2014

Have you looked over your insurance policies? I have a grandfathered in insurance that doesn't pay for breast pump yet--- basically my company is self insured which is a great plan but something that you can't get anymore (like a new company can't). They don't offer breast pump because they don't have to yet (obamacare program has some leniency with regards to timing of putting everything in effect). However it's a great policy overall& my insurance coverage is superior to most people I know in a lot of ways-- my Hosp copay for birth will be zero, my er copay is 25 when everyone else I know is 100-150, reg copays are cheaper than most, never had a prob with a doctor being covered, etc
Anyway yours could be different, but Browse through your coverage or talk to hr. I really doubt they are scrutinizing the bill that much. And if they don't pay, it could be a negotiated discount and you aren't responsible either.

munchkin8590 · October 2014

With my first I was charged for anything that was opened or partially used so I definitely suggest that you take anything that has been opened (diapers, pads, socks, etc.) because they will charge you anyway.

mandamoochie · October 2014

Yeah same, I never received an itemized bill for my DS.... I had no idea how they charged you for diapers, socks, etc...? I would definitely try to contact hospital billing though if it is a concern of yours.

t8keepr03 · October 2014

I did not get nor did I ask for an itemized bill. When I compared my hospital bill for myself and baby to my friends with the same insurance policy they were the same so I didn't ask for an itemized bill. With that being said during the hospital tour I asked the nurse about being charged for diapers, pads etc and she said it's all just one cost. The only thing I would get charged extra for is if I wanted another pair of the mesh undies beyond the 1 pair they give you. She said c section costs would be more because of the compression socks and stuff that comes with that but everything is a lump sum. So I took what was on the cart when we were being discharged.

Angeldcf · October 2014

I'll start with every hospital is different.....

At ours, we have items in the Omnicell that we pull by patient name & are charged to that patient (meds, IV needles, SCDs, pulse ox, CVC-art lines). We also have a ton of stuff (socks, TED hose, gauze, tape, suction tubing, toothbrush/paste, razor, shampoo, insulin needles, syringes, etc) that isn't scanned and therefore not charged directly to the pt. These items are included as a daily, flat-fee "hospital fee" depending on the insurance provider.

So, declining the slippers may or may not be saving you $.

ETA: ask your nurse. I tell my pts/family that any opened item in their room will be tossed so please take the open gauze, tape home if wanted. With DS, my nurse went through the baby cart and told us what we could/couldn't take.

mishka29 · October 2014

I always find it interesting to read about how the American system works since I know so little about it. In Canada we have to bring our own supplies to the hospital. Although I did get one of those giant pads which were so great that I asked for another but was told it was only one per person.

racheltherose · October 2014

I'm just gathering a list of questions to ask for our hospital tour. I'm bummed I can't tour until beginning of December, but as fast as this pregnancy is going I'm assuming November will fly by too.

[Deleted User] · October 2014

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ST3WD · October 2014

mishka29 said:

I always find it interesting to read about how the American system works since I know so little about it. In Canada we have to bring our own supplies to the hospital. Although I did get one of those giant pads which were so great that I asked for another but was told it was only one per person.

Oh, Canada... *pats*

jennypolkadots · October 2014

I happen to have awesome insurance but decided to go with midwives and an out of hospital birth, so will be paying way more out of pocket. Like $4K by 36 weeks instead of about $1200 for a hospital birth with my insurance. So that sucks but that's not your question.

Are you open to planning for an unmedicated vaginal birth? Doing what you can to support a natural labor can save you thousands. Hiring a doula and taking birth classes can pay off in spades. With unmedicated birth, aside from the benefits to you and the baby, you will have a shorter hospital stay and not have to pay the anesthesiologist fees. You can also try to stay home until you are in active labor and the doula can help with that. If that sounds appealing at all I really recommend considering it. No matter what you do, make sure you go over your hospital bill line by line, or call to get an itemized copy if it's not provided to you. You can dispute charges then and ask about lowering costs of some things that are crazy. Like if they give you postpartum tylenol and charge $25, knowing the pill cost them 10 cents... you can always ask to lower the bill.

Another great idea if it is an option for you is signing up for a healthcare FSA at your work. I put $2500 in mine, which is about $104 out of each paycheck. But then I can get reimbursed that much after paying my medical fees and it is at least tax free.

tinyhumantoe · October 2014

I should get to leave with all the diapers, mesh underwear, and xray equipment for what I have to pay through my insurance :P

tinyhumantoe · October 2014

And Damnit, I didn't get any padded socks! I love those things!

LilTiger15 · October 2014

it depends what your deductible and co-insurance amount is. If they are fairly low and you know you will be maxing out the out of pocket, no matter if you take any 'extras' or not, then it makes sense to take everything you can. The key is to understand your insurance out of pocket max and then ask billing department to give you some rough ideas on their charges. For example, just between the charge my OB charged us and the basic hospital expenses, I knew we would be paying the max out of pocket that my policy lists. So, it wouldn't have mattered if we were charged any extras or not, the cost out of pocket for us was the same.

GreenPony33 · October 2014

As someone else already said, each hospital is different but the one i currently work at does not charge for individual items used. They charge a base rate for what you are admitted for ie a stroke costs x, a heart failure admission costs y dollars and labor and delivery costs z dollars. Because each persons stay in the hospital is different some may go beyond what they are charged but then they figure those that have uncomplicated stays make up the difference. A previous hospital I worked for did have a system to track individual items that were used for patients, so the best info i have is to ask the hospital how they do billing.

MrsTucker2011 · October 2014

jennypolkadots said:
I happen to have awesome insurance but decided to go with midwives and an out of hospital birth, so will be paying way more out of pocket. Like $4K by 36 weeks instead of about $1200 for a hospital birth with my insurance. So that sucks but that's not your question.

Are you open to planning for an unmedicated vaginal birth? Doing what you can to support a natural labor can save you thousands. Hiring a doula and taking birth classes can pay off in spades. With unmedicated birth, aside from the benefits to you and the baby, you will have a shorter hospital stay and not have to pay the anesthesiologist fees. You can also try to stay home until you are in active labor and the doula can help with that. If that sounds appealing at all I really recommend considering it. No matter what you do, make sure you go over your hospital bill line by line, or call to get an itemized copy if it's not provided to you. You can dispute charges then and ask about lowering costs of some things that are crazy. Like if they give you postpartum tylenol and charge $25, knowing the pill cost them 10 cents... you can always ask to lower the bill.

Another great idea if it is an option for you is signing up for a healthcare FSA at your work. I put $2500 in mine, which is about $104 out of each paycheck. But then I can get reimbursed that much after paying my medical fees and it is at least tax free.

You can't always have the perfect birth plan even if you plan everything out. I personally know someone who did everything in her power to do an unmedicated vaginal birth, including hiring a doula. She ended up with an emergency c-section within 12 hours.
So keep in mind that you *might* save money hiring a doula, but you could also have to pay for everything else too.

Not trying to scare people, just wanting to point out that doulas aren't the magic wand for perfect birth plans.

michelle142 · October 2014

@jennypolkadots I had a completely unmedicated and uncomplicated hospital birth with DS. I was STILL in the hospital for almost 3 full days.

Unmedicated vs. Medicated birth does not determine the length of your hospital stay.

jennypolkadots · October 2014

@michelle142 - why were you kept for 3 days? You can check out whenever you want to if you and the baby are doing fine. They can not make you stay if there are not medical concerns. Some women choose to stay as long as their insurance pays to rest, especially if they have other kids at home. But OP is worried about medical costs and you definitely can check out much sooner than 3 days!

This is a doctor/hospital policy and not universal obviously. Both OBs I talked to before switching to a midwife told me they will allow women to go home after an unmedicated/uncomplicated birth after 24 hours. They require 48 hours for those who received pain medication or had other issues. 3-4 days for cesarean. Once again, these are their protocols, you could check out early or stay longer if you just wanted to. If everything goes well, I'll be home within 6 hours after giving birth.

michelle142 · October 2014

I had some bleeding issues during recovery.

But a lot of things can factor into how long you stay (completely different for every hospital and individual):

Time of delivery. Hospital policy discharge times. Waiting for OB discharge. Paperwork. Heck, some hospitals won't even let you leave until you take a crap.

Every situation is SO different. Meds vs. no meds has nothing to do with it.

Irishcurls · October 2014

Why do we need to know why @michelle142 stayed for 3 days?? She was sharing a personal anecdote that a medicated birth was not the driving factor in her case.

jennypolkadots · October 2014

@kkleigh10 - After an unmedicated delivery you can check yourself out of the hospital as soon as you and the baby are fine. Your legs aren't numb, you aren't catheterized, and your infant was not just exposed to analgesics and possibly narcotics. These drugs can and do affect the baby's heart tones and responsiveness. So yeah, the care after a medicated birth is different and your body completes a different healing process. Different doctors have different protocols of course. OP needs to look deeper into her health plan and ask doctors for their typical recommendations to know the answers for sure. As I said above, both OBs I talked to said they release women after natural births sooner than medicated births as a general rule.

I never implied that it is somehow a failure to use medication during birth. The vast majority of births are medicated, and everyone here loves their babies and chooses what works for them. OP was interested in saving money and medication for most women is a completely optional expense. While there are special cases (maternal exhaustion is no joke!), the majority of women can have an unmedicated birth if she has the support and preparation to do so. Most insurance plans require you to meet your deductible and then pay a percentage of care up to your total out of pocket maximum. I'm glad your medication was covered but this is not always the case. I have great insurance and would pay 10% of any medication I received. It would only total to a few hundred dollars for an epidural but that is real money that has to be paid. I'm going to go out on a limb here and guess that if OP is worried about the cost of hospital socks, she probably doesn't have the best insurance plan and would like to save a few Benjamins where she can.

OP - learn all about your insurance plan and if it is currently open enrollment, consider other plans as well. Look into using an FSA or HSA if you or your husband's work offers it. Learn about your hospital and doctor's practices. If you are open to alternate birth choices, consider using a midwife and an out of hospital birth if that's an option for you. Good luck!

Irishcurls · October 2014

Holy cow tl;dr.....

jennypolkadots · October 2014

@KristinMTBell - For the 10th time, I don't know OP's insurance plan. I assumed it was awful considering she is worried about the upcoming bills. It is 4x more expensive for us because my insurance is excellent. I have a $300 deductible and pay 10% after that. So my cost of a $10,000 hospital birth would be $1270. My insurance plan doesn't cover midwifery care because of the state I live in (Alabama). My total delivery cost with the midwives is about $3K (I used $4K as an estimate because we are renting a birth house, purchasing some extra supplies, etc). A typical hospital birth would run $10K for me. Thankfully, money was not a factor for us when deciding on a birth plan but I know it is for many women. Depending on the insurance plan, midwifery care may be cheaper than OP's total expected expenses with her insurance. If I had a ACA bronze plan, for example, the cost of a hospital birth would be $2750 deductible plus 20% after that for a total of $4200. There are also several plans that cover midwifery care making it even cheaper, mine is just not one of them. $10K is also a pretty low estimate for a hospital birth and I live in a low cost of living area.

You are absolutely right about the length of stay. You'll see I agreed with all of that in other posts. It depends on the doctor and you can check yourself out whenever you want to.

bhjones1980 · October 2014

jennypolkadots said:

@kkleigh10 - After an unmedicated delivery you can check yourself out of the hospital as soon as you and the baby are fine. Your legs aren't numb, you aren't catheterized, and your infant was not just exposed to analgesics and possibly narcotics. These drugs can and do affect the baby's heart tones and responsiveness. So yeah, the care after a medicated birth is different and your body completes a different healing process.

that is weird, I drugged the shit out of my baby and I was given the option to leave the next day (instead of staying the 2 days), I had him at 10pm so they did want me there overnight at a minimum.

the only time they make you stay for full time in my birthing center (affiliated with a hospital) is for C-sections

bhjones1980 · October 2014

jennypolkadots said:

@KristinMTBell - For the 10th time, I don't know OP's insurance plan. I assumed it was awful considering she is worried about the upcoming bills. It is 4x more expensive for us because my insurance is excellent. I have a $300 deductible and pay 10% after that. So my cost of a $10,000 hospital birth would be $1270.

Your insurance isn't that great, my evil hospital births are $0 out of pocket...

boo yah!

mandamoochie · October 2014

Same here @bhjones1980‌! everything prenatal, l&d, postnatal all covered 100%. I don't even receive explainations of benefits for that stuff.

bhjones1980 · October 2014

mandamoochie said:

Same here @bhjones1980‌! everything prenatal, l&d, postnatal all covered 100%. I don't even receive explainations of benefits for that stuff.

Damn, I thought I was "winning" this contest

mandamoochie · October 2014

) trust me @bhjones1980‌ you are definitely winning

Irishcurls · October 2014

mandamoochie said:

Same here @bhjones1980‌! everything prenatal, l&d, postnatal all covered 100%. I don't even receive explainations of benefits for that stuff.

Yeah I realized this a few weeks ago! It's weird! My delivery bill won't be zero dollars though, so I'm a losing loser. Gotta pay a per diem of $17 or something. Times 3 I think I'll be ok.

bhjones1980 · October 2014

Irishcurls said:

mandamoochie said:

Same here @bhjones1980‌! everything prenatal, l&d, postnatal all covered 100%. I don't even receive explainations of benefits for that stuff.

Yeah I realized this a few weeks ago! It's weird! My delivery bill won't be zero dollars though, so I'm a losing loser. Gotta pay a per diem of $17 or something. Times 3 I think I'll be ok.

You are so low budg.....

mrs&mrsk · October 2014

bhjones1980 said:

jennypolkadots said:

@KristinMTBell - For the 10th time, I don't know OP's insurance plan. I assumed it was awful considering she is worried about the upcoming bills. It is 4x more expensive for us because my insurance is excellent. I have a $300 deductible and pay 10% after that. So my cost of a $10,000 hospital birth would be $1270.

Your insurance isn't that great, my evil hospital births are $0 out of pocket...

boo yah!

me too (i think lol)

AshleySparkle720 · October 2014

My insurance covers 100% of all pre natal, labor & delivery, and post natal care

sooo I'm gonna have to agree with @bhjones1980 and @mandamoochie

MrsTucker2011 · October 2014

My insurance covers all pain meds 100%. But if they didn't and I was at the point that I wanted some, I would make DH pay for it. After carrying a kid for 40 some odd weeks, it's the least he could do, and he wouldn't bat an eye.

Coming from someone who went 13 hours no meds before opting in so I could sleep for the first time in 36 hours.

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