Just got the EOB from insurance for 1st visit bloodwork, $800?! anyone have expensive bills?

kguitarchic18 · September 2015

So i know my insurance is not the best, its a high deductible plan, so until I meet that they don't cover anything, I just get the "discounted rates". I had bloodwork done on my first OB visit at 8 weeks, and she mentioned there was a test she recommended to see if I was a carrier of certain diseases. She said there were two tests, one that was crazy expensive and covered a lot, and then a simpler one that wasn't so crazy which was what she recommended. Both my husband and I said yes to the cheaper test. Now I just got my EOB statement online and there was probably about 10 tests, all around $5-$70 which I though ok, whatever. Then one test at $2400 with the discounted rate at $650, are you kidding me?!

I guess I just wanted to see if this is normal? What do you guys do with insurance and pricing? Am I just supposed to go into these doctor visits and say yes to all these procedures and tests thinking they are something thats covered, and then freak when I get a huge bill? I was thinking about calling my insurance company and asking if I could call during appointments to see if certain things are covered, but I know it will be hard to get a price up front, should I call the doctors office and ask what tests or things they will be doing so I can call my insurance before hand? But even then, if these are important tests I want to have them done. Geez, just a bit of a sticker shock I guess.

cmjenkies · September 2015

Just imagine my disdain whenever I realized I would have to meet my deductible all over again for the new calendar year because DS was born in January? Although I guess it'll be similar with April babies. I guess I need to plan for a same calendar year pregnancy next time! Lol

cmjenkies · September 2015

Also - I have decent insurance and my lab and U.S. bills were always higher than I expected because they had addl limits at that time on bloodwork, etc. Definite sticker shock!

misstopsail · September 2015

Our plan runs May to May, and we've already hit our deductible.. Hello, 'free' baby!
(Our deductible is 7,000.. We hit it with my 2,000 ER visit last month. So I feel your pain!).

You could ask your doctor what they charge for each item.. Then you know that's the max it will cost?

JaysensMom · September 2015

You could call your insurance and ask them what all they do cover when it comes to maternity care. Most insurance companies will give you a roundabout idea on whats covered.

Also if the doctor you see is associated with a hospital you plan on delivering your baby at, you can see if they have a med cap or something where they help with the cost of your bills. A lot of hospitals offer it and cover a lot.

kguitarchic18 · September 2015

@JaysensMom thanks for the info! Wht exactly is a medcap?

DougalMcG · September 2015

@kguitarchich18 it's just the EOB, not a bill right? If so, I wouldn't panic just yet. A lot of doctors have deals with the labs where basically if your insurance doesn't cover it the doctor will only bill you a maximum amount. For example, the deal that my OB has is that I don't pay anything over $99 for that carrier test. Last pregnancy I had an EOB for $4000 for "routine" bloodwork and I didn't wind up paying any of it.

kguitarchic18 · September 2015

@DougalMcG Yes its just the EOB, and I am hoping that the bill comes in at much less

So did you get a bill for less from the Lab, or was it something you had to work out with your doctor? they took my blood at the doctors office, but the sent it to Quest labs, and thats who the EOB is for. Man, I wish I just had amazing insurance with $20 copays those used to be the days!

DougalMcG · September 2015

kguitarchic18 said:

@DougalMcG Yes its just the EOB, and I am hoping that the bill comes in at much less So did you get a bill for less from the Lab, or was it something you had to work out with your doctor? they took my blood at the doctors office, but the sent it to Quest labs, and thats who the EOB is for. Man, I wish I just had amazing insurance with $20 copays those used to be the days!

I didn't get any bills from anyone. The OB and the lab (also Quest) sorted it out amongst themselves.

mrstrax · September 2015

My OB office has you sign off at your first appt on both the pre-insurance cost of your care/delivery and for additional costs (labs, u/s, non-stress tests etc) and you also have to sign seperately that it is on you to contact your insurance for the cost of additional optional testing because insurance coverage on them varies so much. If you had something like that, you may unfortunately be out of luck. Once you get a bill though it may be worn a call to the labs billing department to see why that test is so pricey.

kguitarchic18 · September 2015

thanks all! I did sign off on the estimated delivery fee, but it didnt have any other costs, I will have to go back and take a look at that

mrstrax · September 2015

kguitarchic18 said:
thanks all! I did sign off on the estimated delivery fee, but it didnt have any other costs, I will have to go back and take a look at that

I hope it all works out, and that if nothing else that the peace of mind from the results make the cost worthwhile!

kguitarchic18 · September 2015

That is very true, even knowing the cost up front I don't think I would decline a important test

kimey1 · September 2015

@kguitarchic18 I'm in between insurances for a month so I asked my OB whether we could work out a deal. They said we all need to work together to make it work, and were so helpful and cut the non-insured visits to half. They also suggested that I speak to the billing dept re: other bills (including the lab) that would follow, so that they could reduce the bills. I'm sure paying like this may be the same or helpful to them since they don't have the middleman insurance company involved.

I've also haggled with labs, so I'd strongly recommend you call your OB and/or the lab that billed you, and try and negotiate with them. After going through a miscarriage, I explained that getting so many bills the following months was like pouring salt on it! Last time I was billed $1150 and the staff was able to bring it down to $800 for me when I explained my situation. She felt sorry she "couldn't do more" to bring down the bill, but her deleting some of those urine tests and other small things saved me almost $350! I was so grateful!

runlong3 · September 2015

Is there an actual reason specific to YOU that your OB recommended the test? Or does she just do a blanket recommendation for everyone? IF you have a low risk pregnancy and are not at risk for any genetic diseases (do not run in your family) then I would pass on an optional testing. Optional testing is just that, optional and typically is expensive and not covered by insurance or not always in full. The 20 week anatomy scan, the glucose testing, and then any other tests for legitimate medical concerns are really all you need. You don't need genetic testing/bloodwork or multiple ultrasounds to have a safe and healthy pregnancy.

It will be awesome if your bill comes in lower, but I also have a HDHP and have yet to see my bills differ from the EOB. Working with your OB office and lab sites are definitely one way to lower your bills, but also not electing to add on optional tests/prodecures is another.

runlong3 · September 2015

You should also have a a HSA account to go with your HDHP that you can use to pay off those bills. I strongly recommend maxing it out each year for events such as these.

NachosAndPeaches · September 2015

Can you switch to a better plan? How much do you pay a month? It may be worth it to get the best plan now that you're pregnant since you know you'll be spending the money. I pay a lot monthly but my copays are super low. If We weren't trying we wouldn't have gone for it but now that I'm KU it's totally worth it.

Jules08 · September 2015

I have a high deductible plan. I pay the full amount (of the discounted rate) until I reach $1750 out of pocket. Then I pay 20% of the discounted rate (insurance pays 80%) until I hit $3750. (Then do it all over again next year.) I think my total bill, before insurance, was $48,000 with DS. I paid $3750 for me, and $2200 for DS's bill.

This time it will be $3750 this year (if I am billed for that or more) and then for sure $3750 next year plus 2.0's hospital bill.

kguitarchic18 · September 2015

@runlong3, I guess myself and my husband not knowing any better we opted for the test. She explained that it was a screening to see if I was a carrier of any genetic disorders/etc, and that there was two tests, one crazy expensive, and this other ran which tested for less and was covered and she recommended it. I guess in the future i need to be ready to ask more questions like why would the test be helpful, and if we find anything what does that help with? First appointment and I think just be overwhelmed with everything it sounded good.

@NachosAndPeaches, we have three high deductible plans, and as soon as open enrollment hits in November, I am moving into the higher plan with the lower deductible. I originally figured last year that it could take a year or so to get pregnant, and that I would only have a few visits if I did, so I opted for the middle plan at the time to save money monthly. (now I wish I had just went into the higher plan, but woulda shoulda coulda.)

@Jules08, your plan sounds almost like mine, I think my deductible is $3k right now, with max at $4500, the next plan is a little lower I am hoping, but family max is like $9k so I am going to have to look into putting the little one possibly on my husbands plan if its better.

pinottoparenthood · September 2015

Sounds like maybe the harmony test? Or something similar. My doctor warned me to call my insurance and check to see if they will cover it because it varies all over the board and those tests are very expensive.

seasidesweete · September 2015

You may be able to call your health insurance company to see if your dr office or lab charged higher than the "benchmark" for those items to help you negotiate. Basically there is a range in prices for specific CPT codes and sometimes the dr office tries to charge more than that benchmark. Other plans use this to make adjustments and the dr office writes off that amount. With an HSA I'm not sure there are as many write offs by the ins company. Good luck negotiating!

vvbaby2015 · September 2015

Just wanted to add that you should talk to your bank about opening up an HSA if your employer does not offer one. I have had one for 3 years and the tax benefits are great. I had a surgery A couple of years ago and was able to get a nice chunk of taxes reduced when we used the HSA to fund it.

mrstrax · September 2015

vvbaby2015 said:
Just wanted to add that you should talk to your bank about opening up an HSA if your employer does not offer one. I have had one for 3 years and the tax benefits are great. I had a surgery A couple of years ago and was able to get a nice chunk of taxes reduced when we used the HSA to fund it.

Agreed - and HSAs are great because they roll over to the next year (unlike flex accounts where it's use it or lose it). We hit our out of pocket max the year DD was born (DH also had an emergency appendectomy when she was 6 weeks old) and haven't had major medical costs since, so that account has just been building for the 14 months and is now more than enough to cover this baby, so nothing is coming out our regular month to month budget or savings.

yodiggity · September 2015

I went to Labcorp to get check my thyroid levels and it was over $700. I had to swipe a CC incase Insurance wasn't valid (it is of course) but holy crap. The sad part is I know exactly how much it costs to run those tests due to my job and it's NOWHERE near $700.

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Just got the EOB from insurance for 1st visit bloodwork, $800?! anyone have expensive bills?

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