I'm kind of playing off the Maternity Leave thread, but I'm wondering what your health insurance pays for and what it doesn't? What are your deductible and copays? Does your OB practice offer any payment plan or discounts? And for all you STM+, are there any costs you would want to give us FTM a heads up on?
Re: Health Insurance
This time I have HMO. I had a $25 co-pay my first visit and the rest of my 'standard' care is covered at 100%. Any extra appointments outside of the 'standard appointments' will result in a $25 co-pay (or $35 if at a specialist). When its time to have baby, it will be $150/hospital day for the first 4 days and then covered at 100%. At least this is how I understand it.
I have a $40 copay for sonograms and insurance covers the rest for three over the course of my pregnancy. Otherwise, no co-pay. Blood work and everything else is covered in the cost we were quoted.
Epidural and anestegiolist (spelling?) were billed later and separately, I believe. And of course prolonged stay or NICU or c-section would be added costs to the original amount given.
Our hospital does a payment plan. We have to pay something every month even if it's not the recommended payment. They prefer to have it paid up before due date.
<><><><><>Angel Baby- June 2012<><><><><>
<><><><><>DD2- March 2013<><><><><>
<><><><><>DS1- ETA September 2017<><><><><>
Of course, this is just an estimate, who knows what the cost will be when I actually deliver.
TW:
HSG/FSH/AMH/E2/SA all normal DX: unexplained IF
spontaneous BFP 01/01/2017- Alexander was born sleeping 04/13/2017 at 19w1d ic/chorio
September 2017 HSG #2 & Gonal-F/Femara/Ovidrel/IUI #1 = ep (Salpingectomy of left fallopian tube)
spontaneous BFP 01/02/2018 EDD Aug 30th It's a GIRL!
Cerclage placed on 03/02 Cerclage removal 08/02
This time, bc I'm on a family plan, I have a $2600 deductible/ out of pocket limit. I pay everything out of pocket at whatever discounted price the company gives me (eg- the u/s might be $300 and they will only cover $125. Once they reach an agreement on price with the OB's office, I pay the $125) up to $2600. After that, everything is covered 100% by my insurance. Considering a vaginal birth is upwards of $10k in my state, I'm happy with that. This is an Open Access Plan (OAP), which is similar to a PPO.
I just spoke with the OB office, they require a deposit based on whatever your remaining deductible is, 2 months prior to birth. They do offer payment plans for this, which I'll look into after a few things clear on my insurance (a recent visit to the ER, u/s, etc). I've already got $900 worth of bills going towards my deductible, so at this rate there may not be a whole lot left in July. They will reimburse if I pay more than I owe for the deposit, but considering how long it took for me to get all my bills post baby (over 3 months just for the birth), I'd rather not.
Be prepared for costs that your insurance company may not cover fully. DH's insurance would only cover half of the cost of circumcision for DS. You can call ahead and find out from your insurance company. Also, it's more just having some extra just in case you get a bill three months after birth, when you think all of them have been paid. For whatever reason, it took forever for all our costs to be processed, even though it was just a three day period I was in the hospital.
Side note- If you are BFing/ EPing and plan on getting a pump, look into *when* your plan will send it. My last insurance company would only send it after the baby was born. I had a list of companies from my insurance that were suppliers I could get the pump from. I contacted the ones that had the pump I wanted, and asked how long shipping would take. I chose the one who did overnight delivery. You can get the 'Rx' for the pump and all the paperwork taken care of ahead of time with most of the companies, so all you have to do is contact them when the baby is born. *Some insurance companies will allow you to get the pump much earlier, but if you're going to need it at home, this is important. You can also do rentals with the hospital most of the time as well.
DS2: EDD- 09.08.17
ETA: autocorrect does strange things...
I'm not very familiar with the American system, but if you have no insurance through work are you just on the hook for tens of thousands?
DH was self employed last year and when he turned 26, we looked at options for him. He couldn't get any subsidies because he made over 25k. In our case HSA was not an option because we didn't make enough and we actually thought about betting that he wouldn't get sick and paying the penalty. He ended up on my insurance, but I can't help wonder that if the Affordable Care Act hadn't been in place, if we might have been able to find something on the market.
I remember someone on the loss boards talking about having to choose between the procedure she wanted (D&C) vs a much cheaper in office procedure that would have been more emotionally challenging. Making a health decision based on finances instead of what's best for the patient is heartbreaking.
Our system is definitely not perfect but I'm so grateful for it. I know paying higher taxes is not a popular idea in much of the US but I love my healthcare, Employment Insurance, and Canada Pension!
Married to David 3/22/14
Mommy to my angel Ella Lynne born into heaven 8/24/15
Started TTC again October 2016
BFP on 1/6/17!
DS2: EDD- 09.08.17
Blessed