@alice0218 We’ve been paying OOP for the first half of this pregnancy due to coverage issues (I’m finally covered now but I wasn’t) and my anatomy scan bill was $756 or something like that. I’m surprised your insurance didn’t cover it, but I guess like you said that may just be due to your deductible. My in office ultrasounds are never charged as extra on top of my visit cost (but that’s mainly because my OB looks because she wants to and not because it’s actually routine, she likes to be super thorough) but if she were to charge for them they would be way cheaper than the anatomy scan and other ‘official’ scans done at the actual ultrasound place.
Married 6/1/13
BFP #1 7/2013 MMC 9/17/13
BFP #2 5/2014 MC 6/15/14
BFP #3 11/13/14 (Found in ER with ruptured cyst) Diagnosed MC 11/15/14
BFP #4 4/2015 MC 7/1/15
BFP #5 10/21/15 EDD 7/3/16 Praying for our rainbow!
Mine ultrasounds are covered 100%. My OB has 2 ultrasound techs in her office though—so maybe that is why it is easier to have them covered? It’s all “in house”.
@alice0218 it really just depends on your specific insurance. We have paid around (prob a little less than) $2,000 for each pregnancy between deductibles, and things not covered. The OB fee and the actual hospital bill are the main chunk.
Thank you @winnie1122, @magnolia305, @Chawk17, @Starynightsky24, and @mamaof5already, for the responses. I think this info is so valuable to me because it's so hard to get anything that's applicable at all from googling, and hospitals are just a PITA to try to get answers about billing from.
I think I will just have this bill sent back to billing for recoding, assuming that they've done it wrong, like I've done for every other bill so far (about $1100 worth of perfectly standard things for a normal pregnancy). And I will also talk to my OB to see if she can get it coded differently. And my insurance company to see what codes they want. You would think it would be covered as your standard preventative prenatal care, and I hope it turns out to be after I send it back to be recoded, but I've gotten bills for so many things that are preventative care. I think it might just be this hospital is bad at coding things in an insurance-friendly way. That is what I'm hoping, that in the end it will be closer to nothing, but I don't know that yet. I am glad to hear what your experiences were too! What an effing headache.
alice0218 - I didn't receive a bill or bill to insurance with all of mine, but I remember receiving the billed amount to insurance for three ultrasounds at the MFM practice I was seen at for ultrasounds with my fourth. They were level III scans. They were between 900-$1100. I know the cost can vary quite a bit depending on who performs it, the length and type of ultrasound, etc.
I had military insurance (Tricare Prime and Standard) during four of my pregnancies and didn't pay anything for prenatal care with my first two. I had dual care with the next three and paid OOP for my homebirth prenatal care and delivery.
G 12.04 | E 11.06 | D 11.08 | H 12.09 | R 11.14 | Expecting #6 2.16.18.
@alice0218 We'll pay $1500 OOP for our deductible in this year. When the baby is delivered, it'll be another $2000 to meet the deductible and then co-pay of 15% for standard delivery. I spoke with my insurance company directly and they told me what the cost of labor/delivery/anesthesia etc would be. Also, with my first two sons, we set up a payment plan with the hospital instead of paying $4000 oop (my insurance was different when I had them). We paid $100/mo until the bill was paid in full.
@alice0218 I don’t have a deductible and got a bill for my first ultrasound at MFM. I was so frustrated. After about three hours fighting between the hospital and insurance I got the insurance person to agree to call the hospital and they figurednit all out. It was billed incorrectly and should have been covered 100%. The bill still hasn’t cleared but they claim it should soon. This all being said I’m very spoiled with my insurance as I have amazing coverage and low copays so rarely pay for anything.
@alice0218, I had three ultrasounds in the first trimester that were negotiated by insurance to be about $400 each paid towards my deductible. They were trans abdominal and trans vaginal. My anatomy scan was considered routine prenatal care and was covered 100% (so far as I can tell, no bill ever came). My follow ups with MFM for my velamentous cord insertion are negotiated to be $200 each towards my deductible (I think the difference in price is from it only being trans abdominal). I am not looking forward to when those are weekly. Hopefully that is not until January so it can go towards the deductible for the birth in the new year. We have a high deductible plan.
It really does vary so much with insurance companies my early ultrasounds through the RE were $350 we owed $160 each after the insurance adjusted rate this was a high deductible plan. I picked up my new employers insurance in Aug. the ultrasounds through my regular OB were billed at $260, insurance rate was $120 and insurance covered the entire thing. all of my OB apts since Aug have been considered routine prenatal/preventative and paid by insurance.
if you call your insurance members services they should be able to give you a better idea of the price. I called them to see how much the genitive testing, with the code the doctors office would use to bill and they were able to tell me the adjusted rate, that it would go to my out network deductible, and my costed based on what my deductible and HRA were at that time.
My ultrasounds in office have been covered along with my care. But my ultrasound with the perinatologist wasn’t. And as I hadn’t met my deductible yet, it was over $700.
I am very surprised by how much out of pocket so many of you are having to pay. I thought the Obamacare/AMA plan was supposed to make healthcare more affordable, and get rid of very high deductibles.
I am very surprised by how much out of pocket so many of you are having to pay. I thought the Obamacare/AMA plan was supposed to make healthcare more affordable, and get rid of very high deductibles.
It depends on insurance. I have group health ( Kaiser) so I pay more out of monthly pocket to have insurance but pay less when using insurance- - if that makes sense. But some insurance plans my school offers are cheaper monthly out of pocket but have HUGE deductibles and co- insurance. So a gal I work with has a cheaper monthly insurance, but when her son broke his arm she had to pay total expense out of pocket because deductible is high. So I think it comes down to - do you want to pay now or later?!
Every insurance plan is different, but the way tests and everything are coded is important. The coding determines whether insurance companies deny it or pay and how much they will pay. The easiest thing is to know your plan and if you get a bill that is high or doesnt seem right call the hospital or dr office and have them double check the coding. There are multiple ways to code everything.
I am very surprised by how much out of pocket so many of you are having to pay. I thought the Obamacare/AMA plan was supposed to make healthcare more affordable, and get rid of very high deductibles.
I have insurance through my employer... it has nothing to do with obamacare...
I am very surprised by how much out of pocket so many of you are having to pay. I thought the Obamacare/AMA plan was supposed to make healthcare more affordable, and get rid of very high deductibles.
It did not really improve the cost of insurance. Some people were able to gain coverage that they were previously unable to afford. It certainly did not get rid of high deductibles.
Most americans have insurance through their employer so the quality and cost is often based on the size of the company and the industry they are in. my husband and I work for larger companies he is in IT, I have worked in pharma industry and now healthcare so we have alway been fortunate to have good insurance. We only paid $300 for son’s prenatal and delivery 2 years ago, this baby will be a little bit more than that. However, a friend had her son had the same hospital a year ago and they owed $6500.
I am very surprised by how much out of pocket so many of you are having to pay. I thought the Obamacare/AMA plan was supposed to make healthcare more affordable, and get rid of very high deductibles.
I have insurance through my employer... it has nothing to do with obamacare...
Even if you have employer sponsored insurance, it is affected by AMA. AMA set certain healthcare benefits that employers/insurance has to cover free of charge and limits the out of pocket expenses/deductibles you have to pay. All employers with over 50 employees are affected by AMA.
@alice0218 I have a high deductible plan, so my first few ultrasounds were in the mid $300 range. Since I've had so many appointments and such, I met my deductible and now am paying the 10% coinsurance, so it was $40 this past week (2 US). If I meet my out of pocket max (with just Dec left, I may or may not), I'd pay $0.
My mom and MIL ask for a Christmas list each year, and I am SO preoccupied by the baby, I can't even begin to predict what I'll want/need! A friend suggested a gift card for nursing bras/tanks, and also a cooler for pumped milk, for when I go back to work. Any suggestions out there for a good cooler? I don't have great access to a fridge and work in a school without AC, so something that stays really cold and will store enough for the whole day is a must. Thanks in advance!
@everyone it is pretty shocking (and interesting) to see the wide variety of what people are paying. Thank you for sharing! I think this one may go to my deductible (meaning I'll have to pay it), but I will send it back to be recoded in hopes that it can be recoded as something more routine and covered. Since this is a bill for my first ultrasound at 20ish weeks, I wonder if I can make them call it a routine anatomy scan and have it covered.
About ACA/obamacare - I think if something is preventative care, it's supposed to be covered 100% or close to it, including maternity or prenatal care especially. That was my understanding anyway. So I keep sending bills for things that are normal back to be recoded as something preventative like that. But I don't know what the codes are supposed to be so it's hard to know whether anything is correct, and we haven't actually received any bills back after sending them through this process yet. We have insurance through my husband's employer. I don't think it's a HDHP but it's not that great either and I don't think the deductible is actually low. It's also not a huge company. More than 50 people, but most are part time. Probably less than 500 people, less than 100 on insurance and it's a pretty new company, like maybe 7 years old so they don't have things other companies I've worked for have like HSA, FSA, 401K isn't set up, etc. It makes me miss when I was a retail manager and had insurance with Gap, Inc. That was so great. I never paid for anything but premiums. Even when I had to go to the emergency room, they sent me a reimbursement check for the copay! But of course it doesn't help to think of that, I don't have that insurance now.
I just had a call from my doctor scheduling another 3 ultrasounds to monitor possible risks and plus the normal growth ones. And that isn't even through the end of pregnancy. I'm really hoping they don't all cost $300+! But hearing some of your experiences, it sounds like it's definitely possible. Crossing my fingers for the best!
My mom and MIL ask for a Christmas list each year, and I am SO preoccupied by the baby, I can't even begin to predict what I'll want/need! A friend suggested a gift card for nursing bras/tanks, and also a cooler for pumped milk, for when I go back to work. Any suggestions out there for a good cooler? I don't have great access to a fridge and work in a school without AC, so something that stays really cold and will store enough for the whole day is a must. Thanks in advance!
Not sure about coolers but if you need other ideas I put some things like teething necklaces, a cute nursing cover, and some hair wraps on my list this year.
My mom and MIL ask for a Christmas list each year, and I am SO preoccupied by the baby, I can't even begin to predict what I'll want/need! A friend suggested a gift card for nursing bras/tanks, and also a cooler for pumped milk, for when I go back to work. Any suggestions out there for a good cooler? I don't have great access to a fridge and work in a school without AC, so something that stays really cold and will store enough for the whole day is a must. Thanks in advance!
Yeti coolers are supposed to be very good. They are really pricy, but i would think a small one that could hold like a 6 pack or a gallon sized jug of milk would be plenty large.
My mom and MIL ask for a Christmas list each year, and I am SO preoccupied by the baby, I can't even begin to predict what I'll want/need! A friend suggested a gift card for nursing bras/tanks, and also a cooler for pumped milk, for when I go back to work. Any suggestions out there for a good cooler? I don't have great access to a fridge and work in a school without AC, so something that stays really cold and will store enough for the whole day is a must. Thanks in advance!
Not sure about coolers but if you need other ideas I put some things like teething necklaces, a cute nursing cover, and some hair wraps on my list this year.
Thank you! This is SO helpful! As a FTM, I have NO idea what might come in handy. I appreciate your suggestions!
I second @mamaof5already's suggestion of Yeti cooler. They're supposedly the best!
Me: late 30s | H: early 30s TTC #1 since April 2015 RE Dx: Fibroids, surgery Jan 2016 IUI #1 and #2, Nov/Dec 2016, BFN IVF March 2017: ER - 5R/3M/3F, 1 PGS normal Polyp removed May 2017 FET May 2017 - BFP! Baby boy born 2/2/18
@alice0218 unfortunately, preventive care benefits as defined by the ACA do not include all of maternity and prenatal care. I think some testing done during prenatal visits (like Hep are considered part of the preventive benefits that most health plans must cover without a copay or coinsurance. Breast feeding support is covered, however, under the ACA preventive benefits. Just because something isn't covered, though, doesn't mean your own insurance plan won't cover it without copay, it's just that it's not part of the minimum list of preventive benefits as defined under the ACA.
My mom and MIL ask for a Christmas list each year, and I am SO preoccupied by the baby, I can't even begin to predict what I'll want/need! A friend suggested a gift card for nursing bras/tanks, and also a cooler for pumped milk, for when I go back to work. Any suggestions out there for a good cooler? I don't have great access to a fridge and work in a school without AC, so something that stays really cold and will store enough for the whole day is a must. Thanks in advance!
Yeti coolers are supposed to be very good. They are really pricy, but i would think a small one that could hold like a 6 pack or a gallon sized jug of milk would be plenty large.
Agreed on this brand! We haven't tried their cooler but we have some yeti hot/cold cups and they are AMAZING. Supposedly the RTIC brand carried by Walmart is from the same manufacturer at less cost.
@PeachGal23 Thanks for that clarity. I wish this country would get better about taking care of people as far as more standard healthcare. But that is a whole 'nother topic right?
My mom and MIL ask for a Christmas list each year, and I am SO preoccupied by the baby, I can't even begin to predict what I'll want/need! A friend suggested a gift card for nursing bras/tanks, and also a cooler for pumped milk, for when I go back to work. Any suggestions out there for a good cooler? I don't have great access to a fridge and work in a school without AC, so something that stays really cold and will store enough for the whole day is a must. Thanks in advance!
Yeti coolers are supposed to be very good. They are really pricy, but i would think a small one that could hold like a 6 pack or a gallon sized jug of milk would be plenty large.
Agreed on this brand! We haven't tried their cooler but we have some yeti hot/cold cups and they are AMAZING. Supposedly the RTIC brand carried by Walmart is from the same manufacturer at less cost.
Has anyone bought the new Joovy Qool stroller, wondering if you like it? I was planning to purchase the baby jogger city select lux as our tandum stroller since a bench seat can be added later. However, I have been checking out the new Joovy stroller that just came out. It also has a bench seat option, seats have a higher weight limit, and it is cheaper (and qualifies for the 20% bbb coupons!). I am just hesitant pulling the trigger since they do not seem to have it in store yet?
STMs, what do you think of baby books? Like the kind you put milestones in or record stuff, not books about babies or that you read to the baby. Do you have one for your other children? Did you actually use it or just forget to touch it? If you filled it out did you ever look at it again or no? If you didn't have one for any kids do you wish you did? Or you don't miss it?
It just crossed my mind so I'm wondering. I know my mom had them for my brother and I, but I don't know that I've really looked at them ever. She might have looked at them though. I'm trying to decide if they are worth the time/money and special, or just a piece of clutter and something to make you feel guilty for not filling out. I can see this going both ways. For the record, DH and I are sentimental but not about physical things really. We haven't printed a single photo from our wedding or of us at any time ever. I save greeting cards we've given to each other though. IDK. Are baby books even a thing these days? Or are they going extinct?
@alice0218 - I did a digital baby book with my first, but didn't keep with it after about a year or so. I've jotted down milestones and saved them via word doc over the years, but don't actually keep physical baby books. My mom did with me and my sister.
G 12.04 | E 11.06 | D 11.08 | H 12.09 | R 11.14 | Expecting #6 2.16.18.
I've been wondering about nursing essentials. I know we've talked on the board about breast pumps, but I was curious what people felt were must haves for nursing?
@alice0218 my 4 oldest have old fashioned baby books. I'd say I kept up with then 75%. I think I'll do one for this baby as well, but maybe make my own instead of buying a fill in the blank book.
@gingermama26 the on't nursing essentials i remember really using is a boppy to help position baby to eat with and a good comfortable nursing bra. Other then that i wore normal clothes, ate regular food and didn't need nursing pads.
I've been wondering about nursing essentials. I know we've talked on the board about breast pumps, but I was curious what people felt were must haves for nursing?
Nursing tanks at first, nursing bras, nipple cream for first 3-4 weeks, nursing breast pads both reusable and disposable, boppy, breast pump. I loved having cardigans to wear over nursing tanks.
@gingermama26 a supply of snacks near where you are going to nurse. It never failed with DS1 and DS2 as soon as they would get a good latch I was hungry or thirsty. I always had granola bars and a full water bottle near where I nursed.
@alice0218 I wouldn’t keep up with a baby book if I tried, but I use IG a lot and so I did monthly milestone pics on there the first year along with all the other pictures of DS I took just as I normally would, and you can use Chatbooks to print little books periodically straight from IG including captions from your photos. By the end of his first year I basically had a natural baby book and I didn’t have any extra work to do for it! If you don’t do much social media sharing you can use Shutterfly or FreePrints and make photo books yourself, you’ll just have to record milestone info somewhere as you go if you want to keep track of that stuff.
@gingermama26 Nursing essentials the first go round for me were a nipple shield for the first few months (you can ask for one at the hospital but they don’t like to let you use them. I needed one because my nipples were already bleeding within the first couple hours of breastfeeding and it was too painful for me without it. But I was able to wean off the shield around 3 months) Also a water bottle always handy (nursing makes you ridiculously thirsty), snacks are good if you get stuck in your chair, nursing pads if you’re leaky like I was, shirts with easy boob access, bras or tanks with NO WIRE omg, and if you are lucky enough to be the queen of clogged ducts like me (oh and mastitis twice) heating pad and ice packs. For a heating pad I just put rice in an old sock and tied it up so I could pop it in the microwave and use it to massage the clogged ducts before nursing or pumping. It was a lifesaver for me. But I had issues lol. After my body finally adjusted (like 5 months in) all I really needed was boobs hahaha. It was the first few months that I needed lots of stuff to get through.
Married 6/1/13
BFP #1 7/2013 MMC 9/17/13
BFP #2 5/2014 MC 6/15/14
BFP #3 11/13/14 (Found in ER with ruptured cyst) Diagnosed MC 11/15/14
BFP #4 4/2015 MC 7/1/15
BFP #5 10/21/15 EDD 7/3/16 Praying for our rainbow!
gingermama26 - Nipple ointment, nursing pads and a nursing pillow are often typical nursing essentials to start with. And nursing tanks and/or bras (I use tanks). I used a nipple shield with my first. I added in other things depending on what the situation/issue was, like thrush and low supply. I've used many different galactagogues to boost supply, like nursing cookies, tinctures, fenugreek, and rented a hospital grade pump when I needed to increase it fast. I'll likely have to use galactagogues again since there's a good chance I'll only nurse from one side again. Other things, a good prenatal, lots of water and snacks. I really loved having coconut water on hand during the newborn period (it usually takes 6-8 weeks to really establish a good supply).
G 12.04 | E 11.06 | D 11.08 | H 12.09 | R 11.14 | Expecting #6 2.16.18.
@winnie1122 That's a good idea, thanks for the suggestion. I use IG already so I'll probably continue that and if I ever want to print chatbooks sounds good. I guess I've heard of services like that but never used them.
@alice0218 I have one for my first and im assuming I will have one for this baby too. I must admit that I suck at keeping up with it and sometimes I just filled in approximate dates! With that being said I'm not sure how much time I will actually have to fill It out so it might not happen!
Re: Do you have any questions for STM+(s)?
older siblings: ds 16 dd 14 ds 13 dd 11 dd 7
I think I will just have this bill sent back to billing for recoding, assuming that they've done it wrong, like I've done for every other bill so far (about $1100 worth of perfectly standard things for a normal pregnancy). And I will also talk to my OB to see if she can get it coded differently. And my insurance company to see what codes they want. You would think it would be covered as your standard preventative prenatal care, and I hope it turns out to be after I send it back to be recoded, but I've gotten bills for so many things that are preventative care. I think it might just be this hospital is bad at coding things in an insurance-friendly way. That is what I'm hoping, that in the end it will be closer to nothing, but I don't know that yet. I am glad to hear what your experiences were too! What an effing headache.
I had military insurance (Tricare Prime and Standard) during four of my pregnancies and didn't pay anything for prenatal care with my first two. I had dual care with the next three and paid OOP for my homebirth prenatal care and delivery.
We'll pay $1500 OOP for our deductible in this year. When the baby is delivered, it'll be another $2000 to meet the deductible and then co-pay of 15% for standard delivery. I spoke with my insurance company directly and they told me what the cost of labor/delivery/anesthesia etc would be. Also, with my first two sons, we set up a payment plan with the hospital instead of paying $4000 oop (my insurance was different when I had them). We paid $100/mo until the bill was paid in full.
my early ultrasounds through the RE were $350 we owed $160 each after the insurance adjusted rate this was a high deductible plan. I picked up my new employers insurance in Aug. the ultrasounds through my regular OB were billed at $260, insurance rate was $120 and insurance covered the entire thing.
all of my OB apts since Aug have been considered routine prenatal/preventative and paid by insurance.
if you call your insurance members services they should be able to give you a better idea of the price. I called them to see how much the genitive testing, with the code the doctors office would use to bill and they were able to tell me the adjusted rate, that it would go to my out network deductible, and my costed based on what my deductible and HRA were at that time.
older siblings: ds 16 dd 14 ds 13 dd 11 dd 7
So I think it comes down to - do you want to pay now or later?!
The easiest thing is to know your plan and if you get a bill that is high or doesnt seem right call the hospital or dr office and have them double check the coding. There are multiple ways to code everything.
Some people were able to gain coverage that they were previously unable to afford. It certainly did not get rid of high deductibles.
Most americans have insurance through their employer so the quality and cost is often based on the size of the company and the industry they are in.
my husband and I work for larger companies he is in IT, I have worked in pharma industry and now healthcare so we have alway been fortunate to have good insurance. We only paid $300 for son’s prenatal and delivery 2 years ago, this baby will be a little bit more than that.
However, a friend had her son had the same hospital a year ago and they owed $6500.
About ACA/obamacare - I think if something is preventative care, it's supposed to be covered 100% or close to it, including maternity or prenatal care especially. That was my understanding anyway. So I keep sending bills for things that are normal back to be recoded as something preventative like that. But I don't know what the codes are supposed to be so it's hard to know whether anything is correct, and we haven't actually received any bills back after sending them through this process yet. We have insurance through my husband's employer. I don't think it's a HDHP but it's not that great either and I don't think the deductible is actually low. It's also not a huge company. More than 50 people, but most are part time. Probably less than 500 people, less than 100 on insurance and it's a pretty new company, like maybe 7 years old so they don't have things other companies I've worked for have like HSA, FSA, 401K isn't set up, etc. It makes me miss when I was a retail manager and had insurance with Gap, Inc. That was so great. I never paid for anything but premiums. Even when I had to go to the emergency room, they sent me a reimbursement check for the copay! But of course it doesn't help to think of that, I don't have that insurance now.
I just had a call from my doctor scheduling another 3 ultrasounds to monitor possible risks and plus the normal growth ones. And that isn't even through the end of pregnancy. I'm really hoping they don't all cost $300+! But hearing some of your experiences, it sounds like it's definitely possible. Crossing my fingers for the best!
older siblings: ds 16 dd 14 ds 13 dd 11 dd 7
TTC #1 since April 2015
RE Dx: Fibroids, surgery Jan 2016
IUI #1 and #2, Nov/Dec 2016, BFN
IVF March 2017: ER - 5R/3M/3F, 1 PGS normal
Polyp removed May 2017
FET May 2017 - BFP!
Baby boy born 2/2/18
It just crossed my mind so I'm wondering. I know my mom had them for my brother and I, but I don't know that I've really looked at them ever. She might have looked at them though. I'm trying to decide if they are worth the time/money and special, or just a piece of clutter and something to make you feel guilty for not filling out. I can see this going both ways. For the record, DH and I are sentimental but not about physical things really. We haven't printed a single photo from our wedding or of us at any time ever. I save greeting cards we've given to each other though. IDK. Are baby books even a thing these days? Or are they going extinct?
@gingermama26 the on't nursing essentials i remember really using is a boppy to help position baby to eat with and a good comfortable nursing bra. Other then that i wore normal clothes, ate regular food and didn't need nursing pads.
older siblings: ds 16 dd 14 ds 13 dd 11 dd 7
@gingermama26 Nursing essentials the first go round for me were a nipple shield for the first few months (you can ask for one at the hospital but they don’t like to let you use them. I needed one because my nipples were already bleeding within the first couple hours of breastfeeding and it was too painful for me without it. But I was able to wean off the shield around 3 months) Also a water bottle always handy (nursing makes you ridiculously thirsty), snacks are good if you get stuck in your chair, nursing pads if you’re leaky like I was, shirts with easy boob access, bras or tanks with NO WIRE omg, and if you are lucky enough to be the queen of clogged ducts like me (oh and mastitis twice) heating pad and ice packs. For a heating pad I just put rice in an old sock and tied it up so I could pop it in the microwave and use it to massage the clogged ducts before nursing or pumping. It was a lifesaver for me. But I had issues lol. After my body finally adjusted (like 5 months in) all I really needed was boobs hahaha. It was the first few months that I needed lots of stuff to get through.
With that being said I'm not sure how much time I will actually have to fill It out so it might not happen!