May 2020 Moms

Randoms Dec 9-15

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Re: Randoms Dec 9-15

  • @catem07 My husband's work does not offer insurance, so that has never been an option.  So it's my work plans or ones on the marketplace for any/all of us.  My other concern is that if I go back to work and it's only part time my company does not offer insurance to part time employees.
  • @catem07 I don't know how your insurance is. But I am fully expecting to pay around $1500-$2000 for delivery/hospital stay (for myself and the baby's bills). I think the cost can vary a lot depending on each persons insurance plan.

    While my prenatal office visits are covered 100%, any kind of testing is not and usually falls under my co-pay. The anatomy scan will be my deductible/coinsurance. I am seeing an endocrinologist as well, so every blood draw (every 6 weeks) is a co-pay for me as well as the appointments (once per trimester). If I get GD that isn't covered under "prenatal" and will be a co-pay for each appointment and blood draw.
    _______________________________________________
    TTC#1 July 2015 
    • BFP: 9/16/15 — MC: 11/8/15 Blighted Ovum
    • BFP: 3/10/16 — Baby Girl born 11/20/16
    TTC#2 April 2019 
    • BFP: 9/12/19 — EDD 5/15/20

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  • @m6agua I wish I had your insurance!  I'm looking at $6000 for me for labor/delivery/hospital plus whatever the separate bills are generated for the baby!
  • Oh the subject of delivery costs. My hospital has since changed it’s payment requirements since I had DS2 in 2015. We have to pay our calculated delivery costs before 24 weeks. It worked out to be $1355. We’ve been making payments since September and the final payment will be next month. I’m sure there will be some kind of incurred costs at the hospital (meals, parking, etc) but with my deductible met, we shouldn’t get any bills for delivery itself.
  • My sister and I were just talking yesterday about the cost of having a baby. I’m not 100% sure but I think it’ll be about $2500 for us. Guess now is a good time to find out. 
    @pirateduck I would definitely recommend hunkering down and figuring out IF you would get a better deal on the marketplace. I think I’m general, employer sponsored plans are better but if you work for a very small company (like me) you might be better off on the market place. But definitely do a deep dive to find out the actual cost of things and see if you would save any by going to the market place now. I know it’s a pain to switch insurances but if it’s a better deal financially, then just stick with your work insurance until you figure out if you’re going back to work. Oh also, from a HR standpoint, DO NOT tell your employer that you might not be back after baby! As far as they are concerned, they should think you are definitely coming back. Otherwise you might lose out on benefits that you have earned. 
  • pirateduckpirateduck member
    edited December 2019
    I just assume I would hit whatever my annual out of pocket maximum is on any insurance plan by the time I give birth and spend a night in the hospital.

    If any STMs have experience where it was less than that, please chime in.

  • @pirateduck It really depends on what your insurance covers as far as maternity care. My office visits and ultrasounds are covered. Bloodwork and urology is only covered at a percentage so I’ve already racked up a few of those bills. My delivery costs are covered almost completely, it somehow worked out to $1355 but I don’t remember the exact breakdown. Even if I needed an emergency CS or other care, it wouldn’t add to my current bill because our deductible will be met. Our maternity care is awesome though! 
  • edited December 2019
    @pirateduck Actually, it will likely be more.  As soon as the baby is born, they're an additional participant on your health insurance plan, and they will begin to bill to their deductible.  I was billed something like $1600 for my delivery and that made me hit my max out of pocket so I thought I was done.  Then, in August (9 months after DS was born) I got another bill for $1400.  I called and was like "WTF?" because 1) it was 9 months after he was born and 2) I had already hit my max out of pocket for that year. They told me they have up to a year to bill me, and that I may have hit my max out of pocket, but DS had not, so this was for HIS portion of the hospital care.  So, for example, my max out of pocket is $2k per person on my plan, so I plan on hitting $4k next year for me and the baby.  I love health insurance...   :s

    ETA grammar
    **TW**
    Me: 35 | H: 40
    Married Sept. 2013
    DS1: Nov 11, 2016 <3
    MMC: 11/16/18 (9w6d)
    CP: 2/3/19 (5w3d)
    BFP!  8/24/19
    DS2: May 10, 2020 <3


  • @shamrocandroll that helps immensely, I was asking my insurance rep this very thing just last week and she didn't know off the top of her head...  I asked if I was working towards my out of pocket max or if it's actually double since now there is a new person.  The out of pocket max for two is $12,000.  Ugh.
  • @shamrocandroll "but DS did not reach his max out of pocket"... WTF! That's infuriating. I'm livid for you. Insurance is truly the worst. 
    Me: 28  DH: 29
    FTM
    BFP 08/25/19, EDD 05/04/20
  • m6aguam6agua member
    edited December 2019
    @pirateduck I never hit my out of pocket max until birth and I have a fairly low max and a low deductible. Most plans I *think* are required to have prenatal appointments covered at 100%. It really depends on each insurance and how things are billed I guess.

    For my plan I have my deductible which is X, we have 3 people on our plan and the max deductible X(2). Then after I reach my own deductible(X), I would pay my coinsurance, which is 10% and a max of Y per individual. So the plans out of pocket max is Y(2). Then my plan also has co-pays that are pretty cheap, but my max for co-pays is something ridiculous that I will never ever reach. So basically the maximum I would spend in a year would be X+X+Y+Y+co-pays. Almost everything in my pregnancy falls under the covered prenatal care or a co-pay, the only thing that I know goes toward my deductible/coinsurance is the anatomy scan, which is this year and I've already met my deductible. So next year I probably will not meet my deductible until the birth, unless something ends up being wrong and I need a lot of extra monitoring.

    My last pregnancy was all in one year, so I had met my deductible (X) from the anatomy scan and some other stuff. Then I believe (I don't completely remember) I met my out of pocket max (Y) at the birth, my plan also has a $150 co-pay for any hospital stay. Plus I had all the co-pays from GD and labs and in office ultrasounds. Also because DD was born in that plan year I believe she met her deductible for birth and maybe had a few other expenses. We did 2 tongue tie revisions so those went towards Y for her. So basically I spent X+Y+150+co-pays+X+some of Y.
    If you want to know actually amounts feel free to PM me, I just don't want to post everything here. Maybe if we do some sort of financial thread later on.
    _______________________________________________
    TTC#1 July 2015 
    • BFP: 9/16/15 — MC: 11/8/15 Blighted Ovum
    • BFP: 3/10/16 — Baby Girl born 11/20/16
    TTC#2 April 2019 
    • BFP: 9/12/19 — EDD 5/15/20

  • @pirateduck Ugh, that's awful!  We have a new plan called a health savings plan where I can put a bunch of money (I think up to $7k) into a health savings plan pre-tax and then use that to pay my deductibles.  The max out of pocket is $4k for everyone on the plan, and the downside to this plan is just one person could hit that, whereas with my old plan each person would max at $2k.  So when it was just me and DS on it, it wouldn't have made sense because our max out of pocket was $2k per person, but with the baby going on my plan and a delivery bill, it made sense to go with this plan because we'll hit max OOP for both of us no matter what, and this way we will max out at $4k instead of being able to go up to the OOP max of $6k on the old plan if DS1 has any expenses.  So far, he's averaging one ER visit per year, so I opted for the $4k max plan for 2020.  But it really can be such a gamble if you don't know what your healthcare needs are going to be!  
    **TW**
    Me: 35 | H: 40
    Married Sept. 2013
    DS1: Nov 11, 2016 <3
    MMC: 11/16/18 (9w6d)
    CP: 2/3/19 (5w3d)
    BFP!  8/24/19
    DS2: May 10, 2020 <3


  • Ooo, @shamrocandroll your last post made me think of something else.

    Even if you really haven't use your insurance plans much in the past, plan on really using it in the next 3+ years. So many things happen with a LO while they are growing up, you end up sick more often too. Last year with job changes we unfortunately had 4 different insurance plans through the year. :'(:o DD ended up in the ER twice that year and countless appointments for possible ear infections and other things. I also ended up with Postpartum thyroiditis and needed extra care for the year after birth.
    _______________________________________________
    TTC#1 July 2015 
    • BFP: 9/16/15 — MC: 11/8/15 Blighted Ovum
    • BFP: 3/10/16 — Baby Girl born 11/20/16
    TTC#2 April 2019 
    • BFP: 9/12/19 — EDD 5/15/20

  • I'll also say it does not always make sense to have the whole family on one plan.  My work recently made it so that an employee+family plan (including spouse) is about 2x more expensive than just an employee + child(ren) plan.  We are employee owned and privately insured, so it's an attempt to cut our medical expenses for people whose spouses have insurance available through their own work.  This year, MH's company (a very large worldwide company) did the same thing.  I'm also seeing lots of companies push their employees toward "consumer driven plans" with high deductibles and low premiums, versus the open access plans, which are more expensive for companies to pay for.  So apparently health insurance will not be getting any better for us here in the US for a while.  :confused:
    **TW**
    Me: 35 | H: 40
    Married Sept. 2013
    DS1: Nov 11, 2016 <3
    MMC: 11/16/18 (9w6d)
    CP: 2/3/19 (5w3d)
    BFP!  8/24/19
    DS2: May 10, 2020 <3


  • @shamrocandroll you have just described my situation exactly...  our company has always made it cheap for the employee only on monthly premiums, but to add a spouse is cost prohibitive (literally 5 times the premium for employee only), low low premiums and extremely high deductibles and out of pocket maximums.  So if you don't have a lot of medical expenses (or a spouse/family to add) it's cheap, but as soon as you have medical expenses or a family the costs add up fast.  Ugh.  The whole system is so broken.
  • catem07catem07 member
    edited December 2019
    My in-network OOP max is $3,000. I'm expecting to spend that on delivery. I have no idea what baby's hospital bill will be...We have pretty good insurance but it's not as good as what I had with my daughter, for whose birth I never got a single bill. 
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • @pirateduck is employee + child more affordable than employee + spouse/family? 
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • @catem07 in 2019 it was either employee only or employee plus family (whether that be spouse or unlimited kids) and those were the only options.  For 2020 there is another tier of pricing so we have employee only, employee plus one (child or spouse), or employee + family (multiple people).  However, the real problem is the out of pocket max on all plans is $6000 per individual (in network) and $12,000 per family.  My husband has never had insurance in the 10+ years we have been together :( and we fall through a loophole where he cannot get it through the marketplace.  If he has medical bills we just pay them out of pocket. 
  • Again, the monthly premiums are not bad, I think I pay $110 a month for myself.  It's the deductibles/maximums that are hard to swallow.  
  • @pirateduck It’s kind of one or the other these days. Our out of pocket deductible is super low, however, we pay $500 a month for the family plan. 
  • Re: insurance: H and I work for two different school districts. His district covers him 100%, but to add any dependents on (me or any children) would be outrageously expensive (like $700/month per additional person). My district covers me 100% and only takes an additional $100/month for each dependent. We both have Kaiser plans, but H's is through his district and mine and DD's are through my district because it's wayyyyyy cheaper. This new baby will also be added to my plan.

    This is also the reason we can't even consider the possibility of me becoming a SAHM, unless H changes districts. For all the things I hate about my district, my insurance plan is amazing. I don't pay anything OOP for regular office visits and only a negligible copay for the major ultrasounds. With DD's birth, delivery + one night in the hospital cost a grand total of $250 OOP. I know that's far from being the case for everyone, and I don't envy those of you who have to have back and forth fights with your insurance for everything. I do appreciate the fact that Kaiser is both a care provider and an insurer, since they are ultimately on the hook for any future medical care that is needed if they don't cover something initially.
  • @soprano19 I have the same sentiments about Kaiser. DH is actually switching from his Districts plan to my University plan because it’s $0 for both of us. Once baby comes it’ll be $35/month for a family of three. Unheard of. 

    It just makes me so upset that insurance is sooo different within and between plans just because of the employer. I don’t think any of us should have to potentially go into debt to give birth to our child. But that’s a whole other conversation...
    Me: 28  DH: 29
    FTM
    BFP 08/25/19, EDD 05/04/20
  • @catem07 so width wise we've been sleeping in a king all along and didn't know it?! My life is a lie. It FEELS smaller though.
  • @lisush it’s true. But twins are sooo short no wonder it feels small. 
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • Wow, American health insurance is so interesting! And confusing 😆 Sounds like some of you pay a lot!




    BabyFruit Ticker
  • So it sounds like after birth that you may be too sensitive for TP and a bottle sprayer or bidet is in order.  Does anyone know if the diaper sprayer attachment on the toilet is adequate?  I think it can also be used like a bidet but wasn’t totally sure and wondered if anyone had experience with these? 
  • @pirateduck I just used the plastic bottle the hospital sent me home with. You're going to want warm water and I don't know that a diaper sprayer would do that? 
  • @pirateduck They'll give you a peri bottle at the hospital. But I'm going to try this one this time https://fridababy.com/products/upside-down-peri-bottle
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • rox7777rox7777 member
    edited December 2019
    @pirateduck Absolute no to the diaper sprayer. I know ours sprays like a fire hose and that would hurt. If you have stitches you’ll want warm, light pressure which is why they give you the peri bottle. I switched to flushable wipes around 3-4 days and was fine even with the stitches. If you end up with a CS, you don’t need anything fancy, but the wipes are still nice because you still bleed and it gets messy. 

    ETA: We lived overseas with DS1 and had a bidet. It would have still be too much. Super light spray. Think dripping faucet versus fully turned on. 
  • +1 for peri bottle.  You'll fill with warm water and point from front to back and lightly spray.  Then you'll lightly dab (not wipe) with a wad of soft TP.  The one the hospital gave me was more than adequate, but it would have been nice to have more than one so I could keep one in my bag in case I was out (like, at the doctor's office, not out on the town :lol:).  I kept it from last time so this time I'll have two.  
    **TW**
    Me: 35 | H: 40
    Married Sept. 2013
    DS1: Nov 11, 2016 <3
    MMC: 11/16/18 (9w6d)
    CP: 2/3/19 (5w3d)
    BFP!  8/24/19
    DS2: May 10, 2020 <3


  • I echo all the sentiments about the peri bottle. I kept mine from last time too and have been thinking of getting the Frida one too.
    _______________________________________________
    TTC#1 July 2015 
    • BFP: 9/16/15 — MC: 11/8/15 Blighted Ovum
    • BFP: 3/10/16 — Baby Girl born 11/20/16
    TTC#2 April 2019 
    • BFP: 9/12/19 — EDD 5/15/20

  • Also, I had 3rd degree tearing and physically couldn't crouch down to get in and out of the regular tub to do sitz baths, so my angel nurse gave me one that fits on top of the toilet.  It was a little slice of heaven for my poor destroyed lady parts.  

    It was just like this one
    **TW**
    Me: 35 | H: 40
    Married Sept. 2013
    DS1: Nov 11, 2016 <3
    MMC: 11/16/18 (9w6d)
    CP: 2/3/19 (5w3d)
    BFP!  8/24/19
    DS2: May 10, 2020 <3


  • @shamrocandroll I had the toilet one too. Felt so weird but also so good. 
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • They sell the regular peri bottles super cheap on amazon too- if you have multiple levels on your house I would definitely recommend 2.
  • @rox7777 that was exactly what I needed to know, before learning a potentially painful lesson!  I don't have the sprayer installed yet (and am a FTM) and didn't know how forceful it would be and if that would be bad!  

    I did add this kit to my registry recently because people spoke so highly of the Fridet but I thought friends/family might feel awkward buying one...

    https://www.target.com/p/fridababy-bitty-bundle-of-joy/-/A-50729283


  • @pirateduck As a STM, my registry is basically just a reminder list of things I want to buy...I think a FTM registry can be a mixture of both! No one might buy that for you, but keeping it on there reminds you to get it. 
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • @rox7777 I feel like those who think they didn't poop while delivering a baby just simply weren't told they pooped while delivering a baby.  I was never told I pooped, but I'm 90% sure I saw the nurse quickly dispose of something that came out prior to DS.  It was very discreet and at that point, it was far from the most horrifying thing going on for me.  :lol:  
    **TW**
    Me: 35 | H: 40
    Married Sept. 2013
    DS1: Nov 11, 2016 <3
    MMC: 11/16/18 (9w6d)
    CP: 2/3/19 (5w3d)
    BFP!  8/24/19
    DS2: May 10, 2020 <3


  • @shamrocandroll I know I pooped. I gave no shits - pun intended.
  • @shamrocandroll I didn’t know until about a year ago when MH decided to finally inform me 5 years later that I did indeed poop. So thanks for that dude.
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