insurance/babies question

EIHRHM · March 2011

I seen a friend of mine who said that she has good size bill that the insurance didnt cover when she had her son. She said that she called vassar and the insurance company and they both agreed that they would cover her there, but it was still more then what they thought it would be.

i dont know if its because she had a c section or why it would be more then what she was told, but she said that it was over $1000 but didnt tell me the exact amount and i didnt ask her to go into that much of a detail.

did you call insurance company to see what your "co pay" would be? was it the same as they told you?

Jen&Louie · March 2011

I asked a lot of questions about the cost of hospitalization initially and then more once we found out I'd need a c-section so, I knew exactly what to expect and, yes, the bill matched what I was told. There are separate charges for the mother and the baby. Maybe that was unexpected for her?

mrsredmoose · March 2011

I don't have a definite answer, but anesthesia $ issues often arise during surgeries. I had foot surgery, which was 100% covered by my insurance, but the anesthesiologist did not accept my insurance and I received a bill over $1500. I had called to check before and was told I was 100% covered for the entire surgery and post visits (Ultimately, I did not have to pay b/c the office knew I asked in advance). I've heard about this happening to other people. Maybe that happened to your friend?

Augustbride · March 2011

Right now I don't know what my cost will be however I am aware of what is covered and the % of copay I will need to pay. I agree sometimes you have to fight with your Insurance. For example you have no control over what Doctor you get in the ER so it's possible that your Doctor does not agree to the lower amount your insurance company has negotiated with the hospital. It is not your responsibility to cover the difference it's your insurance companies. This can happen with Pediatric on call doctors and anesthesiologists. So maybe she should comb the bills and see if they are different from the paper the insurance company sends to tell you what they cover. If you see an issue you call the insurance company. Health care coverage is so frustrating sometimes.

ELF4321 · March 2011

Anesthesiologists almost never participate in insurance companies, so even if the hospital and other doctors are covered, you usually have to pay a boatload of $ out of pocket for anesthesia. Also, our insurance only covers 90% of allowable charges, even with participating docs and hospitals, so I imagine with a surgery, we'd still be paying over $1000 out of pocket, easily.

ssage · March 2011

I will be honest in saying I never checked into the cost before the baby. But, I am very happy to say that the entire cost of her birth (both my bill and hers) was 100% covered. And, I had a c-section. I think mine was $17K total and hers was $4k.

navybride06 · March 2011

We knew. We wound up paying less than 1000$ out of pocket for a c-section and 5 night stay.

We also dealt with the pleasure of our insurance being dropped from the Hospital 2 months prior to birth but getting grandfathered in. The PITA was receiving checks from insurance I then mailed to hospital for months afterwards.

We have Blue Cross and GHI through NYC, I had no insurance through my job since NYC only allows you have to have 1 covered NYC employee and I never planned on staying in the city too long to care.

LilacStar11 · March 2011

My husband was laid off and we lost our insurance in the 7th month of my pregnancy so I cant help you with definite numbers. What I can tell you is that when I did call in my first trimester to find out cost and everything, they gave me a number but told me it could vary depending on treatment either I or the baby would need.

The next baby we have, I will make sure to save a good amount over what the insurance co quotes me because it seems that a lot of people get bills that they did not know they would get. HTH

Nikosmom · March 2011

ssage:
I will be honest in saying I never checked into the cost before the baby.

This. The only bill I received was for the baby. We used the hospital pediatrician and some stuff wasn't covered. Only about $250-depends on your insurance.

lisa5ny · March 2011

Once you are PG and you know where you will be delivering you can call your insureance company and find out exactly what will be covered and what you will have to pay out of pocket.

Luckily our insurance covered everything!

cloey615 · March 2011

The big thing with my insurance was that we were pre-authorized for my delivery. My OB handled my delivery pre-authorization. Due to the fact that Kevin went into the NICU, I called the insurance while I was in the hospital and got the pre-authorization for that. It's good that I did, b/c his stay alone was $16K. I am covered for everything and was told early in my pregnancy that I would have to pay copays for doctors like the anesthesiologist. We also had to pay a co-pay to my OB for Kevin's circumscision and to radiological services for an ultrasound. And those were things I never really accounted for.

jesspacatc · March 2011

I had to pay my inpatient co-pay which was $500 (ended up paying 450 because the hospital I delivered at made a deal that if you paid within 60 days of billing, they cut off 10%). It really depends on the insurance. All my pre-and-post delivery co pays were included in a "global fee" from my insurance company. I needed a surprise C-section, but my bill wouldn't have been different if I had SVD.

The thing that most people don't remember is that if you are adding a child under your health insurance plan, they have to meet that deductible for the year (so if you have a kid in the beginning of December, they still have the same deductible as if they were born January 2nd).

insurance/babies question

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