Health coverage once you become PG

[geek96]

I am bored and just received our updated benefits plan for 2012. What does your insurance cover and what do you have to pay OOP for prenatal and postnatal care?

DH's plan just went from good to awesome. For 2012 it was regular copay $30 for all doctor visits and $800 for vaginal delivery or $1200 for c-section. In 2013 it is still $30/visit but now the birth is $30 as well.

[blindyswife]

All of my prenatal visits cost me $0.

I don't know the details of our coverage because its been awhile since I've looked, but when L was born, I wanna say we had to pay $4000-5000 after insurance paid their portion. I could be off by a bit because its been awhile. That included a c-section and two day nicu stay.

[mrssandro]

I have a HSA and I have a $1250 deductible that needs to be paid in full. My midwife likes to have a $500 deposit and then I can pay slowly on the balance up to 32 weeks. One the deductible is paid then I am 100% covered. It's not bad at all.

[geek96]

Dec 5, 2012 10:21:25 GMT -5 swizzlestx said:

$0.

We have a $2k deductible, but our employer puts that $2k in an HRA that just reimburses you. So I pay the deductible costs OOP, getting reimbursed, and then after the $2k nothing.

FWIW, I work at a non-profit and we're not highly compensated so our benefits certainly help!

That is awesome and here I thought we had great insurance.

[tarheels]

$0.

DH is a fed. (A certain kind, not all have this plan, before you curse the government lol.). Sooo I guess we're responsible for the deficit and fiscal cliff. But all of DH's coworkers agree that the insurance is too generous, if there is such a thing. I mean, we don't pay for anything. Ever. Congress could give us co-pays; we'd be totally ok with that. If your employer goes bankrupt to give you benefits, well, then you're out of a job and benefits and that seems pretty counterproductive.

[lauree1183]

DH's work healthcare went from good this year to crappy next year so I switched over to my workplaces health insurance. I pay half of my health premium each month (around $150) and then have a $2300 deductible, but then 100% is covered. DH's plan with me on it would have been around the same cost, but only 80% covered after the deductible.

[mandapanda18]

$0 - I work for a State University (non-profit) and like a PP mentioned, the pay stinks but the benefits are through CALpers and they are AWESOME! I had to pay my $15 co-pay at the first pre-natal apt and then $0 after that, but my H is also covered by a separate insurance, so they pick up the $15 and the $250 I would have had to pay for delivery ;D

[magpie]

We are very lucky to get great insurance through DH's work. $10 copay for all prenatal visits and free delivery.

[geek96]

I work for a college as well. You are definitely right about the sucky pay and good benefits although they starting taking 3.5% out of every check for medical this year. I opt out because DH's union doesn't take money out for medical and they give me 2k a year for not taking insurance.

[awick14]

I live in Canada so for the not part it will be $0. Unless I opt for the extras. (Private hospital room, finding out the sex etc)

[Cheesecake]

I live in Europe, so for me it will be 0. We have an annual co-pay nowadays, which sucks, I think it's going to be 350 for the entire year, GP visits and stuff I bought some extra insurance for (extended doula time and such) are excluded from co-pay and will always be 0.
With my regular kidney checkups and meds I'll reach the 350 max in January, and everything after that is free.

[blindyswife]

Good grief I am jealous of those of you who don't live in the states! Awesome coverage.

[winecheery]

I know we have a co-pay of like $15-30. First post natal is free I believe. Not sure on labor and delivery, DH knows. Not worried.

[G22]

Pretty sure $0. H is military, and most everything is covered.

[ilovecandy]

H is military like previous poster and i think all we pay is for room charge which is around 20 a night depending of course on the hospital.

[vmars]

Husband works for the state so it's free except for the first copay of $15.

[countthestars]

Only OOP costs are for ultrasounds, I believe plus I have a $1,000 deductible for my portion of the hospital stay. No deductible for baby. My plan resets in May so I expect to pay somewhere between $1k and $2k.

[IndiaInk]

My DH's company insurance is awesome esp in terms of prenatal/postnatal coverage. We normally have a $20 copay but its waived for all prenatal and postnatal visits. Everything is free with no deductible. I had an emergency ultrasound and ER visit with one of my miscarriages and the hospital bill was over $2000. We only paid $70 out of pocket for that. I am incredibly thankful for our benefits.

[tarheels]

Dec 6, 2012 10:06:46 GMT -5 blindyswife said:

Good grief I am jealous of those of you who don't live in the states! Awesome coverage.

They all pay 30-50% taxes. It's a trade-off that the vast majority of Americans are unwilling to make. Most Americans cannot conceive of giving HALF of what they earn to the government.

In today's American dollars, if you made just $45k in Belgium or $41k in Ireland, you'd have to give 50% in taxes. If you make $70k in the Netherlands, you have to give 52%. In Denmark, $71k is taxed at 55%. finance.yahoo.com/blogs/daily-ticker/tax-rates-u-highest-world-183946787.html

And those are all itty bitty countries, too. It's not like they have the vast infrastructure or the massive population that we do. I really kinda wonder what they do with all that tax income...free everything for everybody? Must be.

[jewel]

Under my coverage, all prenatal visits have a $5 copay, which includes any treatment or testing (ultrasounds, blood work, etc.). Any inpatient care or hospitalization is completely covered, no copay. I should end up with less than $100 out of pocket, and that is paid tax-free because I use an FSA.

All the money I'm about to spend on fertility testing, possible treatment, and acupuncture (and expensive lube and Pom juice).....that's another story.

[blindyswife]

Dec 6, 2012 13:55:32 GMT -5 tarheels said:

Dec 6, 2012 10:06:46 GMT -5 blindyswife said:

Good grief I am jealous of those of you who don't live in the states! Awesome coverage.

They all pay 30-50% taxes. It's a trade-off that the vast majority of Americans are unwilling to make. Most Americans cannot conceive of giving HALF of what they earn to the government.

In today's American dollars, if you made just $45k in Belgium or $41k in Ireland, you'd have to give 50% in taxes. If you make $70k in the Netherlands, you have to give 52%. In Denmark, $71k is taxed at 55%. finance.yahoo.com/blogs/daily-ticker/tax-rates-u-highest-world-183946787.html

And those are all itty bitty countries, too. It's not like they have the vast infrastructure or the massive population that we do. I really kinda wonder what they do with all that tax income...free everything for everybody? Must be.

I'm kind of a dirty socialist, though, so that all sounds ok too me!

[Cheesecake]

Tarheels, that's not completely true. yes, we have a 52% scale, but that's over everything you make above about $70K, what's below that is taxed lower. You pass through several brackets. At the same time you can also deduct your entire mortgage interest you pay from the highest tax bracket, and the largest portion of what you have to pay goes to unemployment, retirement, disability and health benefits. The actual taxes you pay, especially over the lower brackets, aren't all that high.

If you actually calculate it all, everyone (single person, not family income) who makes up to 200-250K a year is better off financially with the 'super high taxes'. Especially when you take into consideration that the local taxes/real estate taxes and stuff are way lower. My dad's home has the same taxed value as mine, he's in CO, I'm in NL, he pays slightly more per month than I pay for an entire year. My income taxes might be higher, but that pays for all schools, roads, police, fire brigade etcetera etcetera.

It's true that people in the US would never go for that though. I would personally prefer something kinda in between, I wouldn't feel safe/secure in the US system anymore, but the taxes indeed sure are high.

[blindyswife]

Dec 6, 2012 16:14:01 GMT -5 Cheesecake said:

Tarheels, that's not completely true. yes, we have a 52% scale, but that's over everything you make above about $70K, what's below that is taxed lower. You pass through several brackets. At the same time you can also deduct your entire mortgage interest you pay from the highest tax bracket, and the largest portion of what you have to pay goes to unemployment, retirement, disability and health benefits. The actual taxes you pay, especially over the lower brackets, aren't all that high.

If you actually calculate it all, everyone (single person, not family income) who makes up to 200-250K a year is better off financially with the 'super high taxes'. Especially when you take into consideration that the local taxes/real estate taxes and stuff are way lower. My dad's home has the same taxed value as mine, he's in CO, I'm in NL, he pays slightly more per month than I pay for an entire year. My income taxes might be higher, but that pays for all schools, roads, police, fire brigade etcetera etcetera.

It's true that people in the US would never go for that though. I would personally prefer something kinda in between, I wouldn't feel safe/secure in the US system anymore, but the taxes indeed sure are high.

May I move in with you and become a citizen there?

[Cheesecake]

Sure! Come on over!!

Sent from my phone, please disregard typos

[ilikedonuts]

We pay our per person deductible $500 and then 20% of the rest of L&D. Everything else is fully covered. I had like 15 ultrasounds (including an NT), lots of betas, weekly NST from 32-40 weeks, 3-4 L&D visits.

I think with DD my L&D portion was like $1000 maybe?

If you pay anything towards your deductible in October-December, it carries over to the next year too. So my deductible was met for last year and this year because DD was born in October last year.