I have another insurance question

[Deleted]

Just in regards to delivery: a plan that has pregnancy coverage of $600 per day is better than a plan that I'm responsible for 20% right?

Because 20% of 25,000 (pretty sure thats about what Ds birth cost) is $5000 and I would have to stay more than 8 days to rack up $5000 at $600 per day.

Neither has a deductible and they have the same out of pocket max and the same monthly premium.

[shevacc]

I'm confused with how you initially phrased it, but how you explained it the $600/day sounds better. I'm assuming you mean pregnancy coverage with a deductible (or copay) of $600/day rather than all they cover is $600/day. FWIW, I only stayed in the hospital one night for a non-medicated vaginal birth with no complications and it still cost something like $8-9K. So $1600-1800 would be 20% versus only $600.

[christidee]

Is there am out of pocket maximum? I pay 20 percent, but it has a 1,500 maximum that I pay. That might be worth looking into.

[Deleted]

Dec 2, 2013 17:36:19 GMT -5 shevacc said:

I'm confused with how you initially phrased it, but how you explained it the $600/day sounds better. I'm assuming you mean pregnancy coverage with a deductible (or copay) of $600/day rather than all they cover is $600/day. FWIW, I only stayed in the hospital one night for a non-medicated vaginal birth with no complications and it still cost something like $8-9K. So $1600-1800 would be 20% versus only $600.

Ya sorry I explained it wrong.
I think Ds was a lot because I was in labor for 2.5 days, induced and epi, nicu team in the room, Etc. hopefully this time goes much smoother!!

[Deleted]

Dec 2, 2013 17:38:45 GMT -5 christidee said:

Is there am out of pocket maximum? I pay 20 percent, but it has a 1,500 maximum that I pay. That might be worth looking into.

Ya there is and it's a lot more than that! These are plans through the ACA and they are all very similar to each other so there's not much wiggle room, but some.

[laurack]

So you pay only $600 per day no matter what or you pay 20 percent of everything? Yes I'd choose $600 per day because the day of the delivery could be thousands or tens of thousands if things get complicated etc.?

If all is normal you will be out 2 days at $600 a day.

[shevacc]

Dec 2, 2013 17:39:19 GMT -5 ladybug said:

Dec 2, 2013 17:36:19 GMT -5 shevacc said:

I'm confused with how you initially phrased it, but how you explained it the $600/day sounds better. I'm assuming you mean pregnancy coverage with a deductible (or copay) of $600/day rather than all they cover is $600/day. FWIW, I only stayed in the hospital one night for a non-medicated vaginal birth with no complications and it still cost something like $8-9K. So $1600-1800 would be 20% versus only $600.

Ya sorry I explained it wrong.
I think Ds was a lot because I was in labor for 2.5 days, induced and epi, nicu team in the room, Etc. hopefully this time goes much smoother!!

I wouldn't mind exactly the same labor, but I hope yours goes much quicker (and less stressfully!) the 2nd time around! I still have no idea how they charged sooooo much for mine.

[Deleted]

E's delivery was over 55 thousand! So I'd say that 600 a day is way cheaper.

[sunshineluv]

But does the 600 a day include all the pre labor visits? When I got my hospital bill it was for the hospital and all the other office visits? So if that is separate would you have to pay a percentage of that and 600 a day? What is the difference in premiums for the two plans?

[Deleted]

Dec 2, 2013 18:16:22 GMT -5 sunshineluv said:

But does the 600 a day include all the pre labor visits? When I got my hospital bill it was for the hospital and all the other office visits? So if that is separate would you have to pay a percentage of that and 600 a day? What is the difference in premiums for the two plans?

There is no copay/fee for "pre and post natal visits"

The premiums are like $4 different.

There is another plan that's $130 less per month but I'd be responsible for 30 or 40%- that's so much!!!

[kkfeb04]

You are forgetting an important factor.... contracted rate. It's always different than the amount charged. My insurance paid $7K of the billed $87k combined for Katelyn and I. I paid $0, I met my $250 OOP max. That was c-section, 6 overnights for her, 4 overnights for me (I was able to stay without being billed those 2 days), NICU, etc.

So you should be looking at your OOP max. Unfortunately, you can't find contracted rates because it varies by company and plan.

[Deleted]

Dec 2, 2013 19:13:45 GMT -5 kkfeb04 said:

You are forgetting an important factor.... contracted rate. It's always different than the amount charged. My insurance paid $7K of the billed $87k combined for Katelyn and I. I paid $0, I met my $250 OOP max. That was c-section, 6 overnights for her, 4 overnights for me (I was able to stay without being billed those 2 days), NICU, etc.

So you should be looking at your OOP max. Unfortunately, you can't find contracted rates because it varies by company and plan.

True but I am going with the same dr and hospital as D and same insurance company but different plans obviously so I'm kind of just assuming it will be similar? Ugh I hate this! Too many choices and all expensive anyway!

[puppylove64]

Are you sure they don't pay $600/ day max? I've heard of those plans often!

[jaime183]

Also is that just for the hospital stay or the hospital stay plus all the care? They bill everything as separate codes so it falls under different categories.

Mine didn't seem expensive until I added up all the parts- my midwife, my epi, my l&d, my post partum stay, the testing, etc

[Deleted]

Dec 3, 2013 0:42:37 GMT -5 jaime183 said:

Also is that just for the hospital stay or the hospital stay plus all the care? They bill everything as separate codes so it falls under different categories.

Mine didn't seem expensive until I added up all the parts- my midwife, my epi, my l&d, my post partum stay, the testing, etc

It's everything

[jaime183]

Dec 3, 2013 0:53:24 GMT -5 ladybug said:

Dec 3, 2013 0:42:37 GMT -5 jaime183 said:

Also is that just for the hospital stay or the hospital stay plus all the care? They bill everything as separate codes so it falls under different categories.

Mine didn't seem expensive until I added up all the parts- my midwife, my epi, my l&d, my post partum stay, the testing, etc

It's everything

that seems like great insurance then! especially since you got your bfp