Question about out of pocket Insurance Costs

[flatlan]

We are trying to put together a baby budget and I have noticed from posts in the past that people have said "Our delivery is going to cost us $xxx.xx out of pocket" I would just like to know how you arrived at that figure. I realize that unforeseen complications can drive up the price. We do not have insurance through our jobs and pay for it ourselves. We do have maternity coverage. Can I just call the insurance company and ask for an estimate? Thanks!

[Deleted]

Yes, you need to talk to your insurance company.

[Deleted]

Didn't you get a copy of your plan document? It should show your OOP, etc in there. I'd call and request one.

[mrs.spunky]

It depends on the plan.
If you have a plan with a deductible, I all but guarantee you will meet that deductible and may get up to your MOOP amount, so you should plan for whatever that number is, times two - you and baby.
All of this information should be in whatever documents your insurance company gave you when you signed up for the plan.

[flatlan]

Thanks for the help ladies! We do have a deductible and I would have never thought about having to meet it for both me and the baby. Ihave very little experience with insurance and I get so confused. I will look over our documents and come up with an estimate and then double check it with the insurance.

[Chirp]

Another option...

My OB/Gyn has a policy for every maternity patient. They send in a pre-labor estimate to the insurance company so every patient knows up front what the best case scenario is that they'll have to pay.

If "vaginal birth with no complications" then $___
If "c-section with no complications" then $___

Mine was accurate. I had a vaginal birth with pitocin, antibiotics, 2 rounds of stadol, an epidural, and 3 nights in the hospital and the estimate was spot-on.

[Chirp]

Oh, another thing to keep in mind. Check to see if your deductible runs on a calendar year.

If it runs on a calendar year and you pay your deductible (in full or partial) before the end of 2012 but don't deliver until 2013, you'll have to pay it again in 2013. Plus the baby's deductible for 2013.


I figured that out when I paid my deductible in 2010 and 2011. Blood work and ultrasounds were in 2010, but the birth was in 2011.