Mine is covered 100%, with the exception of the $10 copay I paid for my OB intake appointment. I also don't pay any premiums for my insurance. I know my situation is unusual, but $4700 OOP sounds incredibly high to me. Most people I know who have to pay anything OOP end up owing ~$1500, all-inclusive. If I were you, I'd definitely run the numbers and seriously consider switching to a lower-deductible plan.
I paid a copay to the OB (I forget how much) for prenatal care. $2500 to the hospital as my co-pay a copay to the pediatrician plus co-pays for my ultrasounds
Using an in-network OB and hospital resulted in us only paying $500 for all pre-natal care and L&D. We felt pretty lucky, especially when we saw the EOB.
Post by thatgirl2478 on Aug 8, 2012 16:49:41 GMT -5
100% - minus the $20 initial visit fee at the OBGYN to confirm pregnancy and the $175 initial hospital fee. I have yet to pay for a single well baby visit (any of the scheduled appointments). If we take her because she's sick or otherwise it will be $30 I think (prices went up).
But - I have a great plan through DH's work (he's a fed).
Pre/Post-natal - 100% L&D - I paid $2K (1K per night). Hospital bill was $16K+ for a regular vaginal delivery with epidural Baby - Well baby visits are covered 100%
I paid $15 for the entire pg, both times. For the first, I was high risk and had a million NSTs, ultrasounds, etc.
I'm not high-risk, per se, but have had several ultrasounds beyond what's standard to monitor small potential problems (club feet, dilated kidney). As long as they're being ordered by my doctor, they're covered 100%. My visit to a genetic counselor around 20 weeks was also fully covered, as was the ensuing MaterniT21 test (to rule out the possibility that a chromosomal abnormality caused the club feet), and our upcoming consult with an orthopedic surgeon will be fully covered. I wish we didn't have to go through so many appointments, especially since no one's sure baby's feet will need correction, but I do love my insurance.
Post by jackpackage on Aug 8, 2012 17:27:07 GMT -5
I feel your pain OP. We reached our 4K OOP max with my pregnancy. I didn't have any co-pays, but we spent about 1K with labwork, while the rest was L&D.
$20 for first visit and remaining visits were covered under global billing. No hospital copay. Total hospital bill with insurance adjustments was around $18,000, so very thankful it was covered 10%
I did have to pay around $200 in assorted parking fees by the time we left the hospital.
It would be $250 hospital copay this time around.
ETA: Insurance we have is $13K a year for family (employer pays 90%).
Post by vanillacourage on Aug 8, 2012 18:07:56 GMT -5
Our deductible was $3k, after that it was 80/20, we met our max OOP of $5k with several thousand left for the insurance company to fully cover. Mid-risk pregnancy, induced VBAC that ended in a c/s = $$$$$.
I paid a $25 cop-pay to my primary OB and to my high risk OB. All of my labs/urine samples ar being billed wrong so they are not hitting my insurances universal pregnancy code and I have been paying 80/20 on those. The cystic fibrosis blood test was $230 out of my pocket!
But we have a $3000 family max out of pocket and I'm assuming we'll hit that with the labor.
We went with the HD plan this year. The PPO and HD plans at my work have the same OOP Max. The PPO is an 80/20 after $1500 deductible up to $5500 OOP max. The HD is just $5400 max OOP. My HD premiums were over $1000 cheaper and my employer puts $500 into an HSA for me. So I paid $5400 but total bills so far are $26k(DS has had some minor health problems and tests).
Post by kittycatlove on Aug 8, 2012 20:52:20 GMT -5
I paid one lump sum to my OB with no copays. All my ultrasounds were covered because I was high risk, as well as my CVS. I think after meeting deductible and out of pocket it was about $3500. All of the babies well visits are covered 100% with no copay- but this is something with the new healthcare reform and depends if your insurance is grandfathered or not.
Post by UnderProtest on Aug 8, 2012 20:57:13 GMT -5
I had 80/20 coverage but a max oop of 3k. I was way past that by the time I actually got pg. My eob showed the scheduled c section for twins plus 4 nights in the hospital was around $27k. My two nights in the hospital and emergency appendectomy was $32k. I think I got my money's worth on my insurance last year (that didn't include the full IVF cycle that was covered). Sorry for that tangent. I'm not sure how much the kids well visits were. They can't seem to bill consistently. One bill is a $100 and the same stuff for the other kid was $1000. Makes sense.
Post by sawyerthedestroyer on Aug 8, 2012 22:24:25 GMT -5
I had an HMO through AETNA. I paid a $50 co-pay to the OB for my initial visit, each visit after that and all U/S performed in-house were covered, my post-natal visits also fell into this because they were related to the pregnancy. I had a $500 co-pay to the hospital for delivery. I had a $25 co-pay to the Pedi for each well-baby visit.
Post by pacificrules on Aug 9, 2012 1:44:05 GMT -5
We paid $400 out of pocket ($200 deductible for me and for DD). That said, there was about $600 per month taken out of my paycheck when we switched to the higher plan (when I was pregnant).
Everything except co-pays. I think they were $10 or $15 for each prenatal office visit and for DD's pediatric well visits (shots only visits), there was no co-pay.
The only thing I ended up using my deductible for was the doula. I had zero costs for the delivery itself if you don't count the doula (and even she was covered at 80% after I met my deductible).
We have amazing insurance through DH's job. Which is another reason I want to get a BFP asap since he is thinking of changing jobs next year.
I paid a 40 dollar co pay at the beginning that covered all my prenatal visits. I had to pay a 25 dollar co pay for my NT scan. And I paid 150 for the delivery. So just over 200 dollars covered all my blood work, tests, prenatal visits, ultrasounds, and my c section and subsequent hospital stay. I thought that was pretty good.
Post by dcrunnergirl on Aug 9, 2012 7:21:11 GMT -5
By the time I went on hospital bedrest, I had already hit my OOP max for the year ($3K, due to some physical therapy earlier in the year), so I didn't pay a dime for my month of hospital bedrest (which cost about $70K) or for any of my prenatal appts or ultrasounds or for delivery or my post-natal hospital stay.
If I hadn't already hit my max, it would have cost $270 for my prenatal care and then probably about $500 for my delivery/post-natal care.
We also paid about $300 for the babies' care in the hospital, including being seen by neonatologists b/c they were slightly premature (but they didn't have any NICU time, just a few extra tests).
Post by whitepicketfence on Aug 9, 2012 7:45:38 GMT -5
I had different insurance policies with each child since I was still working and on my employer's insurance when I had DD1. With DD2, I was a SAHM and on DH's plan.
With DD1, I paid my $20 co-pay at my initial prenatal appointment and never had to pay anything else. I had a c-section and although my costs totalled close to $30K, I didn't have to pay even a penny OOP. All of her well-baby visits were covered 100% after I paid my $20 co-pay at each visit.
With DD2, I think I paid around $500 OOP to meet my deductible while I was pregnant. I found out that I was pregnant in November and had to pay my $250 deductible for that year and then had to pay the $250 again in January to hit my deductible for that year (I was due in August). I paid another $40 after my VBAC delivery since apparantly one of the pedis who treated DD2 in the hospital was considered out of network. All of her well-baby visits have been covered 100% after paying our $20 co-pay at each visit.
Post by Ashley&Scott on Aug 9, 2012 8:34:51 GMT -5
Prenatal care: My OB bills globally (flat fee after delivery) We did pay $25 per ultrasound, we had 3. Also $100 for various bloodwork & $200 for my rhogam shot.
Hospital/L&D: We paid $3,700 ($3k for me & $700 for DS) I have a $1,500 deductible & $3k max OOP per person. Newborn care is not subject to the deductible thankfully. The total bill for both of was just under $20k. This includes all OB fees, anesthesiologist, hospital fees, pedi, etc. I had a routine delivery & we had a 2 night hospital stay.
Well visits are covered 100%, $25 copay for sick visits.