Question about having a baby without maternity insurance. (2013, tax)

[fzx]

I feel so sorry for this situation. This is really an example of how our HC sys has gone wrong.

I am not sure about the maturity insurance. Basic instinct tells me that, if it only covers a very certain type of event, i.e. being pregnant in a forseeable future, the insurance will be more like a discount program instead of a real insurance. Why somebody wants to do you a favor by footing an event possibly costs anywhere between 10k-150k+?

One thing I think you can do is to find out how much Northside Hospital (delivers 75% of Atlanta babies) will charge for virginal or C-section birth. Rules of thumb are: the price has a lot of flexibility. Hospitals prob. will print a price and gives commercial insurance 60% off, which is still much higher than what Medicare and Medicaid pay. In your case, I guess Medicaid will be the possible low end since not too many senior women need this service.

The cheapest way of cause is, to find a midwife, assuming your wife is still in her prime age.

Sadly as it sounds, if you do not have enough money to pay for, say 10k, the delivery, it might be harder to raise a kid.

Best luck,

[RoslynHolcomb]

Originally Posted by fzx

I feel so sorry for this situation. This is really an example of how our HC sys has gone wrong.

I am not sure about the maturity insurance. Basic instinct tells me that, if it only covers a very certain type of event, i.e. being pregnant in a forseeable future, the insurance will be more like a discount program instead of a real insurance. Why somebody wants to do you a favor by footing an event possibly costs anywhere between 10k-150k+?

One thing I think you can do is to find out how much Northside Hospital (delivers 75% of Atlanta babies) will charge for virginal or C-section birth. Rules of thumb are: the price has a lot of flexibility. Hospitals prob. will print a price and gives commercial insurance 60% off, which is still much higher than what Medicare and Medicaid pay. In your case, I guess Medicaid will be the possible low end since not too many senior women need this service.

The cheapest way of cause is, to find a midwife, assuming your wife is still in her prime age.

Sadly as it sounds, if you do not have enough money to pay for, say 10k, the delivery, it might be harder to raise a kid.

Best luck,

I'm pretty sure that if they have a virginal birth the cost of delivery will be the least of their concern.

[residinghere2007]

Just had to chime in that a $20K c-section is cheap. My daughter was born via c-section and we got the rundown of the charges and it was nearly $60K. The c-section itself was over $30K.

I honestly would be afraid of the risk of needing emergency intervention or if the baby is ill and needs a NICU stay.

My mom back in the late 80s got pregnant with my brother and lost her job during the pregnancy and couldn't get coverage (back then medicaid wouldn't cover a pregnant woman unless they were dirt poor) and ended up developing gestational diabetes and needing an emergency c-section and my little brother had a collasped lung, weighed 12 lbs, and had to spend a week in the NICU. They got bills in excess of $200K and ended up having to file bankruptcy.

[lorilove]

Correction - just checked my bill. My insurance is 409 per month so my friend that is 20 years younger and has maternity insurance pays more than me!

FYI - here is an example of how insurance rates have increased


Jul 2008 $248
Jul 2009 $280
Jul 2010 $325
Jul 2011 $375
Jan 2012 $409

[RainyRainyDay]

I have BCBS PPO through my employer. Just received a bill in the mail for $6,312.11 for a D&C last month in the gynecologist's office. That's about a half-hour procedure, under anaesthetic. Gynecologist is in-network and I didn't realize she was using an out-of-network surgical team to assist her. I thought this fairly routine procedure would be no big deal. Apparently I unintentionally agreed to shell out the price of a second-hand car. (By the way, the results were clear. I'm fine. Just out a few thousands of dollars).

I'm from Canada, where if you go to the doctor and they say you need a procedure, you have it and you're done. I know all you conservatives out there LOVE LOVE LOVE your free-enterprise health care insurance system. Any of you care to pay my bill?

[chalvey]

My cousin was born at Northside, 9 years ago, and it costed around $12,000 (insurance took care of most of it). I am honestly staggered at how expensive some of these procedures cost. Makes me glad that my parents got me a national insurance card.

[ToucheGA]

Originally Posted by mrpanda

<snip> I called Johns Creek Emory hospital today and they have a plan for the uninsured for $3750 for normal delivery which i find to be very reasonable. Unfortunately Coventry would not cover any doctor visits related to maternity. <snip>

Also keep in mind that the $3,750 almost certanly does not include the fees for the OBGYN, the Pediatrician, or the Anesthethiologist (assuming that she has an epidural.) Hospitals rarely bill on behalf of physicians nowadays, since the hospitals do not employ physicians. These costs might be as low as a few hundred dollars a piece, but can skyrocket if surgery is needed, or if the child has complications.

[RainyRainyDay]

Originally Posted by ToucheGA

Also keep in mind that the $3,750 almost certanly does not include the fees for the OBGYN, the Pediatrician, or the Anesthethiologist (assuming that she has an epidural.) Hospitals rarely bill on behalf of physicians nowadays, since the hospitals do not employ physicians. These costs might be as low as a few hundred dollars a piece, but can skyrocket if surgery is needed, or if the child has complications.

This is a vital thing to understand.

Spouse and I have had a few medical procedures in recent years, in hospitals and free-standing facilities. None involved an overnight stay. All can be chalked up essentially to a tiresome aspect of aging: health problems crop up.

Every one of these episodes has resulted in a cascade of bills from all the independent supporting personnel and facilities (as mentioned above by ToucheGA, also medical labs for the lab work) that were involved in our care. This isn't something you can even research beforehand. For example, we both had screening colonoscopies a few weeks apart, in the same facility with the same doctor. The costs were different, because in one case the anaesthesiologist was in-network to us, in the other, not. The primary doctor himself was in-network.

Husband even tried to find out the cost of a procedure before-hand. He called the hospital (like the OP on this thread) and got a reasonable seeming number. Unfortunately, that didn't include the bill from the medical specialist who conducted the cardiac MRI and wasn't the referring cardiologist.

It just makes me crazy when I read how the free-enterprise medical system in this country controls costs by allowing patients to be well-informed consumers. It's impossible to be a well-informed consumer. If you ask the doctor about costs, they have no idea. Somebody in their billing office doubtless knows, but as the patient, you don't see that person. And what are you supposed to do, tell the doctor "please ensure an anaesthesiologist who's in my insurance network is the person scheduled to work on the day I'll be going under?" They don't control that. Nobody does, really. As the patient, any time you agree to have any medical procedure at all, you're playing medical bill roulette. And my experience is with the "premium" option of the BCBS PPO offered by my employer.

[mrpanda]

http://www.sbua.org/link/KW_HS.pdf

I will be able to qualify for this group plan. I currently have an independent plan with Covetry for $300/month with a high deductible. This plan covers maternity and$10,685 has 0 deductible but a cap limit.

$10,685 - Basic 10 Plan - $494/month
$26,000 - Choice 25 Plan - $680/month

How does this group plan compare to any independent plans with Aetna and BCBS? Assuming a normal delivery with no complications... is it possible to keep the costs down below $13,000 for prenatal care, doctor visits, and deliver for a singleton? Johns Creek Emory hospital delivery offer of $3750 was only offered to people without medical insurance.

[FromGA]

Originally Posted by RainyRainyDay

This is a vital thing to understand.

Spouse and I have had a few medical procedures in recent years, in hospitals and free-standing facilities. None involved an overnight stay. All can be chalked up essentially to a tiresome aspect of aging: health problems crop up.

Every one of these episodes has resulted in a cascade of bills from all the independent supporting personnel and facilities (as mentioned above by ToucheGA, also medical labs for the lab work) that were involved in our care. This isn't something you can even research beforehand. For example, we both had screening colonoscopies a few weeks apart, in the same facility with the same doctor. The costs were different, because in one case the anaesthesiologist was in-network to us, in the other, not. The primary doctor himself was in-network.

Husband even tried to find out the cost of a procedure before-hand. He called the hospital (like the OP on this thread) and got a reasonable seeming number. Unfortunately, that didn't include the bill from the medical specialist who conducted the cardiac MRI and wasn't the referring cardiologist.

It just makes me crazy when I read how the free-enterprise medical system in this country controls costs by allowing patients to be well-informed consumers. It's impossible to be a well-informed consumer. If you ask the doctor about costs, they have no idea. Somebody in their billing office doubtless knows, but as the patient, you don't see that person. And what are you supposed to do, tell the doctor "please ensure an anaesthesiologist who's in my insurance network is the person scheduled to work on the day I'll be going under?" They don't control that. Nobody does, really. As the patient, any time you agree to have any medical procedure at all, you're playing medical bill roulette. And my experience is with the "premium" option of the BCBS PPO offered by my employer.

It would be truly free enterprise if the government (Medicare/Medicaid/...) and employment-based health insurance were not present. With these two involved, it is quasi free market, and all this confusion.

If citizens were responsible for purchasing in the free market, I dont see how costs will be kept hidden for long.