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I'm looking at two plans for 2018 and we're planning to have a baby next year.
Plan A)
Office pregnancy visits - no charges
Child birth - 20% coinsurance
Delivery facility service - 20% coinsurance Deductibles - $5k single, $10k Family
Plan B) Maternity Coverage (Delivery) - $850 Copay then 50% Coinsurance after deductible Deductibles - $5600 single, $14700k Family
Geez - 30% more coinsurance plus only a $600 higher deductibie for under $1,800 year. I'd take Plan A. Something goes wrong and that 50% coinsurance can become very expensive.
Geez - 30% more coinsurance plus only a $600 higher deductibie for under $1,800 year. I'd take Plan A. Something goes wrong and that 50% coinsurance can become very expensive.
Does the 20% coinsurance means I pay 20% of the bill?
50% co-pays. What if something bad happened and you are in the hospital for a week or so and the bills total $50,000,it's pretty easy to get to that amount. You would first pay the $5,600 deductible then 50% of the remaining bill.
I'm looking at two plans for 2018 and we're planning to have a baby next year.
Most plans publish a standardized Summary of Benefits Coverage (SBC) like the one in the link below that includes the cost of having a baby (page 7). That plan lists $7,460. Obtaining this from the insurer (or HR dept for employer plans) will be most accurate.
50% co-pays. What if something bad happened and you are in the hospital for a week or so and the bills total $50,000,it's pretty easy to get to that amount. You would first pay the $5,600 deductible then 50% of the remaining bill.
By law, plan B will have a Maximum Out-of-Pocket (MOOP) of $14,700. The plan pays 100% of in-network services after that. The OP did not state how out-of-network services are treated.
Quote:
The U.S. Department of Health and Human Services (HHS) has finalized the 2018 out-of-pocket (OOP) maximums for health care coverage. The 2018 limits will be $7,350 for self-only coverage (up from the 2017 cap of $7,150) and $14,700 for family/other than self-only coverage (up from $14,300).
Plan A is the better plan. That's why the premium is more.
Coinsurance = the percentage of the bill you owe out of pocket AFTER your deductible has been met.
After you meet your deductible on Plan A insurance would pay 80%. You owe 20%.
On Plan B you must meet deductible then insurance would pay 50% and you owe 50%.
OBGYNS usually bill prenatal care globally. This means they bill 1 charge for all care during the pregnancy. They do not bill 9 months of prenatal visits for each individual date of service.
Don't cheap out on insurance especially if you are having kids. My sister in law went with the cheap option after my niece was born. They just received 8k with of bills last week when baby had a respiratory infection and was inpatient for 1 day. She wishes she would have paid that extra premium now to get the better benefit.
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