Insurance and out of pocket expense

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Re : Insurance and out of pocket expense

Postby darcynulph » Wed May 17, 637684 4:20 am

My dd and my hospital bill came to $280,000 and we paid our $3000 deductible which was a great deal because she was born in April so all of the follow up tests and the synagis was covered. We have UHC and it was great insurance in my eyes. When we got home from the hospital they assigned a nurse to us if we had any questions and to make sure we understood her care and to get any referrals if needs. Also when I got pg(m/c 9/06) they called as soon as they got the information from my doctor with a prenatal survey, gave me a nurse to contact if I started to have problems and send a book about pregnancy. In Arizona there is a program that will take care of your hospital bills depending on your income at the time of delivery, it would have limited our liability to about $1700, but that only because they wanted to use only my dh's income because I was going to be on leave for awhile. I didn't feel comfortable doing that so we paid the 3k.

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Re : Insurance and out of pocket expense

Postby sarab » Tue May 16, 637684 8:47 am

With my first pregnancy, our out-of-pocket was $5500. Considering the bills for both Maggie and me were over $400,000, I guess we got off "easy". Our deductible was $400 and we payed 10% of everything else until we reached the out-of-pocket max.

The second time around, DH's company had done away with the highest coverage insurance plan - we joke that it was because of us. This time our deductible was $750 and we payed 20%, which capped off at $8500. Again, I was much happier paying that than the $200,000+ that my son and I racked up.

All in all, we are paying about $14,000 for our two little kiddos. We made payment arrangments with most of the places we owed money too, and it seemed that most were happy to work with us.

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Re : Insurance and out of pocket expense

Postby amiejo » Sun May 07, 637684 4:12 am

My first two pregnancies, I paid $15 for the inital OB visit and after that nothing. Everything including NICU stay was covered 100%. That was great considering my daughter's NICU stay was close to $500,000 and my son's was close to $200,000.

My third pregnancy was a completely different story. Copays, deductibles, etc. for me totaled about $1500 and my daughter's bill was like $200. It bites to have such an expense but we prepared for that and more...anticipating another NICU stay (thankfully we had a much better pregnancy this time around).

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Re : Insurance and out of pocket expense

Postby deerhart » Fri May 05, 637684 8:22 pm

I paid a total of $25 for both of my pregnancies ($10 copay for the 1st $15 for the second) everything else was 100% covered. I had the copay only for the first visit to the OB-Gyn, after that nada. My bills for the first had to top out well over $200k and were probably a good $100k for the 2nd (including hospital stays, all admits, labs etc..). This was UHC

I am on UHC (the plan is even called the same thing) and my costs would be WAY different if I had another child now (copays at each visit, like a $500 deductable and 20% of most costs after that I think, it would be pricey). Different employers pay for differnet amounts of coverage.

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Re : Insurance and out of pocket expense

Postby kara » Fri May 05, 637684 8:08 pm

I will say that I had a strange intuitive thought at about 3 months into my pregnancy at a time when we were able to make changes to our insurance policy. I made hubby sign up for the most expensive(best) plan we could get. We didn't have to pay any co-pays for any of my visits or any diagnostic testing (US, etc). We paid an Out of Pocket Maximum of $2500. Our bill was small considering we had a 2.12er...$116,000. We pay on the bills in installments. The hospital probably doesn't like that, but we went from 2 incomes to 1 and had MANY MANY other expenses that came from delivering early and being sent home with a 3 and 1/2 pound baby. Note: We didn't pay a dime until the hospital, the doctors and the insurance company figured out all the bills and decided where the money from out out of pocket maximum would go. We didn't want to have to track down payments if they went to the wrong place....and attempt to get the money b ack.

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Re : Insurance and out of pocket expense

Postby ozierja » Fri May 05, 637684 4:33 pm

I have great insurance and my NICU bill for 54 days was about $253,000 (also not including doctors fees and testing fees) and my hospital bill was $67,000. I paid around $50 for those however doctor's fees were much more out of pocket. I think my portion of all of the doctors fees ended up being around $3,000. My insurance was BCBS.

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Re : Insurance and out of pocket expense

Postby missgamecock » Fri May 05, 637684 4:23 pm

quote:Originally posted by missgamecock

I have excellent insurance. $15 for primary and specialist visits. Meds are $10/20/35 according to generic and brandname. BCP generic - FREE, Brand - $35. Outpatient surgery $15. Pregnancy - $15 at the first visit to confirm, then no charge for prenatal, delivery, postpartum. Bloodwork - free. NST - $15 each visit. Radiology - $20. Hospital stays - FREE. ER - $50 copay. Durable medical equipment -50%. Home nurse visits - $15. No deductibles.

With my pregnancy with Sara - I paid a $15 copay at the first visit with my obgyn. Then I paid $20 for each US. My bloodwork was all free. With my peri, I paid quite a bit but not nearly what anyone else pays. I paid $15 for each visit. Then after Sara was born I started getting zapped for extra copays. They charged me a copay for the doppler blood flow studies, nst, us, etc even though this was within the same office visit. So I ended up paying an extra $100. I would say my out of pocket expenses (including meds which were constantly changed dosage wise) was about $1000 for the whole pregnancy (Sara and me). Insurance paid out about $4k for me and another 2k for Sara. No time in the NICU and she went home with me after a 2 day stay. My premiums are taken out pretax and they are $95 a payperiod but will be going up to $110 a payperiod. This is for self and family.

I expect next time will be twice as expensive as my dr has said that he will be treating me more aggressively. So I am assuming more tests and everything. If I had a baby in the NICU, as long as the baby went to the children's hospital near me that is innetwork, it would be covered in full as an inpatient hospital stay. There are no catastrophic limits that I am aware of (I have checked).

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Re : Insurance and out of pocket expense

Postby kris21225 » Fri May 05, 637684 2:50 pm

I am very lucky and my husband has excellent insurance. For everything, specialists, constant monitoring, NICU, my week stay when I had my son, when I lost my second daughter and had to deliver and then have a D & C (which I didn't know counts as an operation, I thought it was just a "procedure"), all I had to pay were the $15 co-pays for the monthly OB visit. When I had my first daughter they charged a $200 admittance fee, but a few months later we got a check for that because our insurance covered that as well. I am very, very lucky.

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Re : Insurance and out of pocket expense

Postby stacya1 » Fri May 05, 637684 2:20 pm

I will potentially be in the hospital for 7 weeks and our out of pocket will be $1700. Potentially we could have another $1700 for the baby and if I am still here in 07 my clicker goes to zero so I will have another $1700

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Re : Insurance and out of pocket expense

Postby suz7171 » Fri May 05, 637684 11:03 am

Considering that I had twins and that they were 8 1/2 weeks early, our NICU bill (only the 29 day hospital stay - no tests, doctors' charges, etc) - which was paid by our insurance 100% - was $250,000. Thank the Lord for insurance!

We ended up paying abour $7,000 - $8,000 out of pocket for their first month of life. They were born right before the new year so we were grateful to get a little extra from Uncle Sam but we also had to pay DOUBLE out of pockets for 2003 and 2004 because their NICU stay went from Dec - Jan. Then we had a slew of doctors' apppointments over that first year. Thankfully, they were only $10 co-pays. Again, there were two babies.

My husband changed jobs when the boys were 4 months old...if that had happened before the boys were born we would have paid a total of $800 for all of the insurance coverage does vary a lot.

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