NatashaB

Just bumping up this thread as I have recently found out I am expecting

I have found a nice obgyn who delivers at a hospital local to me, so that is a good start. I have insurance cover but obviously the copays are going to add up and there is a maximum out of pocket cost of $5k on the policy, so i assume that the birth will cost us roughly that amount. I have the option to take out medical insurance when i start work next week - is it worth doing this so that they can pick up the copays and costs not covered by the other insurance? ($110 per month for a policy just for me). How does it work if you have 2 policies, one a family one and one a personal one? At what point does the baby become separate to me for insurance purposes - immediately it's born, or is there a wait period? (if i take out additional insurance cover just for me obviously it may not cover any of the baby's additional costs whilst in hospital - a stay in special care or whatever).

I need to ask the insurance what tests they will cover (CF, downs etc). Do I need to notify them that I am pregnant?

The obvious answer is to talk to my husband's company who supplies the health insurance but I am starting work there next week and obviously don't want to tell them at this point. The policy is pretty vague.

Does anyone else have any wisdom they would like to impart - anything I should find out about or be aware of? I don't even know anyone with kids here so am a bit clueless as to how everything works.

Duncan Roberts

One would be designated primary and one secondary. The claims would initially be sent to the primary then any remaining balance would be sent to the secondary. Rules for both policies would still apply, co-pay, deductible, etc. Which one gets designated primary depends on how they are taken out, if you get one via your employer that would usually be designated primary and the other policy would be secondary. In your case it may save you money in co-pays but your secondary probably wont pay out anything until you meet the $5k and you would be paying out the extra money for the policy premium.

Personally I think multiple insurance policies only make sense if you are not paying for one, if you have to pay for them both then you really need to sit down and work out the financials because you will likely be stuck in them until the end of the year.

Duncan Roberts

To update, our new insurance does not have a co-pay but won't pay anything until we pay $3000 out of pocket for the year if we use preferred (not just in network) facilities and doctors.

NatashaB

Thanks, that is very useful. Both policies would be through the same employer so I believe the primary/secondary designation would be based on who was born first in the year. Maybe the flexible spending account would be a better option (but then we have to make sure we don't pay in more than we spend as we can't get it back).

Duncan Roberts

Is the plan with the $5k deduction an HSA or a "regular" plan.

NatashaB

it's a regular plan - a PPO.

Bob

Co-pay, there should just be one, the first one when you see your doctor and the rest should be covered, but you might have a second one at the hospital.

The baby, that'll depend on the policy and the state. Usually you have 30 days once the baby is born before they go onto their own cover, and usually it should happen automatically and you notify them of the SSN once you get it. That's not to say that won't happen because on our last policy we had to notify the insurance within 10 days and get her on her own policy within30 days with her own SSN or we'd have to wait till next enrolment, which wasn't a problem because I'd been laid off by then and COBRA for me was $1500, so we just went straight over onto the wife's policy.

As for wisdom, sign up to baby's r us registry, you'll get freebies and check their classes out, they have some good nappy and feeding classes and you get freebies.

Also, check that the insurance covers pre natal classes and that they cover a hospital tour. When we were having ours, pre-natal was covered for the missus but not for the spouse and we were reimbursed and it was $90 a person, but if we did it at the hospital rather than else where, it also included a free tour of the hospital, which other wise would have been $75....again you get a lot of freebies.

Things you won't need to buy, snot suckers, digital thermonitors, a collection of baby creams...you'll get loads of those free before you leave the hospital...and steal the baby pad sheets as they're so much better than the ones you get on changing tables that you buy.

Oh and congrats!

Rete

I separated your posts and made you your own thread. Not wise to tack it onto an out of date thread.

Rete

Same employer, same insurance company, then I believe you will find that you will not be able to get two policies. Either your husband will continue to insure you under his policy as a "dependent" or you will have to be dropped from his. Then he will have individual coverage and you will have your own policy which will be individual. You can have double insurance if you are not working for the same company.

This is because 1) the same insurance company is not going to cover you twice and 2) the employer is not going to be willing to pay for two premiums.

ldyinlv

Absolutely get the insurance!!!

jackattack

I worked for the same company as my husband and when I joined, we ran the numbers all ways and figured out that it was more cost effective for me to be insured as an employee and not as my husband's spouse. I was able to choose either option but since the employer covers a portion of the employees healthcare, and didn't give you any rebate if you chose not to sign up for a subsidised healthcare, it made more sense for us to sign up separately.

And as far as I remember, i got to keep the baby on my plan for 30 days. I had to go online (or call) and tell work of a 'life change' within 30 days of the event and add the baby so my healthcare became "employee and family". I think that any complications from the birth or with the baby would have been covered under my plan initially. That being said, once I registered for employee and family healthcare, my increased premiums were backdated to the date of delivery.

Congrats

MsElui

be careful of the tests. My OB/GYN WAS in network - but sent some of my tests to an out of network lab and i got stiffed those charges.

I had a scan at 8 weeks and at 22 weeks - both standard and covered by insurance. I opted/asked for a 13 week scan so i could have a neuchal fold test done (as i had done in england with prev 2 kids). I cant remember if i had to pay for it or wangled my doc into saying she recommended it so it was covered (as this was non standard). They wanted to get me with other tests which i declined as unecessary (ie the glucose tolerance test was not necessary - hadnt had it in my first 2 pregnancies in england as i never had indicators of an issue - they seem to give this test to everyone here at 24-26 weeks).

i dont remember having any copays for the ob/gyn visits/scans/tests (although my memory is not what it used to be!)

NatashaB

Thanks everyone, heaps of useful stuff to think about!

shauny2k5

I work for UnitedHealthcare, one of the larger insurers.

One lesson i've learned is that insurers never questions an OB when he/she is dealing with a pregnant patient when it comes to tests. If your OB thinks a certain test is worth having, have them bill the insurance for it, and you should have no problem. If they deny the claim, message me and i'll tell you how to write a letter that we get the claim paid on appeal.

My wife just had our baby one month ago, and I can assure you that it is very expensive. All together, the pregnancy cost our insurance about $21,000; off which we paid $3,100 (our out of pocket).

If both of your insurances will cover a pre-existing pregnancy, I recommend going with the plan that has the lowest OOP limit; and dropping the other. With the plan that has the $3000 deductable, you can open a free Health Savings Account online and put money in there to pay all of your OOP expenses, and you'll then be able to claim them tax free when you file your taxes in 2012.

TracyTN

I would call your insurer to find out in advance what is covered during your pre natal care and what isn't.

I had a baby in July 2010 and it only cost me $240 out of pocket - that was for all pre natal care, including tests and ultrasounds, medicines - I am a slightly older first time mom (39) so I had the Down's test as well. That also includes my labor and delivery, and the hospital stay for both me and my daughter.

I should add that it would have only been $140 out of pocket if they hadn't freaking sent me home the night I went into labor, causing another admitting copay for when I went back (4 hours later...grrr!).

Point being - depending on the coverage, it may not cost you as much as you would think.