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Pregnant + very confused - any advice appreciated

Pregnant + very confused - any advice appreciated

Old Nov 9th 2017, 3:03 pm
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Default Pregnant + very confused - any advice appreciated

Hi there,

I'm really hoping that someone who has been through this will be able to help with some pointers, if possible, please.

We've been in Brooklyn NY for about 5 months now. I've recently found out that I'm pregnant (for the first time) and although I've searched high and low for information, the more I read, the more confused I get about what needs to happen next.

We have insurance, and from what I can work out through our insurer's website, it looks like we'll have all but approx. $2,000 of the whole thing covered, which could be worse.

I have no idea where to start with finding a Doctor or how to even get our first appointment booked, which is causing me no end of anxiety

So any advice is appreciated, thank you!
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Old Nov 9th 2017, 3:10 pm
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Default Re: Pregnant + very confused - any advice appreciated

You need an obstetrician. You may have a web tool linked go your insurance to help you find an "in network" doctor, as your coverage won't pay as much if you go go one that is out of network. If you don't have a direct link to a web tool, just go to your insurer's web site and there should be a link to find in network providers of medical services.

At this point you can't go too early, so find an obstetrician ASAP, and make an appointment. And don't stress about it, a large percentage of their patients are first timers who have no idea what is going to happen and how they will manage to get through it all, so your situation is far from unusual.

Good luck!
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Old Nov 9th 2017, 3:16 pm
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Default Re: Pregnant + very confused - any advice appreciated

Originally Posted by Pulaski View Post
You need an obstetrician. You may have a web tool linked go your insurance to help you find an "in network" doctor, as your coverage won't pay as much if you go go one that is out of network. If you don't have a direct link to a web tool, just go to your insurer's web site and there should be a link to find in network providers of medical services.

At this point you can't go too early, so find an obstetrician ASAP, and make an appointment. And don't stress about it, a large percentage of their patients are first timers who have no idea what is going to happen and how they will manage to get through it all, so your situation is far from unusual.

Good luck!
Thank you so much, Pulaski.

Looking at Doctors online and reading "star ratings" and price quotes seems like a whole world away from going to see the family GP back home.

I have found a tool on our insurer's website but I'm struggling to get it to give me any helpful results, but I've not searched for the word obstetrician, so I'll give that a go. Thank you again.
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Old Nov 9th 2017, 3:21 pm
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Default Re: Pregnant + very confused - any advice appreciated

Go the website of your insurance company. Do a search to find an in network OB/GYN. If you want to you can do a little research online on each doctor to see which one you would like to visit, it's entirely your choice who to see. The doctor you see at the first appointment will likely be the doctor who delivers your baby.

Phone the OB/GYN office and make an appointment. Tell them you're pregnant and how many weeks along and they'll advise when to schedule the appointment. If you have any questions about insurance costs or billing, ask to speak with the billing co-ordinator at the office who should be able to help you understand things. Or call your insurance company helpline and have them talk you through it. Your insurance card should have a helpline number on it. Good luck!
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Old Nov 9th 2017, 3:22 pm
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Default Re: Pregnant + very confused - any advice appreciated

As recommended look at the healthcare insurance website for lists of doctors who are in network for your healthcare plan. They will be listed under OB/GYN.

If you have any neighbors with children, you might want to ask them who they used for prenatal care and delivery. Once you have decided on who to use, you call their practice and make an appointment. It is that simple. Once you are at the appointment, it is recommended that you have an in-office interview with the doctor you have chosen. They are not all created equally, even in the same practice office.

Find out what their preferences are as to type of delivery, i.e. vaginal or C-section (yes, some nitwits (doctors) prefer C-section over vaginal birth), natural childbirth, who will help with delivery if your doctor is not available when your water breaks and you are ready to push. Just because you are seeing one doctor, it does not mean that will be the doctor to deliver the baby. So be sure that the other doctors in the practice will honor the method of delivery you want if all goes well.

BTW congratulations!
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Old Nov 9th 2017, 3:26 pm
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Default Re: Pregnant + very confused - any advice appreciated

Agree with Pulaski. Don't delay. Try and get recommendations from friends/colleagues on a good Obstetrician (usually referred to as OBGYN in the US) but then check they are 'in network'.

As to costs. This will be dependent on your individual policy as to what is covered and how much.

In general, most policies will have copays, deductibles and an annual out-of-pocket max.

Copays are normally a set charge for each visit and/or procedure.

The annual deductible is normally how much you must pay before the insurance pays anything.

The maximum out-of-pocket is the maximum amount you will pay in any annual period. Usually Jan 1st to Dec 31st but not always.

So, potentially, if your max out of pocket is $2000. You could end up paying $2000 for this year and another $2000 next year.
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Old Nov 9th 2017, 3:27 pm
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Default Re: Pregnant + very confused - any advice appreciated

Any star ratings or reviews you see online are generally from 3rd party commercial sites, people review doctors here like they review restaurants! They're good for an overview and just to double check there's nothing worrying out there about a doctor you're considering but in my experience there tends to be a lot of lower reviews because someone had to wait 15 mins in the doctor's waiting room! People are sometimes reviewing their overall doctor's office experience rather than actual medical care. So they're a useful overview but I wouldn't swear by them. And any costs you see online don't really mean much once you factor insurance into things.
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Old Nov 9th 2017, 3:53 pm
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Default Re: Pregnant + very confused - any advice appreciated

Having done this myself recently (baby is 3 months now), I can understand how confusing it is. Completely agree with whay everyone has said. Look at your insurance company website, many OB/GYNs also have websites with insurance information, and ask around for recommendations. The explained the payment to me and it was done I installments over the first 5 ish months so it was more manageable. I started getting bills from the hospital and anesthesia company about a month after the baby came. All in all we paid about $3000 out pocket.
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Old Nov 9th 2017, 4:07 pm
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Default Re: Pregnant + very confused - any advice appreciated

And if you have a Health Savings Account or Flex Spending Account you can be reimbursed through that if you have enough money in the account.

If you healthcare insurance is decent and your doctor is in network, then the cost should not even be a worry for you. Both the doctors and the hospital will do installments if needed.
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Old Nov 9th 2017, 5:05 pm
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Default Re: Pregnant + very confused - any advice appreciated

As you do your research, also check what hospitals the OBs you find have admitting privileges. That is where the delivery will take place. If you're in Brooklyn for example, you might not want to go to Mt Sinai on the Upper East Side.
I lived in Queens, but was working in Manhattan and was going to have quite a number of appointments during my pregnancy so chose a doctor in Manhattan and was okay with the delivery being at Mt Sinai, rather than closer to home. But I had a car.
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Old Nov 9th 2017, 5:20 pm
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Default Re: Pregnant + very confused - any advice appreciated

Check your policy very carefully to determine what you're covered for, and check all bills - you'll get separate bills for different aspects of your (and your baby's) care. Make absolutely certain that the costs have been billed accurately, and that the insurance company has paid what your policy states it should pay.

I became pregnant a similar length of time after I moved to the US, and was completely clueless as to how the insurance system works. You definitely need to be on top of things - the insurance company did not pay out the amount covered by my policy and I had to really fight to get them to finally do so. They eventually did, but it took almost 2 years after my first child's birth to get everything finalised.

A few things to watch out for:
1) My policy covered ALL pre-natal care, up to and including the birth, with one single $20 co-pay. When the bills came through, they had only covered the birth at 80%. Every time I called them, they would consistently agree that it had been billed incorrectly and then 2 weeks later I'd get another letter stating that the payments were correct and I would start the whole calling cycle again. I didn't give up and eventually they paid out.
2) Pre-natal coverage including birth only covers the cost of the obgyn attending. It doesn't cover facilities - you'll be billed separately by the birthing facility itself so make sure it's in network as well. If you want a midwife, you'll likely have to pay for that yourself.
3) Ask for an itemised break down of all charges. The hospital will bill for every single thing you use, even if you weren't consulted - e.g. sanitary pads, gowns, net underwear, pacifiers etc. The billed cost is astronomical so if it's items you can provide for yourself, do so, and make it clear to the hospital staff that you do not want those items before they've torn open the packet. If they still appear on your bill, fight it. I didn't realise this for my first child, and didn't take that kind of thing with me but even our portion of the cost was way more than we would have spent if I'd just packed those things in my bag.
4) You'll likely be billed for use of the nursery for your baby even if you don't use it, but I would recommend not using it (at least, if you're breastfeeding). You'll get way more sleep if the baby is in the same room as you.
5) Anesthesiology is a separate bill - you'll want the anesthesiologist to be in network as well if possible.
6) Ask about pediatricians - you'll need to choose one before your baby is born. Depending on the normal procedures where you are, it may be this pediatrician who checks on the baby at the hospital, or it may be an on-call pediatrician at the hospital - either way, you'll want to make sure they're in network as well.
7) Pain management during labour was, in my experience, pretty much limited to narcotics. If you'd like to try other things, you'll need to research and push for it. I provided my own TENS machine for my second birth, which was really helpful.

I paid $3k for my first child. Then I learned what I wish I'd known before and only paid about $1200 or so for my second. Not having an epidural saved a ton of money. Funnily enough, the insurance company did exactly the same thing the second time, and didn't cover the obgyn delivery at 100%. It's almost as though they make a habit of it...

Bear in mind that post-natal care over here is generally abysmal. Being newly arrived in a foreign country, you'll need a support network (especially with it being your first child). If you have parents/family/friends who can come and stay for some time after the birth, that would be ideal. If not, join local baby/mom groups asap - the last thing you want is to be feeling isolated with a newborn.
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Old Nov 9th 2017, 5:31 pm
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Default Re: Pregnant + very confused - any advice appreciated

Two more things:

Firstly - CONGRATULATIONS!!!!!! Sorry, I forgot that important part

Secondly - unrelated to the US, but entirely related to having a first child. If you've bought any baby books, throw them out now. If you haven't, don't get any. One of my biggest regrets with my firstborn is that I tried to follow the books and, honestly, it only added to my anxiety/depression/feelings of inadequacy, and made me a worse mother. Do what comes naturally and you'll be much better off, I promise.
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Old Nov 9th 2017, 5:44 pm
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Default Re: Pregnant + very confused - any advice appreciated

Originally Posted by Wintersong View Post
5) Anesthesiology is a separate bill - you'll want the anesthesiologist to be in network as well if possible.
This is one of the biggest scams out there. In my experience, very few anesthesiologists are in-network. We were hit by this a couple of times in Alabama. It's not easy to establish if they are in network or not.

Luckily for the OP, New York passed a balance billing law in 2015. Florida passed a similar law last year.

Basically, provided your primary doctor or facility is in-network, all other services are considered in-network and out-of-network providers can't bill you separately at out-of-network rates.

This should be the law everywhere.
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Old Nov 9th 2017, 6:38 pm
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Default Re: Pregnant + very confused - any advice appreciated

Interesting points by everyone! For me, I don't remember getting separate or any bills in NYC in 2013 and I did get an epidural. Most (all) of my costs were covered by insurance, thankfully. I did have to pay for a room as I didn't want to share. I believe I paid that at the time of service.

You don't need to choose a pediatrician before the baby is born but can do so if you wish. The hospital's pediatrician will check on your baby.


By the way, congratulations!

Last edited by fbf2006; Nov 9th 2017 at 6:44 pm.
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Old Nov 9th 2017, 6:44 pm
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Default Re: Pregnant + very confused - any advice appreciated

Originally Posted by chawkins99 View Post
This is one of the biggest scams out there. In my experience, very few anesthesiologists are in-network. We were hit by this a couple of times in Alabama. It's not easy to establish if they are in network or not.

Luckily for the OP, New York passed a balance billing law in 2015. Florida passed a similar law last year.

Basically, provided your primary doctor or facility is in-network, all other services are considered in-network and out-of-network providers can't bill you separately at out-of-network rates.

This should be the law everywhere.
Definitely!!
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