Friday, October 8, 2010

Insurance, Epidurals, and the Cost of Having A Baby (continued...)

In some ways these medical/baby posts are incredibly boring. Feel free to skip them. However, I felt like I was walking blind into the cost of having a baby, and this may help some people to know how much it could cost or at least what costs to ask about as they estimate their costs with their own doctor/hospital/insurance.

So... I've learned a lot in the past few days. For instance.

1. You will pay multiple people, and the cost of each will be billed separately. We've been making payments for this delivery since spring since my work insurance plan has such a high deductible ($3,500 pre-deductible, 80/20 afterwards, and a total of $5,000 maximum out of pocket). I thought this was going towards our complete birth cost. I was wrong... it's just to pay my doctor and for some of the basic checkups, etc. I pay separately for all other costs (anesthesiologist, hospital stay, pediatrician, etc).

2. Epidurals are expensive. I was initially quoted $3,000. Geez. Don't get an epidural if you don't have insurance. However, the negotiated costs via insurance in the 80/20 range of my insurance make it a viable prospect. *sigh of relief*

3. However, it turns out that staying at a hospital is ridiculously expensive. Labor and recovery end up being probably two days in the hospital, and WITH insurance negotiating the cost for me, it'll probably still be $9,000. Whatttt??? Can I just deliver, check into the nicest hotel around and get room service from a fancy restaurant.... and still pay WAY less? That is so crazy to me. Of course, that means that the hospital stay alone will put me above my maximum out of pocket expenses for my insurance, which means if I do go to the hospital to deliver I'm guaranteed to pay the $5,000 but no more, right?

4. Wrong. Not all insurance is like this, but mine (with a major insurance company) is tricksy and the baby's expenses as soon as it's out of the womb are its own expenses with its own deductible. So really, while it's a maximum out of pocket expense of $5,000 for me, it's a maximum out of pocket expense of $10,000 if we're talking both me and baby. Chances are that we won't come anywhere near that, but the kid's hospital stay alone is estimated at a negotiated rate of $1,000. Again... ridiculous.

5. Infant-only insurance is hard (if not impossible) to find. Adding the baby to my insurance policy will cost me about $400 per month, which is not affordable for us, especially considering that high deductible means we're still basically paying the baby's expenses out of pocket. I took a friend's advice and went looking for infant-only insurance. I shopped a few major companies and none of them offer it. So... either you pay ridiculous amounts to add the baby to your insurance or the baby goes uninsured? Hmm. Luckily it looks like we'll be able to add the baby to Isaac's insurance through his graduate school, and that plan is much better than mine is AND it's much cheaper to add the baby. This may be our life-saver if it works.

I'll probably do one more post on this since I'm waiting on some final pieces of information to fill out a cost comparison spreadsheet between a birthing center and the hospital birth costs. At the moment the hospital birth is more expensive, but only slightly after all things are considered. If that is true then if I was an all-natural type, the birthing center would absolutely be the way to go (I totally think they're safe and a great idea for those who want to go that route). On the other hand, if you're the type that really would rather have pain relief and a hospital stay where you can be taken care of instead of recovering at home.... the hospital appears to be somewhat equal in price... if you have insurance. Because in the end pretty much it seems like having a baby will probably hit your deductible no matter which way you decide to deliver!

And... let me rant here for a moment... Our system has variants. One hospital or one doctor might charge more than another. But really, although our system is meant to be for a consumer/capitalist society, because insurance stands in as the middle man we really have no idea what the initial cost is or how much it can be reduced. I can get quotes, but it's all behind the scenes stuff and I'm just doing guess-work and estimates, and the fact that I'm doing it at all really surprises people because they expect Americans to just walk in, get whatever the doctor tells them to get, and pay the bills that are sent to them.

It's like walking into a restaurant and saying you're hungry and you want a certain kind of food, and then being fully reliant on the waiter to decide what type of food you'll actually get and how much of it. AND the waiter has no idea what the prices are... she's just ordering for you. You find out the price when you leave the restaurant, and if you can't afford it, sucks to be you. I don't understand how people can think our system is working. I am above the income level to receive federal assistance via medicaid, both my husband and I are employed and insured.... and yet I find medical costs to be unaffordable for us. They are more than our rent, our car... anything. And this is not a rare procedure for heavens sake... it's having a freaking baby. However, IF you can pay for a really nice insurance plan (or your work does, which probably means you have a nice job), you do sort of have unlimited access to medical care. It's just an unequal system...

7 comments:

Kacie said...

Hah, Amy, so true, and it sounds like you're getting great information. We had a medical emergency early in our marriage in Chicago. Though in the end insurance covered most things, it was amazing how powerless I felt without information beforehand. I'm really trying to be responsible here, but it is difficult!

My plan at work is a work paid plan, so that is really nice, except when you actually have medical costs... like now. I'm super jealous of my friends in England, Canada, and Australia. A friend in Australia asked me why we weren't haven't kids yet a couple of years ago. When I answered it was too expensive he was shocked. "What? The government doesn't pay you?" The government not only paid for their birth, it also paid them for having a baby AND paid monthly payments afterwards. Amazing... that's for underpopulated Perth, though, and obviously we're in a very different situation.

And no, I don't qualify for Medicaid. That's the rough thing. When it's a sliding scale with medicaid to catch the bottom rung, it sucks to be just above the bottom rung but not have much money... it ends up costing the most out of pocket for people in our category.

Anonymous said...

Well we don't get paid for having babies as far as I know, although I think you do get something like £200 to buy you vegetables for the sake of the baby's nutrition apparently (wierd) but I find it VERY bizarre to understand what you are going through now. Too expensive to have a baby - I mean, I just can't get my head around that. Are you allowed to opt out on certain things if you don't want them like certain scans? I am SO sorry - I love the NHS, for all its inefficiency and mess ups (which are plenty for sure) I just think it is an amazing system and I feel so so privileged. I would so much rather pay more taxes than have to pay a deductible on having a baby or my health care. So all in all, do you know how much it's going to cost you out of pocket? Also, will your premiums go up? Do work take it out of your salary? I'm really sorry it's so hard and I am really thinking of you and think you are doing an absolutely awesome job.
Love always,
Rachel

Bob said...

Most states have a children insurance program that's low-cost (usually called CHIP). Here's a link to the Texas plan: http://www.texaschildrenshealthplan.org/

brevisdictus said...

Also, I don't know if you'd be eligible for this, but you can check out http://www.dshs.state.tx.us/wichd/gi/eligible.shtmas well.

Bob

kelleyann said...

Oh wow. That seems like a LOT to pay.

People always complain about HMOs but for some things they are good. I could have chosen a PPO or HMO at my job. Since we knew we wanted to start trying after about a year of employment I chose the HMO b/c of the birth policy.

I paid $240 TOTAL for all of my pre, delivery, post and Canaan's care. A $5000 deductible seems ridiculous!

product liability insurance said...

There are so many things to do when a new baby enters the family. Health insurance is an important matter to settle as soon as possible.

Insured Insurances said...

hey girl! you write really well...