question about health insurance and pregnancy.

Semidevil

Diamond Member
Apr 26, 2002
3,017
0
76
I always assumed that if I get health insurance for my spouse through my employer, and assuming I dont get the crappy basic one(also assuming the type of insurance), it would have at least some form of coverage for all the pregnancy visits, and the hospital stays when it comes to delivering.

Is that true?

I had someone tell me today that heatlh insurance and 'pregnancy insurance' are 2 completetly different things, and if I want to get any sort of coverage for my wife when she becomes preggers, I need yo purchase a whole different type of insurance?

someone explain and tell me.
 

minendo

Elite Member
Aug 31, 2001
35,558
16
81
Originally posted by: Pabster
It varies. But you'd better be prepared. Birth is not a cheap experience. ;)
Exactly. You can't put a price on all of your hopes and dreams. :p
 

Mxylplyx

Diamond Member
Mar 21, 2007
4,197
101
106
Just look at the benefits booklet and see what coverages, if any, there are for maternity benefits and what the costs are. In addition, I believe federal law prohibits pregnancy from ever being considered a pre-existing condition.

Any employer sponsored plan I've ever seen includes maternity benefits.
 

Mossimo142

Member
Jul 20, 2005
79
1
71
Actually i have quite the different experience with healthcare/insurance and birth. I am a federal employee and think I have pretty good health insurance - United Healthcare of the Midwest.

My daughter was born a month or so early and did not have fully developed lungs. Expenses for my wife (now ex grrr), were around 6k and my daughters hospital bill was around 60k. She had to stay an extra week with a neonatologist oncall 24/7.

All I had to be pay the very first $10 co pay for her first pregnancy dr.'s visit and a 250 hospital admission fee for my wife. Since my daughter stayed longer than my wife I had to pay another $250 admission fee for her, but only having to pay $510 out of ~ 65-70k in medical bills is pretty f'ing sweet if you ask me.
 

JulesMaximus

No Lifer
Jul 3, 2003
74,459
854
126
I honestly can't believe that any citizen of this country needs to worry about whether or not the birth of a child is covered by insurance or not.

Sad fucking state of affairs we have ourselves in if you ask me.
 

fossilburner

Member
May 22, 2008
88
0
0
Originally posted by: JulesMaximus
I honestly can't believe that any citizen of this country needs to worry about whether or not the birth of a child is covered by insurance or not.

Sad fucking state of affairs we have ourselves in if you ask me.

:(
 

nanette1985

Diamond Member
Oct 12, 2005
4,209
2
0
You do have to check out the type of insurance before you sign up. I know that as an employer, you can save on insurance by not including things like having babies. Be prepared.
 

vi edit

Elite Member
Super Moderator
Oct 28, 1999
62,387
8,154
126
Definitely check with your HR office for specifics on benefits.

My wife and I have the same insurance and it worked out like this:

$100 co-pay for all of her routine prenatal visits combined(that was like 12 seperate office trips).

Then it was a $300 delivery charge for my wife, and a $300 visit fee for my daughter.

$700 out of pocket...though technically it was more like $500 since we used the medical flex plan that took out pre-tax money.

Total billable tab for just the hospital part at delivery was over $32,000. Plus whatever the prenatal visits were.
 

RichardE

Banned
Dec 31, 2005
10,246
2
0
Originally posted by: vi edit
Definitely check with your HR office for specifics on benefits.

My wife and I have the same insurance and it worked out like this:

$100 co-pay for all of her routine prenatal visits combined(that was like 12 seperate office trips).

Then it was a $300 delivery charge for my wife, and a $300 visit fee for my daughter.

$700 out of pocket...though technically it was more like $500 since we used the medical flex plan that took out pre-tax money.

Total billable tab for just the hospital part at delivery was over $32,000. Plus whatever the prenatal visits were.

32k for birth? Jesus....


/loves his healthcare
 

JEDI

Lifer
Sep 25, 2001
30,160
3,300
126
Originally posted by: Semidevil
I always assumed that if I get health insurance for my spouse through my employer, and assuming I dont get the crappy basic one(also assuming the type of insurance), it would have at least some form of coverage for all the pregnancy visits, and the hospital stays when it comes to delivering.

Is that true?

I had someone tell me today that heatlh insurance and 'pregnancy insurance' are 2 completetly different things, and if I want to get any sort of coverage for my wife when she becomes preggers, I need yo purchase a whole different type of insurance?

someone explain and tell me.

yup, you need a maternity add-on. plus if she was preggers already, it's a preexisting condition. ie: too late

note:
it depends on the insurance company/plan, obviously
 

Slew Foot

Lifer
Sep 22, 2005
12,381
96
86
Cant say Ive ever heard of any health insurance that wasnt pure crap that didnt cover maternity, in fact, most plans cover maternity better than almost anything else. When my Aunt was in practice, the noninsured cash rate was $2000, that included delivery and all prenatal visits.
 

Queasy

Moderator<br>Console Gaming
Aug 24, 2001
31,796
2
0
Originally posted by: Mossimo142
Actually i have quite the different experience with healthcare/insurance and birth. I am a federal employee and think I have pretty good health insurance - United Healthcare of the Midwest.

My daughter was born a month or so early and did not have fully developed lungs. Expenses for my wife (now ex grrr), were around 6k and my daughters hospital bill was around 60k. She had to stay an extra week with a neonatologist oncall 24/7.

All I had to be pay the very first $10 co pay for her first pregnancy dr.'s visit and a 250 hospital admission fee for my wife. Since my daughter stayed longer than my wife I had to pay another $250 admission fee for her, but only having to pay $510 out of ~ 65-70k in medical bills is pretty f'ing sweet if you ask me.

I had two different private health insurance companies for birth of both of my kids. My first was born 8 weeks early and spent 3 week in the neo-natal intensive care unit.
My second almost came out at week 23 and we were told she would die if she did. The doctors tried something immediately to save her and keep her from coming out and she ended up being born only 4 weeks early and didn't have to spend anytime in intensive care.
My wife spent most of both pregnancies on bedrest both at home and in the hospital.

Through it all, I never had to worry about my insurance beyond filling out forms and straightening out payment for one bill because the insurance company filled out a form wrong.

Like Mxylplyx, I've never seen health insurance that didn't cover maternity care. It's mandated by law more often than not.
 

Queasy

Moderator<br>Console Gaming
Aug 24, 2001
31,796
2
0
Originally posted by: JEDI
Originally posted by: Semidevil
I always assumed that if I get health insurance for my spouse through my employer, and assuming I dont get the crappy basic one(also assuming the type of insurance), it would have at least some form of coverage for all the pregnancy visits, and the hospital stays when it comes to delivering.

Is that true?

I had someone tell me today that heatlh insurance and 'pregnancy insurance' are 2 completetly different things, and if I want to get any sort of coverage for my wife when she becomes preggers, I need yo purchase a whole different type of insurance?

someone explain and tell me.

yup, you need a maternity add-on. plus if she was preggers already, it's a preexisting condition. ie: too late

note:
it depends on the insurance company/plan, obviously

link

Federal law bars group health insurance plans that cover maternity from considering pregnancy a pre-existing condition. This means that if you change group health plans while you're pregnant, your new group health insurer (as long as it covers maternity) can't deny claims related to your pregnancy. But a variety of loopholes means pregnant women could still lack insurance coverage for their prenatal care if they don't do some careful planning.

 

Paperdoc

Platinum Member
Aug 17, 2006
2,297
272
126
I live in Ontario, Canada, where basic health care costs are covered by government-paid insurance. Most costs linked to a child's birth would be covered by that system. The problem here has become that nobody understands how much that is. We hear constantly people complaining about high taxes and high government expenditures for health services; a few wish we could all do like the USA and just pay for it all ouselves. But I bet almost none of them know that a basic uncomplicated birth can total 30 grand at the hospital, PLUS all the prenatal care!!!
 

MrChad

Lifer
Aug 22, 2001
13,507
3
81
I guess it depends on your insurance coverage. My wife's prenatal and hospital care was all covered by our insurance, no "add-ons" necessary.
 

Corbett

Diamond Member
Jun 8, 2005
3,074
0
76
Originally posted by: Semidevil
I always assumed that if I get health insurance for my spouse through my employer, and assuming I dont get the crappy basic one(also assuming the type of insurance), it would have at least some form of coverage for all the pregnancy visits, and the hospital stays when it comes to delivering.

Is that true?

I had someone tell me today that heatlh insurance and 'pregnancy insurance' are 2 completetly different things, and if I want to get any sort of coverage for my wife when she becomes preggers, I need yo purchase a whole different type of insurance?

someone explain and tell me.

Why dont you talk to your HR department? They will know EXACTLY what your insurance covers.
 

dullard

Elite Member
May 21, 2001
25,045
3,399
126
From what I've seen, most basic plans do not cover anything pregnancy related. You can get a pregnancy option, but that is often about $300 per month extra. Your employer may or may not pay that extra $300/month. So, you might come out to $3600/year + whatever deductables and other fees you might have to pay for the pregnancy.

Compare that to a straight cash program at the local hospital. Many will cover everything pregnancy related for about $6k if you sign a contract to pay it before any complications are discovered.

Unless you plan to have a child every year, it often is cheaper to not have pregnancy coverage through insurance. This has two big catches though: it assumes your employer doesn't cover the extra insurance premium and it assumes you actually get the hospital to agree to a fixed rate early on.
 

PokerGuy

Lifer
Jul 2, 2005
13,650
201
101
My wife ended up having to stay at the hospital when she was pregnant with twin boys. After the boys were born, they had to stay at the neonatal ICU for two weeks. Altogether, my out of pocket for this stuff was around $10,000.

Now I happen to be in a position where that's a lot of money but I'll just have to make some sacrifices for a while to pay for this stuff. I can't imagine that most americans have $10,000 in cash laying around to pay for childbirth.... and that's not even counting all the other stuff that goes with the birth of a child of course, I'm just talking about the cost of the pregnancy and deliver.

OP, most likely pregnancy is covered, I'd be very surprised if there are too many group health plans that don't cover pregnancy and delivery. Check with your HR folks though.
 

nanette1985

Diamond Member
Oct 12, 2005
4,209
2
0
Originally posted by: Slew Foot
Cant say Ive ever heard of any health insurance that wasnt pure crap that didnt cover maternity, in fact, most plans cover maternity better than almost anything else. When my Aunt was in practice, the noninsured cash rate was $2000, that included delivery and all prenatal visits.

Maybe, but the insured rate was a lot more than that. Then the insurance companies, or whoever, started having rules about reimbursement and all that. Insurance co's don't like discount rates - unless it's the insurance company that's doing it.

If you've read this thread you can no longer say that you've never heard of health insurance that doesn't cover maternity. :D But you're right, if you have maternity coverage then it probably be really good coverage.
 

queenrobot

Platinum Member
Aug 20, 2007
2,061
0
0
I have a crappy group insurance plan. They do not cover pregnancy. Yet another reason for me not to have kids! :)
 

Scarpozzi

Lifer
Jun 13, 2000
26,389
1,778
126
My group insurance through work has $15 copay per visit and I think $50 for the actual child-birthin' charge. It's not bad at all considering it's spanned over many months. Most everything you need for vitamins, drugs, etc are all fairly cheap anyhow. I've not actually had to pay it yet, but my boss was telling me he was surprised by how good our plan here is for an HMO.

Now....United Health Care bought John Deere, so it might suck now....who knows.
 

hanoverphist

Diamond Member
Dec 7, 2006
9,928
23
76
ive never had insurance from work that didnt cover maternity and all that comes with it. my first was born within the 1 year no benefits when i got one of my jobs, so we went to the county for help. $750 total at the county hospital, and the care was exceptional. my twins were born almost 3 years later with insurance coverage, 250 a kid and 50 for the wife. total. natural twins birth at 36 weeks too. there were 4 docs and 22 students watching, that apparently doesnt happen too often. my son was born breach with the cord wrapped around his throat, and had complications at first... the extra costs were absorbed by the insurance as well. the final hospital bill was a bit over 90k when all said and done, im really glad we had insurance at that point.
 

spidey07

No Lifer
Aug 4, 2000
65,469
5
76
I have never heard of insurance not covering pregnancy. Here it is 150 dollar copay for the delivery and any associated costs and 10 bucks co-pay for doctor visits, all associated prescriptions free.