Good health insurance plan in the US?

[nightkd]

Sorry to intrude, we're not pregnant yet, but starting to TTC soon, I thought this would be the best place to ask... We're looking for a good health insurance plan that will cover me ASAP and obviously include the maternity coverage!

Any recommendations? We're generally looking for health insurance for the both of us, but the Maternity stuff is most important currently... We're a bit lost as we've seen a LOT of places who have like a year limit - so you have to have the coverage then wait a year before you conceive?!????

Any advice appreciated!! We're in Oklahoma (if that makes a difference - some companies seem to be more local or have certain things in certain states...)

 

[tasha41]

*cough* move to Canada *cough*



Sorry I have no useful advice! lol

 

[nightkd]

!!! I did say any advice appreciated! I'd prefer to move back to the UK if we were going to do any moving! It's so much simpler there!!

 

[Seity]

Are either of you offered it through work? I have a choice of plans through my office and I chose the one I could afford that covered my usual medical expenses (aka once a year exam and not too expensive prescriptions) and had a good maternity coverage as well (since I knew we were going to ttc). Our plan at work is effective as soon as you sign up for it.

 

[nightkd]

Nope, unfortunately not.

I've looked into a couple, looks about $250 a month, or more... The website doesn't give enough details on it though... Do you end up paying a big excess aka how much of your maternity treatment etc do you end up paying for before the insurance does? The $250-$300 plan I was looking at is like a $5000 excess.

 

[nightkd]

Somebody said it was better to get a plan with a lower excess - like we pay for the first $1000 and just pay a higher amount each month towards the insurance, as it works out better than doing a higher excess and paying a lower amount out each month.... I guess that makes sense - $1000 and $490 each month or $5000 and $200 each month... Doesn't it?!

 

[Seity]

I pay a little over $200 a month for my plan. I also have to pay $350 deductible before the insurance starts to cover things. However, copay's and prescriptions don't count toward the deductible. I got a plan with 100% maternity as long as I went to a provider on their list. So, as best as I can tell I don't pay anything for my maternity. I went to a doctor that wasn't on their list when I had a UTI, so I had to pay for that 100% and so that came out of my deductible for the year, but so far that's the only time I've had to pay because I almost always go to a doctor off of their list. I hope that helps explain it some.
Some plans pay a percentage, like 85% and you pay the other 15%, some will just have a copay that is a set amount usually around $20 that you pay every time you visit a doctor on their provider list. Lower monthly costs often have a higher deductible, so you have to look at see what sort of things might apply to that if any to see if you're better of with a higher or lower monthly cost. Maternity is almost always listed separately on the plans since it generally is covered a bit better than a regular doctor or hospital visit.

 

[amerikiwi]

!!! I did say any advice appreciated! I'd prefer to move back to the UK if we were going to do any moving! It's so much simpler there!!

Ha ha--I was going to recommend moving to NZ!

 

[LogansMama]

Private Insurance SUCKS. I am lucky that I get it through work... its my understanding though - that there are many insurance companies that offer maternity coverage after about 3 months on the plan... I don't believe they ALL require a year.

HOnestly - your best bet will be to get a job that offers it. If you can't, then expect to pay a HUGE amount. OR - don't bother and just use medicaid? Not your best option, but will cover your needs if you wind up pregnant before you have proper insurance.

 

[nightkd]

Thanks. We're not even that desperate for regular medical insurance, just the maternity side would do us right now..

What is Medicaid?

Lol! I don't think moving is an option, otherwise we'd go back to the UK!!!

DH is going to ask at work tomorrow as they did sort him out some medical insurance when he first started, he doesn't think it's THROUGH work, it was just because he'd just moved here and his uncle (who he works for) helped him set up some insurance... It's always a possibility that he could get a discount or something though, so he's going to have a word and see what he can find out.

 

[Gunner's Mama]

I did my research online by searching websites that compared different companies plans side by side in Oregon. Each state licenses insurance companies so you have to search for available plans in your state. It is expensive...we pay $504 month for $1000 deductible and pay 20% on everything else with a $3000 out of pocket maximum each year. Read the fine print...some plans may seem like a good deal till you look at the details. We get the first few Dr.'s visits for $15 and then we start working towards the deductible for us. Good luck. I had excellent coverage with my son and only had to pay about $150 out of pocket...with this baby we are looking at $3000.

 

[nightkd]

We had one company keep ringing us over and over even though we said we didn't want the insurance, they said they'd taken us off of their calling list but they rang again, 4 times! Put the phone down on us multiple times... =/ So I'm a bit worried about providing our contact information, as all of the comparison sites I've checked out ask for address/telephone number etc.

Somebody in TX said they only paid $500 out of pocket in total...that'd be fine with us!!! We just don't want to be paying several thousand if we don't need to!!

 

[nightkd]

I am so frustrated!! I've just looked through a load of 'recommended' plans based on information I provided and they are either ridiculously expensive, confusing or don't cover until you've had a years worth of coverage before you conceive!!

I found one that will cover about $2000-$2500...

Can you have more than one plan at once? Eg one plan to cover the majority then another to cover some of what's left? We obviously know that we're going to end up paying out SOME amount!

 

[MommaBunni]

You could do Medicaid and a supplemental Medicaid plan with that. I haven't been on it as I have Blue Cross and Blue Sheild through work. But the few people I know on it got great and if not better coverage than I did and mine is pretty amazing. (Some had the 4-D scans done for FREE!) I don't know much about medicaid so you'd have to look it up. Good luck dearie!

 

[Chaos]

We have Blue Cross Blue Shield 123 options plan.

We pay a higher premium of 300 and some change a month, but only have a $1000 deductible (excess) to pay before they will cover anything. We have nearly met that for the year now. After that BCBS will pay 90% of the bill and we pay 10%.

Our 10% goes towards a further $4000 deductible and once that is reached BCBS will cover 100% of the bill.

Although the premium is expensive, its been good for this pregnancy because the OB office care alone has reached 3200, then we will be getting a bill from the hospital, which I'm estimating will be about 5000, then if I have an epi, some more. Out of that we will only need to pay about 700.

I dunno about waiting a year, I fell pregnant 28 days after our policy started haha. Insurance is on a yearly basis tho and the excess resets every 12 months, kinda like car insurance back home.

Oh, if you go for insurance by your self, privately, most places will not give you maternity coverage, you have to get insurance through a job to get that coverage .. I have no idea for that reason (we looked in to it also)

Also look in to the fine print. A lot of insurances will only cover you if you go to a specific OB they've listed. Our insurance let us choose our own OB as long as they were 'in network'.

I miss home and the NHS, I told the hubby it'd be cheaper to buy a plane ticket and let me fly home and have her lol.

 

[nightkd]

Thanks guys. DH went and spoke to the insurer that his uncle set him up with when he was first here...the guy said there's no point getting maternity insurance, it's better just to get health insurance that covers Drs Visits etc and Emergencies (including emergency C-Sections) and just put a certain amount of money away each month for the birth itself... We're going to get a health savings account when we can. But guess what; I can't get Health Insurance until (the guy wasn't sure on this) I've been here a year (which can't be right) or perhaps until I have my SS number. Just another thing to add to the list of 'can't do's' until I have that SS number.

Some positivity though, just need my SS number.

 

[Chaos]

Thanks guys. DH went and spoke to the insurer that his uncle set him up with when he was first here...the guy said there's no point getting maternity insurance, it's better just to get health insurance that covers Drs Visits etc and Emergencies (including emergency C-Sections) and just put a certain amount of money away each month for the birth itself... We're going to get a health savings account when we can. But guess what; I can't get Health Insurance until (the guy wasn't sure on this) I've been here a year (which can't be right) or perhaps until I have my SS number. Just another thing to add to the list of 'can't do's' until I have that SS number.

Some positivity though, just need my SS number.

Welcome to the American Visa process

 

[nightkd]

^ It's not as sexy as I'd imagined. V.V

Ah well, I have a nice list of things to do when I get my SS number!!!

 

[mrso]

Just a few thoughts....
If your hospital bill is only 5000 total then you are going to be very lucky. With our 20% copay the hospital bill was almost $3500 and baby care alone was $ 1200 (our 20%). They charge you for everything. 800mg Advil were 5.00 a pill. Plus if you have an epi you typically have to pay the anasthialogist spearate and when the pediatrician checks out the baby they will also send you a bill. It gets really frustrating. Your insurance will cover a portion of those charges but just an FYI.


Currently I am on a group policy through my husbands company but before we were married I had an individual policy. My monthly premium was 450 and deuctable for everything EXCEPT maturnity was 500. Maturnity deductable was 5000. Then after that they covered 20%. That was with Blue Cross Blue Shield of Wyoming. Blue Cross is very good about paying for almost any doctor becasue they are a "state" mandated insurance company. A lot of facilities (hospitals, doctors, dentists) are "providers" of BCBS insurance so they offer other discounts when a claim is processed. The facility pays a fee to BCBS so you get better coverage.

At one point I had Assurant Health insurance and it was horrid. You had to have a doctor in their "network" in order for them to pay anything. In Wyoming there are no networked doctors so it made me rethink my insurance options.

When I had my individual BCBS policy I had to have coverage for 8 months before they would cover any maturnity stuff. With my group BCBS policy I didnt have any waiting period. Most insurance policies have maternity coverage it just depends on how much you want to pay for it.

As far as using Medicare/medicaid/title 19 (different name for each state)/ WIC (women infant children program)/ or any other state/government program... you have to qualify for them. Typically you have to be low income or poverty line to qualify for these. They take into consideration the family income and make you take in months of pay stubs to prove income amount.

Just a few more things to think about when looking at insurance and Government programs. Good luck with the SS card

 

[mrso]

My SIL is 18 weeks pregger and quit her job therefore lost her insurance when she was 12 weeks along. Dont know why, but it was the dumbest thing she could have done. Her husband makes too much money to qualify for any government assistance so they now have tons of debt and a baby on the way.

They are looking at paying about 17,000 to 20,000 dollars for the prenatal care/delivery/and hospital bills. I would hate to say what is costs if something is wrong and they have to go to Denver for specialized care.

Just remember ladies everybody charges for everything. You will have prenatal care, ultrasounds, perscriptions, then the doctor charges a separate charge for the delivery, anasthelogist, pediatrician, hospital, lab fees. So dont think that 17,000 is over-estimating the price for baby and delivery.