I have an insurance question.

[MamaLoCo]

Ok, so my OB made a payment plan for me to cover my care and delivery at the hospital. It wasn't really a "plan" since I just paid it all at once but it was only about $411.
So here's the breakdown of the financial agreement.
My deductible is $600
My co-insurance is 80/20
My total estimated portion is $411.19
then they wrote in, "Allowable $2055.99"

So I know that my portion of the 80/20 coinsurance is the $411 because 20% of $2055.99 is $411.19. I don't know where the figure $2055.99 came from though. I'm guessing that's the total estimated cost of the care and delivery but that seems low compared to what other people have said they paid so maybe that's not including delivery afterall? But the agreement says that "Following this schedule will ensure that your delivery is paid in full by your 7th month of pregnancy" so it has to include delivery.

I also have $0 of my $600 deductible met so I'm curious as to when I'm expected to pay that. Is that stuff that the hospital will end up charging me that they just deducted from the total amount I'd owe? I thought I understood what was happening when we talked about it at my doctor's office but now I'm realizing they didn't really explain anything to me other than what I would pay them. I assumed that the bills I was getting from the lab companies was going towards the deductible and that over the course of my care, I'd be expected to reach the deductible maybe...but all of that is going towards my Out of Pocket Maximum.

So when am I going to be paying the deductible and who am I paying that to? That's the part I don't understand. Am I going to be getting a bill for $600 from the hospital after my delivery or am I going to be getting a bill for more than $600 or what?

and as a side question, what the heck are they adding into these delivery costs? We haven't even discussed a "birth plan" or what type of delivery I want or what type of drugs I want or don't want to use...maybe they didn't include the delivery and that's going to go towards deductible and I'll owe more later? I assume if they charge me in advance for drugs and epidurals, if I don't use them I'd be refunded...

I'm just so confused but I want to be financially prepared and not surprised with unexpected bills.

 

[Kristalebear1]

You know id be just as confused as you were. I didn't want to r&r though. I suggest calling your insurance company and asking them.

 

[MamaLoCo]

You know id be just as confused as you were. I didn't want to r&r though. I suggest calling your insurance company and asking them.

what is r & r?

 

[Kristalebear1]

You know id be just as confused as you were. I didn't want to r&r though. I suggest calling your insurance company and asking them.

what is r & r?

Read and Run, haha sorry its used commonly in my other pregnancy forum im on

 

[jlw617]

R and r= read and run

I'd just ask the billing person at your OBs office to explain everything, I hate insurance! We are used to having military insurance and I didn't have to know anything because they took care of it all.

 

[MrsStutler]

It's hard to answer since I don't know the super specifics of your plan but a call to them might help clear some things up.

For me the OB charges $2985 for her care which includes all the prenatal visits, her delivery charge and the follow up visit. What didn't get included was the lab work and the cost for the two ultrasounds she does. Those bills were sent to the insurance which gave an "allowed amount" and then I paid what was left. That did not go towards my deductible, but it did go towards the out of pocket max like yours.

The hospital will charge you for pretty much everything else delivery related. This includes your stay, any drugs, any anesthesia (epidural), and anything else you can think of from the time you are admitted to the time you are discharged. You may actually get a separate bill from an anesthesiologist if you go with an epidural (each hospital is a bit different on that).

Your baby will also get a bill from the hospital for their stay and possibly a separate bill from the pediatrician who sees them during their stay.

You will most likely pay the deductible amount out of the hospital bill but it's hard to say without knowing all the ins and outs of your specific plan.

My insurance had a deductible of $3500. Co-insurance of 80/20.
I ended up paying the entire $2985 to my OB (actually I'm STILL paying this off three years later haha) and then the hospital charged their stuff. I had to pay around $1400 or so for the hospital bill and then my son had his bill for around $900 (he gets his own deductible! yay!) and then the pediatrician bill for about $145.

I hope that helps but try giving your insurance a call or find a local insurance agent and I've found they are usually very willing to help you figure some of that stuff out! Good luck!

 

[babyvaughan]

I know most people say the total hospital stay comes to around $7k after everything. As far as your deductible if you haven't met it by the time you deliver it will be added to what you owe. So lets say your bill is 7k you will pay 600 dollars before your insurance pays a dime. So remaining $6,400 will be under your coininsurance so 20% is $1280. The 2k must be just your doctors fees for his/her part in the delivery of your baby. I would go to the hospital you plan to deliver at and meet with financial adviser they will help give you a better estimate of cost!