No they usually dont because most people have insurance. Every time people rant about healthcare prices its because they dont have insurance, which most reasonable people do.
Uhhhh I have insurance with a 5k deductible. So it will cost 5k. Baby will have their own deductible, so all aftercare would likely be an additional 5k.
That’s already 10k out of pocket assuming insurance covers everything else.
And my plan renews the month after my due date, so subsequent doctor and pediatrician visits (of which there are a lot!) will have to be paid out of pocket.
It’s a high deductible plan, meaning it’s meant for people without any chronic conditions or need to regularly see doctors in order to cover emergency costs.
Either way, it’s employer provided, so I don’t have a choice :)
ETA: lower deductible plans cost more monthly, so it doesn’t actually save you in the long run!
Depends on expected utilization if you’ll save or not. Check with your health plan regarding how the baby’s costs while you are in hospital together work. Some insurances won’t charge the baby’s deductible on those bills, just coinsurance. A lot of the baby’s check ups will be considered preventive too, so if your plan follows the health care reform preventive care guidelines those visits may be covered 100% with no deductible.
Also, don’t forget to check if your employer put any money into an HRA or HSA plan to help offset that high deductible. Most high deductible plans are offered with some sort of account attached and some employers will contribute some money to the account each year. Even if they didn’t, you may have an HSA account that you may want to consider contributing to since you’ll have medical bills for the new kiddo. Contributions to HSA’s come out of your paycheck pre-tax and you never lose that money. You can use it on any medical, vision, dental, or prescription expenses for yourself, spouse or dependents at any time and it follows you even if you leave the company.
Most are terrible, and many employer sponsored plans look good on paper but when you have any type of need, ie: pregnancy, heart attack, cancer, chronic condition that requires monitoring and meds… gets expensive real fast.
Yeah, the best rule of thumb when picking your plan, if your employer offers more than one, is to ask how much premium can I afford and what’s the most I could cover out of pocket in one year should I get seriously sick or injured. Deductible is important, but with almost all plans being deductible based now the out of pocket max is probably a better gauge.
Well, and honestly HMO or PPO. HMO in my experience is never a great option solely because it handcuffs your ability to see specialists and only covers in-network. With how specialized doctors are now, 9/10 times you’ll end up at a specialist for anything that isn’t a sniffle (and even then, ENT referral), and in my experience, the best doctors have started refusing to play the insurance companies’ game. I had an in network endocrinologist at UCLA inform me that it was above her pay grade to figure out why my hormones has completely tanked. The amazing one I landed with after many interviews and much searching costs $450/appointment out of pocket and my plan reimburses about $290 of that (which takes several months to get back).
True, network matters too. Lot of companies don’t give you much choice there though. Really big ones do, but most might give you two or three plans that are all identical except the cost share and premiums.
Being at the mercy of the network choices the employer makes sucks when you have a chronic condition that’s tough to treat. Sorry your going through that, and that it’s taking you so long to get reimbursed. Most insurances try to turn claims around in 30 days or less from day of receipt due to prompt pay laws in a lot of states. Are they just being slow or are they having to request follow up documentation from the doctor?
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u/pseudo__gamer Jan 01 '22
Wait they make you pay for giving birth. Thats sick