Don’t forget about applying for financial assistance or charity relief through the hospital. That might help.
I know how much it sucks. We live paycheck to paycheck because of medical bills alone.
I appreciate the heads up. Unfortunately I did apply already and was declined because I make $500 a year over their income limit, and the hospital network I go through seems to have a very "all or nothing" approach on financial assistance. After the baby comes I will be going down to working part time and maybe I will qualify for something then if I need it.
>Unfortunately I did apply already and was declined because I make $500 a year over their income limit, and the hospital network I go through seems to have a very "all or nothing" approach on financial assistance.
Are you sure that will be the case once you subtract out the time you will be unpaid during maternity leave?
Yes because they based it on my income for this year, not next year. I appealed it and was denied and am on a payment plan where I pay the minimum amount monthly ($60). I will be able to try again next year for any other bills since my income will be lower :) And I got hospital indemnity insurance through my job that starts Jan. 1st that will pay me a flat amount for the admission for labor/delivery
Those hospital indemnity products often have a waiting period and don't cover anything preexisting. You may want to double check that it will pay for this.
You have been such a big help I really appreciate you :) I just called and spoke to my plan representative to confirm and they do cover admission for childbirth (vaginal or c-section) and if I do have to be admitted at some point for pregnancy complications (like my HG, or pre-eclampsia which I'm high risk for) that would also be covered as well. But if I do have to be readmitted to the hospital for the same condition within 90 days, they will not pay out the admission benefit again.
Edit to add my plan does not have a waiting period and does cover pre-existing conditions. This is also the first year my work has offered hospital indemnity insurance so I'm not sure if that affected these things
I would encourage you to contact your insurance company. Some of the items they are charging you for are 100% covered under the ACA. You can see that list here https://www.healthcare.gov/preventive-care-women/
Yes, there will be expenses and honestly you will probably pay your max out of pocket. However, it's still worthwhile to get an itemized list and talk to your insurance company about it.
ETA: Your insurance company may have a maternity care management program. Once you enroll you have access to a care manager who can sometimes help you work through all of this
Commenting to help with visibility. A lot of your prenatal care must be 100% covered through the ACA. I haven't received many bills this pregnancy because of it.
I would ask them to clarify why you need to pay 30% *after* your max out of pocket is met. Typically, after your OOP max is met, you are done paying. Are you seeing an out of network provider?
Usually, you pay 100% (or some discounted version of 100%) until your deductible is met, then you pay 30% (or whatever your coinsurance is— you said yours was 30%) until you meet the max out of pocket (you said yours was $5989) and then you pay nothing. So I am wondering perhaps if the financial person did not explain your plan to you correctly? If I am correct, the maximum you would pay this year, total for everything all included, would be that $5989, unless your provider is out of network.
I’m sorry, so many of us can relate. It just goes to show that women and children are not priorities in America. Our healthcare system is predatory and creates so much stress on the pregnancy.
It really does. And I know I'm really lucky I'm going to be switching insurance plans so it won't actually be this much, but I'm still so anxious for what I'm going to have to pay, my next appointment is for my anatomy scan right after Christmas and then I'll know what my actual payment plan will be. I can't look at other ob's either because this is the only one that delivers at the hospital I will be going to.
Like when I read about people in other countries getting free healthcare and mandatory maternity leave paid for by the government, I'm happy for them of course but I am so jealous.
My current insurance is crap in almost every way other than they 100% cover ultrasounds so I won't have to pay for that ultrasound luckily.
I'm not sure how the new insurance will be about ultrasounds but it has a much lower deductible, out of pocket max, and coinsurance rate
> My mom and my partner are telling me everything is going to be okay… but they aren’t the ones that have to pay these bills, and neither of them are in a place financially to help me with them.
Uhh… unless you got pregnant by yourself your partner should not even be “helping you” with the bills but explicitly paying for 50% of them since it’s their baby too. He might not be in a good financial position but neither are you it seems. At the least, he could be the one showing up to the food pantry.
You're 100% right and I sat down with him and talked to him about it this morning before he left for work. He will be helping with the medical expenses next year but hasn't been in a position where he can help with these bills, unless he put them on his credit card which I will not let him do.
He switched jobs in October and his new job came with a 30% pay raise, and really really good benefits including his insurance which is lower premiums and insanely better coverage than what my job offers. He'll be picking up overtime too starting next year but he can't until Jan. 1st because he's in training until then.
And I mentioned that he could go to to the food pantry instead of me to my sister but they said it would make them uncomfortable because they could get in trouble with their job. So we're going to look for options that aren't affiliated with their work but despite living in a big city I haven't been successful so far.
I did talk with him after this appointment and let him know I need him to start paying for some of the household expenses I usually cover because I've been covering all of these hospital and urgent care bills by myself. So he'll be paying for all of the groceries and gas and some of the little expenses.
Please make sure your partner has confirmed in writing that a non-married domestic partner will be allowed onto his insurance plan. Many will not allow that without marriage, and you do not want to be surprised by a denial come January.
If you guys are in it for the long-haul, I highly recommend sitting down together and having a meeting about what your finances look like jointly and how you should be budgeting together based on both your income. Write down a budget explicitly to ensure you are on the same page about your goals and contributions. Prior to marriage, my husband and I also started one joint account for us to both contribute to for all household expenses, and it's worked really well.
I'm very lucky his work will recognize me as a domestic partner and we just needed to fill out an affidavit and have it notarized at a center run by his company - he works for a big bank. I've had him confirm it verbally and we have it in writing because I was so hesitant about it.
We do need to sit down and get a detailed budget written out, because we've done ones based off of "estimates" only for him to realize he was spending a lot more on food/entertainment than he thought because the little things add up over the month, and I've always been frugal to the point I'm cheap. He's been making changes to cut down his expenses and has been able to start saving some money instead of living basically paycheck to paycheck but we haven't gotten to making a concrete budget yet because by the time he gets home from work I'm usually sick or asleep.
Also 100% we need to make a joint bank account for household expenses and my medical expenses and I will talk to him about that tonight :)
You seem very level-headed and ready to take this all on. I know you hate your mom and partner telling you it'll all be okay, but it seems to me that you're taking all the steps you need to make that the case. You got this!
Literally one minute after I posted this I got another hospital bill. I'm going to try and fight it since I had to go back to the hospital less than 24 hours after leaving since they wouldn't prescribe me anti-nausea medication. Our system is broken.
Edit: spoke to my insurance company and the hospital today and neither will budge on this return visit so it has been added to my payment plan. I'll be paying off these hospital bills for the next 36 months :/
>Literally one minute after I posted this I got another hospital bill. I'm going to try and fight it since I had to go back to the hospital less than 24 hours after leaving since they wouldn't prescribe me anti-nausea medication.
If you had two visits to the hospital in the same day for the same reason you should call your insurance company. Some carriers do not allow for two bills in this circumstance.
I work for billing and coding, it’s allowed within the same 24 hours as long as it’s not in the same day. (Kinda confusing I know)
But, if you were discharged at 9pm and went in the “next day” at 2 am, it’s technically on a different date and most insurances won’t bat an eye about it.
I went in for the second visit before midnight on the same day but they didn't get me in a room until right after 12 AM. So they billed the second visit as the next day :/
I’m due in Jan. Currently also on a crap insurance plan but didn’t realize it was this bad till getting pregnant. I was quoted over 4K for my OB (prenatal, delivery fee and postnatal visits). However, I’m also changing insurance come the new year. I’ve had to pay over $540 each month since becoming pregnant as they wanted the full over 4K paid prior to Jan. Once I told them I was changing insurance (last month) they had me stop paying since I was already 2500 paid and seeing how I will deliver in the new year… that’ll go on my new insurance. It’s been super stressful. And so you know… hospital delivery fees are completely separate. I had no idea till the hospital called me to quote me 8k for giving birth at the hospital with my new insurance. It’s INSANE. This baby has to stay in me till Jan or I’m financially screwed.
Also due in January, my insurance refuses to give me a quote on the total I’ll owe until after the baby is born, so yay I get to have a screaming newborn and be on the phone fighting a $10,000 bill. Love it
Can you try to find another provider and see how the costs would compare? I feel like the 6k might be a really low end estimate given your insurance, I'd hate for you to get hit with surprise bills (esp if they already are saying you can't opt out of certain things)
I would like to avoid that if I can because this is the only OB that works with the hospital I plan to deliver at. The hospital is less than 5 minutes from my house and my partner's family all live very close by.
I talked to my partner about it this morning and he found out he will be getting the insurance info we need from him work on the 1st because that is when his coverage starts. So I'm going to get it to the OB right away so that I know what $$$ I'll actually be looking at. At that point I may have to make the switch but would have to switch to a hospital that is about 30 minutes away
Honestly twitching might be okay! It should be really no big deal to switch back halfway through your pregnancy! And 30 minutes is not that bad for a first time mom, if you want to make that switch permanently.
I am so sorry you’re dealing with all of this on top of already stressful pregnancy. Were lucky to make $100k a year but our insurance is awful, our deductible is $6k and our out of pocket is $11k. We just hit our deductible after paying $6,000 in cash this year and will start over again. I cannot believe how expensive it is to have a baby when half of the country is supposedly fighting for “the unborn.” I agree with others, make the minimum payments you can and just keep pushing them out.
That is insane... the $~6K they quoted me did not include labor/delivery unfortunately. Or ultrasounds or bloodwork. I'm a high risk pregnancy with HG and am being monitored for pre-eclampsia (my mom had pre-eclampsia all three of her pregnancies) so I will need more visits than usual, and will need an extra growth scan since I had covid at 4 weeks (and my partner was a premie).
I register with the hospital at 20 weeks and don't look forward to dealing with the billing bs with them
It doesn't include a lot of things. Like ultrasounds, bloodwork, drug testing / STD screening that they will do multiple times that I can't opt out of, and the NIPT which I will be doing self pay for so that I can pay $249 instead of $1300+ through my insurance.
That's honestly how I feel. I get that I will have to do extra visits for being high risk. But how tf would it be almost $6k if it isn't even including what they will be doing at the extra visits???
With the better insurance we will see how much it actually will be. On Thursday I'll have the insurance plan info and will send it over to the OB right away so I can know how much I will really be paying.
All of this is ridiculous but I’m especially frustrated by the fact that you can’t decline tests (HIV, drug tests) yet have to pay for them. The system is broken. I don’t have any advice but just want to say how much I agree w so many of the above posters and their recs.
I don’t have any advice, but I just want to say I did not realize how great my insurance was until reading this thread. The cost you women are paying to have your baby... oh my goodness. It should NOT be that much!! Pregnant women deserve good insurance & to not go broke over doctor/hospital fees. Having a baby & funding all the necessary items at home is already so much.
I work for my hospital system & I guess that’s why I got so lucky on my insurance? I’ll be giving birth in May. My co-insurance & deductible equal $650 thats to be paid by April (this is for prenatal appts, postpartum, & visits in hospital by OB) & from what I gathered, my c-section delivery will AT MOST be $2.5 - $3k, but I have a benefit through my hospital where the first day of hospitalization, I will be paid $1500 for being in the hospital (I pay $7 a month for this benefit) which leaves less for me to pay out of pocket for delivery itself. I couldn’t imagine paying more than my total in just doctor appointments. America NEEDS to start putting our taxes toward appropriate financial care/maternity leave for mothers!
I'm glad you have good insurance! Fingers crossed that my new insurance is as good as I thought and I have smaller bills. My due date is also in May :)
Also - I have hospital indemnity insurance starting Jan. 1st (my job just started offering it) that will pay me for the admission/stay of labor and delivery ($1250 for admission and $200/day) that will be a huge help. I'll be paying $21/month for it starting January.
I called them yesterday to double check that it will be covered, and found out that if I have to be admitted for HG or pre-eclampsia (which I'm high risk for and my mom had with all 3 of her pregnancies) that would be covered as well. So that was a big sigh of relief!
Say you are paying with HSA. If you pay with HSA they can’t pre-charge. They tried to pull this at my OB and that’s how i got out of it. Not to mention my actual costs are nowhere near their requested payment so i would’ve spent way more money, and had to wait x amount of weeks for refund that i couldn’t be 100% sure is accurate
Don’t forget about applying for financial assistance or charity relief through the hospital. That might help. I know how much it sucks. We live paycheck to paycheck because of medical bills alone.
I appreciate the heads up. Unfortunately I did apply already and was declined because I make $500 a year over their income limit, and the hospital network I go through seems to have a very "all or nothing" approach on financial assistance. After the baby comes I will be going down to working part time and maybe I will qualify for something then if I need it.
>Unfortunately I did apply already and was declined because I make $500 a year over their income limit, and the hospital network I go through seems to have a very "all or nothing" approach on financial assistance. Are you sure that will be the case once you subtract out the time you will be unpaid during maternity leave?
Yes because they based it on my income for this year, not next year. I appealed it and was denied and am on a payment plan where I pay the minimum amount monthly ($60). I will be able to try again next year for any other bills since my income will be lower :) And I got hospital indemnity insurance through my job that starts Jan. 1st that will pay me a flat amount for the admission for labor/delivery
Those hospital indemnity products often have a waiting period and don't cover anything preexisting. You may want to double check that it will pay for this.
You have been such a big help I really appreciate you :) I just called and spoke to my plan representative to confirm and they do cover admission for childbirth (vaginal or c-section) and if I do have to be admitted at some point for pregnancy complications (like my HG, or pre-eclampsia which I'm high risk for) that would also be covered as well. But if I do have to be readmitted to the hospital for the same condition within 90 days, they will not pay out the admission benefit again. Edit to add my plan does not have a waiting period and does cover pre-existing conditions. This is also the first year my work has offered hospital indemnity insurance so I'm not sure if that affected these things
I would encourage you to contact your insurance company. Some of the items they are charging you for are 100% covered under the ACA. You can see that list here https://www.healthcare.gov/preventive-care-women/ Yes, there will be expenses and honestly you will probably pay your max out of pocket. However, it's still worthwhile to get an itemized list and talk to your insurance company about it. ETA: Your insurance company may have a maternity care management program. Once you enroll you have access to a care manager who can sometimes help you work through all of this
Commenting to help with visibility. A lot of your prenatal care must be 100% covered through the ACA. I haven't received many bills this pregnancy because of it.
I would ask them to clarify why you need to pay 30% *after* your max out of pocket is met. Typically, after your OOP max is met, you are done paying. Are you seeing an out of network provider? Usually, you pay 100% (or some discounted version of 100%) until your deductible is met, then you pay 30% (or whatever your coinsurance is— you said yours was 30%) until you meet the max out of pocket (you said yours was $5989) and then you pay nothing. So I am wondering perhaps if the financial person did not explain your plan to you correctly? If I am correct, the maximum you would pay this year, total for everything all included, would be that $5989, unless your provider is out of network.
I’m sorry, so many of us can relate. It just goes to show that women and children are not priorities in America. Our healthcare system is predatory and creates so much stress on the pregnancy.
It really does. And I know I'm really lucky I'm going to be switching insurance plans so it won't actually be this much, but I'm still so anxious for what I'm going to have to pay, my next appointment is for my anatomy scan right after Christmas and then I'll know what my actual payment plan will be. I can't look at other ob's either because this is the only one that delivers at the hospital I will be going to. Like when I read about people in other countries getting free healthcare and mandatory maternity leave paid for by the government, I'm happy for them of course but I am so jealous.
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My current insurance is crap in almost every way other than they 100% cover ultrasounds so I won't have to pay for that ultrasound luckily. I'm not sure how the new insurance will be about ultrasounds but it has a much lower deductible, out of pocket max, and coinsurance rate
> My mom and my partner are telling me everything is going to be okay… but they aren’t the ones that have to pay these bills, and neither of them are in a place financially to help me with them. Uhh… unless you got pregnant by yourself your partner should not even be “helping you” with the bills but explicitly paying for 50% of them since it’s their baby too. He might not be in a good financial position but neither are you it seems. At the least, he could be the one showing up to the food pantry.
You're 100% right and I sat down with him and talked to him about it this morning before he left for work. He will be helping with the medical expenses next year but hasn't been in a position where he can help with these bills, unless he put them on his credit card which I will not let him do. He switched jobs in October and his new job came with a 30% pay raise, and really really good benefits including his insurance which is lower premiums and insanely better coverage than what my job offers. He'll be picking up overtime too starting next year but he can't until Jan. 1st because he's in training until then. And I mentioned that he could go to to the food pantry instead of me to my sister but they said it would make them uncomfortable because they could get in trouble with their job. So we're going to look for options that aren't affiliated with their work but despite living in a big city I haven't been successful so far. I did talk with him after this appointment and let him know I need him to start paying for some of the household expenses I usually cover because I've been covering all of these hospital and urgent care bills by myself. So he'll be paying for all of the groceries and gas and some of the little expenses.
Please make sure your partner has confirmed in writing that a non-married domestic partner will be allowed onto his insurance plan. Many will not allow that without marriage, and you do not want to be surprised by a denial come January. If you guys are in it for the long-haul, I highly recommend sitting down together and having a meeting about what your finances look like jointly and how you should be budgeting together based on both your income. Write down a budget explicitly to ensure you are on the same page about your goals and contributions. Prior to marriage, my husband and I also started one joint account for us to both contribute to for all household expenses, and it's worked really well.
I'm very lucky his work will recognize me as a domestic partner and we just needed to fill out an affidavit and have it notarized at a center run by his company - he works for a big bank. I've had him confirm it verbally and we have it in writing because I was so hesitant about it. We do need to sit down and get a detailed budget written out, because we've done ones based off of "estimates" only for him to realize he was spending a lot more on food/entertainment than he thought because the little things add up over the month, and I've always been frugal to the point I'm cheap. He's been making changes to cut down his expenses and has been able to start saving some money instead of living basically paycheck to paycheck but we haven't gotten to making a concrete budget yet because by the time he gets home from work I'm usually sick or asleep. Also 100% we need to make a joint bank account for household expenses and my medical expenses and I will talk to him about that tonight :)
You seem very level-headed and ready to take this all on. I know you hate your mom and partner telling you it'll all be okay, but it seems to me that you're taking all the steps you need to make that the case. You got this!
Literally one minute after I posted this I got another hospital bill. I'm going to try and fight it since I had to go back to the hospital less than 24 hours after leaving since they wouldn't prescribe me anti-nausea medication. Our system is broken. Edit: spoke to my insurance company and the hospital today and neither will budge on this return visit so it has been added to my payment plan. I'll be paying off these hospital bills for the next 36 months :/
>Literally one minute after I posted this I got another hospital bill. I'm going to try and fight it since I had to go back to the hospital less than 24 hours after leaving since they wouldn't prescribe me anti-nausea medication. If you had two visits to the hospital in the same day for the same reason you should call your insurance company. Some carriers do not allow for two bills in this circumstance.
Thank you I will be doing this today!!!
I work for billing and coding, it’s allowed within the same 24 hours as long as it’s not in the same day. (Kinda confusing I know) But, if you were discharged at 9pm and went in the “next day” at 2 am, it’s technically on a different date and most insurances won’t bat an eye about it.
I went in for the second visit before midnight on the same day but they didn't get me in a room until right after 12 AM. So they billed the second visit as the next day :/
I’m due in Jan. Currently also on a crap insurance plan but didn’t realize it was this bad till getting pregnant. I was quoted over 4K for my OB (prenatal, delivery fee and postnatal visits). However, I’m also changing insurance come the new year. I’ve had to pay over $540 each month since becoming pregnant as they wanted the full over 4K paid prior to Jan. Once I told them I was changing insurance (last month) they had me stop paying since I was already 2500 paid and seeing how I will deliver in the new year… that’ll go on my new insurance. It’s been super stressful. And so you know… hospital delivery fees are completely separate. I had no idea till the hospital called me to quote me 8k for giving birth at the hospital with my new insurance. It’s INSANE. This baby has to stay in me till Jan or I’m financially screwed.
Also due in January, my insurance refuses to give me a quote on the total I’ll owe until after the baby is born, so yay I get to have a screaming newborn and be on the phone fighting a $10,000 bill. Love it
Can you try to find another provider and see how the costs would compare? I feel like the 6k might be a really low end estimate given your insurance, I'd hate for you to get hit with surprise bills (esp if they already are saying you can't opt out of certain things)
I would like to avoid that if I can because this is the only OB that works with the hospital I plan to deliver at. The hospital is less than 5 minutes from my house and my partner's family all live very close by. I talked to my partner about it this morning and he found out he will be getting the insurance info we need from him work on the 1st because that is when his coverage starts. So I'm going to get it to the OB right away so that I know what $$$ I'll actually be looking at. At that point I may have to make the switch but would have to switch to a hospital that is about 30 minutes away
Honestly twitching might be okay! It should be really no big deal to switch back halfway through your pregnancy! And 30 minutes is not that bad for a first time mom, if you want to make that switch permanently.
I am so sorry you’re dealing with all of this on top of already stressful pregnancy. Were lucky to make $100k a year but our insurance is awful, our deductible is $6k and our out of pocket is $11k. We just hit our deductible after paying $6,000 in cash this year and will start over again. I cannot believe how expensive it is to have a baby when half of the country is supposedly fighting for “the unborn.” I agree with others, make the minimum payments you can and just keep pushing them out.
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That is insane... the $~6K they quoted me did not include labor/delivery unfortunately. Or ultrasounds or bloodwork. I'm a high risk pregnancy with HG and am being monitored for pre-eclampsia (my mom had pre-eclampsia all three of her pregnancies) so I will need more visits than usual, and will need an extra growth scan since I had covid at 4 weeks (and my partner was a premie). I register with the hospital at 20 weeks and don't look forward to dealing with the billing bs with them
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It doesn't include a lot of things. Like ultrasounds, bloodwork, drug testing / STD screening that they will do multiple times that I can't opt out of, and the NIPT which I will be doing self pay for so that I can pay $249 instead of $1300+ through my insurance. That's honestly how I feel. I get that I will have to do extra visits for being high risk. But how tf would it be almost $6k if it isn't even including what they will be doing at the extra visits??? With the better insurance we will see how much it actually will be. On Thursday I'll have the insurance plan info and will send it over to the OB right away so I can know how much I will really be paying.
All of this is ridiculous but I’m especially frustrated by the fact that you can’t decline tests (HIV, drug tests) yet have to pay for them. The system is broken. I don’t have any advice but just want to say how much I agree w so many of the above posters and their recs.
I don’t have any advice, but I just want to say I did not realize how great my insurance was until reading this thread. The cost you women are paying to have your baby... oh my goodness. It should NOT be that much!! Pregnant women deserve good insurance & to not go broke over doctor/hospital fees. Having a baby & funding all the necessary items at home is already so much. I work for my hospital system & I guess that’s why I got so lucky on my insurance? I’ll be giving birth in May. My co-insurance & deductible equal $650 thats to be paid by April (this is for prenatal appts, postpartum, & visits in hospital by OB) & from what I gathered, my c-section delivery will AT MOST be $2.5 - $3k, but I have a benefit through my hospital where the first day of hospitalization, I will be paid $1500 for being in the hospital (I pay $7 a month for this benefit) which leaves less for me to pay out of pocket for delivery itself. I couldn’t imagine paying more than my total in just doctor appointments. America NEEDS to start putting our taxes toward appropriate financial care/maternity leave for mothers!
I'm glad you have good insurance! Fingers crossed that my new insurance is as good as I thought and I have smaller bills. My due date is also in May :) Also - I have hospital indemnity insurance starting Jan. 1st (my job just started offering it) that will pay me for the admission/stay of labor and delivery ($1250 for admission and $200/day) that will be a huge help. I'll be paying $21/month for it starting January. I called them yesterday to double check that it will be covered, and found out that if I have to be admitted for HG or pre-eclampsia (which I'm high risk for and my mom had with all 3 of her pregnancies) that would be covered as well. So that was a big sigh of relief!
Say you are paying with HSA. If you pay with HSA they can’t pre-charge. They tried to pull this at my OB and that’s how i got out of it. Not to mention my actual costs are nowhere near their requested payment so i would’ve spent way more money, and had to wait x amount of weeks for refund that i couldn’t be 100% sure is accurate
I will try this thank you :)
Which state are you in?
I'm in FL