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Forum: Trying to Conceive Your First Child

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  #1  
October 8th, 2008, 08:51 AM
STL_Beth's Avatar Platinum Supermommy
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Ok, so it's that time of year again when we have to estimate how much medical expenses we'll have in 2009 for our flexible spending account. If you estimate too high - you lose it, so we try to get as close as we can. The last 2 years, we have estimated so low, that we have run out by June...

I know this can vary greatly depending on a lot of factors, but I really have NO idea what things cost. My insurance copay is $45 for a specialist and it would be $45 copay TOTAL for all prenatal/postnatal visits. I also think the hospital coverage is 90% after a $500 deductible and $100 copay for ER (if they don't admit you). The thing is I could get pregnant up until around March and still be having this baby in 2009, so that's almost 6 months of trying and a good possibility. How much will it cost to stay in the hospital, etc when I have the baby????

Also, if I don't get pregnant by then, I would assume I would start taking medications. Are those covered by your insurance? I would think certain ones, like what my doctor wants to give me to induce ovulation would be covered since not ovulating is a problem (not necessarily elective), but what about like clomid. I'm pretty sure IUI and IVF isn't covered - how much do those things cost? Any other costs I might be forgetting??? ANY help would be great.

We also kind of talked about it that if we really overestimated, then we would have DH get his lasik surgery next year to use up more of that, but I really would like to plan on baby costs.
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  #2  
October 8th, 2008, 09:14 AM
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I know this is frustrating cause I've gone through this before. I choose not to do it anymore because my expenses are less than $100 because I rarely go to the doctor.

Let's say you go to the doctor twice at $45 - so there is 100.

Think about other doctors, such as the eye doctor and what if you get sick, so there is another - 100.

Most injectables are not covered in most insurances, but you really don't know if you'll need that....
but most insurances (and check this out) will let you buy over the counter meds, such as tylenol, advil, antacids, etc...and they count......do you know how much the formulary drugs are? Add another 100 or so for that.

What expenses does DH have?

I'm always afraid of losing the money....so I'd lowball it. You can start taking out $20-40 a month and stashing it away in a baby fund, so you'll have extra $$ for that time. That is what I do.

Also, most hospitals will end up settling with you. So if your bill is 4,000 - you can normally settle for a couple hundred dollars. (I was in the hospital for 3 days with pancreatitis back in 2004. I had an MRI that costed $10,000 and I ended up settling it for $500 and a few dollars)....

Just things to think about. Hope you get it figured out.
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  #3  
October 8th, 2008, 09:22 AM
MrsMamaS's Avatar Mega Super Mommy
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I am not much help since my company's health insurance is zero deductible and I have no out of pocket expenses for my prenatal care.

I do know that my doctor's office told me that just the doctor's services would cost $2500-$3000. That was all prenatal care and delivery. This does not include any hospital costs for testing, sonograms, or the delivery room.

Good luck!
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  #4  
October 8th, 2008, 09:31 AM
STL_Beth's Avatar Platinum Supermommy
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JLStombaugh - that's great that you have such a great medical plan. I didn't even think about it, but aren't the testing, u/s, etc covered under my 1 time $45 prenatal copay for my ob/gyn or do they charge you separately for that stuff? I'm so clueless.

Lee Ann - I do have other expenses. Our eye care is about $300 or so (we have contacts, etc) and then my husband suffers from rings around his throat (really wierd)...anyway, he has to get an upper endoscopy done every few months to widen his throat....
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  #5  
October 8th, 2008, 10:05 AM
ZaydensMomma's Avatar Aaron Nicole
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My DH and my health insurance (we have separate health insurance due to the fact we are college students and I am on disability) are worthless when it comes to TTC..but will cover prenatal care when I become pregnant.

I wish my DH was still on state health insurance..then TTC would be covered.
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  #6  
October 8th, 2008, 10:14 AM
MrsMamaS's Avatar Mega Super Mommy
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Quote:
JLStombaugh - that's great that you have such a great medical plan. I didn't even think about it, but aren't the testing, u/s, etc covered under my 1 time $45 prenatal copay for my ob/gyn or do they charge you separately for that stuff? I'm so clueless.

Lee Ann - I do have other expenses. Our eye care is about $300 or so (we have contacts, etc) and then my husband suffers from rings around his throat (really wierd)...anyway, he has to get an upper endoscopy done every few months to widen his throat....[/b]
That might all be covered under your copay for you. See for me, my doctor's office sends you to the hospital for basically everything. I had to go for my bloodwork and even to pee in a cup, and I will definitely have to go for my u/s. So far, in the insurance paperwork I have received, I always get separate statements - one for the doctor's office, one for the hospital. And the insurance company pays them separately. Like I said, I don't know what I'd have to pay because I haven't had and won't have a single copay because of my coverage.

If all else fails, my doctor had an insurance specialist who called my insurance while I was seeing the doctor for my first visit so by the time I was done she could tell me my expected costs (which are $0). Maybe you could call your OB/GYN's office and ask?

P.S. - My coverage is really good, but it costs. It's almost $1400 per month. That's almost $47 per day! Insane! Thankfully my work pays 75%. The kicker is when I go off for maternity leave, I'm responsible for 100% for those six weeks - that's $2000!!!!
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  #7  
October 8th, 2008, 10:18 AM
Hopingfor1soon's Avatar Expecting a Miracle!
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I will be back on in a bit to add more to this....my major and career is financial planning so I deal with ALOT!

Anyways, remember that things as simple as contact solution, Tylenol, cough drops etc...can also be paid for by your flex spending account....so the money isnt wasted and you can stop up!

Like I said I will be on later and crunch some numbers for you and see what I get! haha
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  #8  
October 8th, 2008, 10:32 AM
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I just wanted to add that even though you O on your own, if your Dr puts you on ANY fertility drugs including clomid, it will be considered infertility and wont be covered if you don't have fertility coverage. I originally saw my RE for recurrent pregnancy loss...not infertility but as soon as I started meds I was switched to infertility. Hopefully it doesn't come to that for you but I just wanted to give you a heads up. Most insurances cover something, ours covers everything up to IUI or IVF so our injectable cycles we have been doing have been covered. Just call your insurance and ask what exactly is covered.

Also I wanted to add that your insurance company should also be able to tell you what a normal vag or c/s hospital stay might run you.
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  #9  
October 8th, 2008, 10:40 AM
STL_Beth's Avatar Platinum Supermommy
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Holy Cow! I can't believe they don't pay for your health insurance during maternity leave. I will go on Short term disability for my maternity leave, which gives me 6 weeks, but I may take longer depending if I have the extra money saved up. I'm on my husband's insurance, so it continues to cover me regardless of what I do. I've already factored in everything else (my husband's throat surgeries, his medication, etc) and I know that I can use it on other things, but if I overestimate by $1,000 or something, how much extra cough syrup can 1 person have? :-)

I just wanted a basic idea of what having a baby costs. A friend at work said a cheap baby (no drugs, etc) would be about $2,000. I don't want to think the extreme (preemie and lots of NICU or something), I'd rather error on the side of too low. Does anyone know how much a round of Clomid or IUI or IVF costs?
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  #10  
October 8th, 2008, 12:38 PM
MrsMamaS's Avatar Mega Super Mommy
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Quote:
Holy Cow! I can't believe they don't pay for your health insurance during maternity leave. I will go on Short term disability for my maternity leave, which gives me 6 weeks, but I may take longer depending if I have the extra money saved up. I'm on my husband's insurance, so it continues to cover me regardless of what I do. I've already factored in everything else (my husband's throat surgeries, his medication, etc) and I know that I can use it on other things, but if I overestimate by $1,000 or something, how much extra cough syrup can 1 person have? :-)

I just wanted a basic idea of what having a baby costs. A friend at work said a cheap baby (no drugs, etc) would be about $2,000. I don't want to think the extreme (preemie and lots of NICU or something), I'd rather error on the side of too low. Does anyone know how much a round of Clomid or IUI or IVF costs?[/b]
I know - it sounds terrible, but it's totally understandable. I work for friends of the family at their very small trucking company. We're so small that I'm not covered by FMLA. I am the only employee that's ever needed maternity, so they weren't sure how to handle it. Unfortunately for me, if they pay my insurance while I'm off, they'd have to offer to do the same for anyone else who has any type of short-term disability issue. I cannot ask them to open themselves up for that kind of liability, so I've accepted that it's my bill to pay. They are being really nice and working with me. They're letting me "bank hours." Basically, they pay me for less hours than what I actually worked and are letting me save those unpaid hours to pay for my insurance while I need to be off.
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  #11  
October 8th, 2008, 01:05 PM
Brenda04's Avatar Mega Super Mommy
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I have a friend that is paying everything out of pocket and prenatal, hospital delivery (being that everything is normal no nicu or preemie) she is looking at $8,000.00

A round of IVF could be up to $10,000.00

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  #12  
October 8th, 2008, 01:21 PM
STL_Beth's Avatar Platinum Supermommy
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Quote:
I have a friend that is paying everything out of pocket and prenatal, hospital delivery (being that everything is normal no nicu or preemie) she is looking at $8,000.00

A round of IVF could be up to $10,000.00[/b]
HOLY COW!!!

Well I'm thankful that my insurance will cover 90% then. I did a little googling and I read something about how certain insurance companies cover infertility meds or that you can purchase separate insurance for that purpose. Has anyone ever heard about that?
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  #13  
October 8th, 2008, 01:27 PM
ZaydensMomma's Avatar Aaron Nicole
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Quote:
Quote:
I have a friend that is paying everything out of pocket and prenatal, hospital delivery (being that everything is normal no nicu or preemie) she is looking at $8,000.00

A round of IVF could be up to $10,000.00[/b]
HOLY COW!!!

Well I'm thankful that my insurance will cover 90% then. I did a little googling and I read something about how certain insurance companies cover infertility meds or that you can purchase separate insurance for that purpose. Has anyone ever heard about that?
[/b]
Do not let that scare you. You have to "shop" around to get IVF costs. I do know there's a clinic in Indianapolis that does IVF for $4,000. It's at http://ivf-indiana.com/ There are a few JM members over at TTC with medical assitance are driving all the way to this Indy clinic.
If the doctor says IVF is our only option then we will use that clinic in Indy. I'm from Indiana so I have that advantage to go home. I'm paying everything out of pocket. You are LUCKY to have insurance with that option.
Where did you see you can buy insurance for infertility meds as secondary insurance. I've been looking for secondary insurance but I doubt I will be able to afford that.
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  #14  
October 8th, 2008, 01:42 PM
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Quote:
Lee Ann - I do have other expenses. Our eye care is about $300 or so (we have contacts, etc) and then my husband suffers from rings around his throat (really wierd)...anyway, he has to get an upper endoscopy done every few months to widen his throat....[/b]
Most insurances will only make you pay the one time for all prenatal care, but check first.
Add in your $300. And everytime your DH has to go to the doctor add that in too.
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  #15  
October 8th, 2008, 02:26 PM
STL_Beth's Avatar Platinum Supermommy
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Most insurances will only make you pay the one time for all prenatal care, but check first.
Add in your $300. And everytime your DH has to go to the doctor add that in too.[/b]
Yeah, I know for sure that we only have to pay the 1 time copay...what I'm not sure about is like someone else mentioned if I will do my u/s and other tests at the doctors or if I get sent to the hospital and have to pay a separate bill for that. My doctor's office is located in a building in or near the hospital, so I am inclined to think that that 1 time fee covers everything. I guess I also assumed that my doctor would be the one performing the u/s, but I guess not? See how clueless I am? HAHA

The wierd thing about my DH is that when he goes in for these procedures, they are 100% covered, no copay, but then he has to have a follow up visit with the doctor about 2 weeks later (and to get his rx) and that costs $45 copay for a specialist visit....STUPID!!!

I think we are going to put away $2000 for all baby related stuff and use it for lasik if I don't need it for baby stuff.
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  #16  
October 8th, 2008, 04:42 PM
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I know this is may not be what you want, but you said that you had short term disability, is it a policy and does it cover pregnancy?
I actually use to have a pregnancy policy through Colonial Insurance. It was a short term disability policy that defined pregnancy as a short term disability. It payed up to 75% of my salary for up to four weeks once you have a baby.

I also had hospital policy through them that if I ended up spending one day in the hospital, I got $2,000 to cover expenses. Both policies paid directly to me and not towards the hospital or bill collectors.

The short term pregnancy policy costed me $48 / month. And the hospital policy costed me $16. It was all supplemental and was not covered through my work.

So there is another option you could potentially look into. I only found out about it cause the woman with colonial approached me at a health fair at work and told me that they have coverage for women who want a baby. You have to be on the policy for at least 10 months for it to pay-out....I guess cause if you bought it at 9 months they wouldn't make any money.

Just something additional to check out. You could call a few places and ask if they have a short term disability policy that covers pregnancy.
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  #17  
October 8th, 2008, 06:17 PM
ZaydensMomma's Avatar Aaron Nicole
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Quote:
I know this is may not be what you want, but you said that you had short term disability, is it a policy and does it cover pregnancy?
I actually use to have a pregnancy policy through Colonial Insurance. It was a short term disability policy that defined pregnancy as a short term disability. It payed up to 75% of my salary for up to four weeks once you have a baby.

I also had hospital policy through them that if I ended up spending one day in the hospital, I got $2,000 to cover expenses. Both policies paid directly to me and not towards the hospital or bill collectors.

The short term pregnancy policy costed me $48 / month. And the hospital policy costed me $16. It was all supplemental and was not covered through my work.

So there is another option you could potentially look into. I only found out about it cause the woman with colonial approached me at a health fair at work and told me that they have coverage for women who want a baby. You have to be on the policy for at least 10 months for it to pay-out....I guess cause if you bought it at 9 months they wouldn't make any money.

Just something additional to check out. You could call a few places and ask if they have a short term disability policy that covers pregnancy.[/b]
Who are you referring to? Me or others?

You mean look into Colonial insurane or others? I'm such an idiot in insurance dept.
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  #18  
October 8th, 2008, 07:15 PM
STL_Beth's Avatar Platinum Supermommy
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I am enrolled in a short-term disability plan. It covers pregnancy and I would get 6 weeks, 4 of those weeks would be 60% paid, the other 2 are either unpaid or I use my PDO time. I would then get another 6 weeks under FMLA, which would either be unpaid or PDO time again. My work is pretty flexible and depending on the time of the year, I may take off even more than that. I probably won't quit completely but I will cut back to part time or 40 hours or something.
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