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Maternity coverage.. am I understanding this right?


Forum: July, August & September 2012 Playroom

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  #1  
January 23rd, 2012, 01:11 PM
3Sapphires's Avatar Platinum Supermommy
Join Date: Feb 2008
Location: the mountain state
Posts: 11,409
We pay through the nose for our insurance (well actually DH's employer pays 70%), mostly because I knew I wanted more kids and wanted good coverage.

So we don't have a deductible = yay!
My copay for prenatal care is $30 = yay (maybe? not sure if I will have to pay this every visit or not, with our previous insurance I only had to pay for the first visit.)

and a 0% coinsurance for the hospital stay - does this mean it is covered 100% I am thinking it does since out of network would be 20% coinsurance, but I want to make sure I am getting this right...
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  #2  
January 23rd, 2012, 01:16 PM
Moldovandish's Avatar Mega Super Mommy
Join Date: Mar 2007
Location: Raleigh, NC
Posts: 4,602
With the hospital stay, does it say somewhere in the policy that 100% is covered? It sounds like it does, but you might want to double-check the language.

In my policy it says that the prenatal care one-time copay is $30. So if it's not clear in your document if it's one-time or not, then you might want to call the insurance company to clarify.
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  #3  
January 23rd, 2012, 01:24 PM
Lyz's Avatar
Lyz Lyz is offline
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Location: Delaware
Posts: 6,250
Sounds like there isn't a copay but it may not be covered 100%. I would double check with your insurance company. I had great insurance with my duaghter but still ended up paying $800 after all was said and done. I didn't have a co-pay for my hospital stay either.

Oh, and I had no copay for my prenatal visits.
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  #4  
January 23rd, 2012, 01:37 PM
Mega Super Mommy
Join Date: Oct 2009
Posts: 4,065
I would check with the insurance company too, there's always fine print stuff that might be confusing.
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  #5  
January 23rd, 2012, 02:58 PM
beginswithb's Avatar Veteran
Join Date: May 2010
Location: Ohio
Posts: 298
Definitely call the insurance company! I'd rather hear things laid out for me than assuming. I called mine today just to have them tell me what's covered, what isn't and what I will pay.
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  #6  
January 23rd, 2012, 07:07 PM
twoboys's Avatar photography co-host!!
Join Date: Feb 2009
Location: Holly Springs, NC
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yes, if your in doubt at all call your insurance company!! Sounds like you have a pretty good plan though!
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  #7  
January 23rd, 2012, 07:48 PM
JulieMc's Avatar Loving my babies. :)
Join Date: Nov 2008
Posts: 9,004
Lucky duck. That's how our plan was with my first baby...except, I didn't have to pay any copays. It was 100% covered. Then the employer changed insurance cos. and we got a crappier plan. This time I'm responsible for 10% coinsurance on everything...
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