Log In Sign Up

Insurance question


Forum: June 2013 Playroom

Notices

Welcome to the JustMommies Message Boards.

We pride ourselves on having the friendliest and most welcoming forums for moms and moms to be! Please take a moment and register for free so you can be a part of our growing community of mothers. If you have any problems registering please drop an email to boards@justmommies.com.

Our community is moderated by our moderation team so you won't see spam or offensive messages posted on our forums. Each of our message boards is hosted by JustMommies hosts, whose names are listed at the top each board. We hope you find our message boards friendly, helpful, and fun to be on!

Reply Post New Topic
  Subscribe To June 2013 Playroom LinkBack Topic Tools Search this Topic Display Modes
  #1  
July 30th, 2013, 05:52 PM
Mega Super Mommy
Join Date: Dec 2012
Location: Northeast USA
Posts: 2,111
Just want to start off saying that I am NOT trying (and do not want) to start any kind of debate on the Affordable Health Care Act. Just a real question. Here goes:

We have Blue Cross Blue Shield PPO and have a co-insurance deductible. Essentially, for hospitalizations we pay 20% up to $3000 per person per year and I think $6000 per family. (And yes - this is supposedly a great plan - and we pay an arm and leg for it). Anyway - here is the question. I am getting all the bills from the birth. The one from the doc who delivered her. The one from the anesthesiologist who administered the epidural. The pediatrician who visited Ellianna in the hospital (as the hospital does not have one on staff - you pick the practice that you will ultimately follow up with). And yes - when the ped sees your child at birth in the hospital, this goes under co-insurance and not under a co-pay. (Our 20% for the ped seeing Elli in the hospital was $161 - not huge but just think the ped got another like $640 from the insurance company). Anyway - just getting the bills from the hospital. It appears that there is a separate hospital bill for me and one for Elli. In addition, I have to meet the co-insurance deductible for me of $3,000 and Elli has to meet a separate $3000. I guess I naively thought that there would be one hospital bill that covered both of us. I thought that we would only have a maximum of $3000 co-insurance since it is one event. Did anyone else experience something similar. I am calling the insurance company tomorrow to try to understand.
__________________
Kimberly

Reply With Quote
  #2  
July 30th, 2013, 06:11 PM
wildchihuahua's Avatar Mega Super Mommy
Join Date: Apr 2007
Location: San Antonio, Texas
Posts: 1,488
It sounds right to have the separate bills and deductibles. That's the way mine worked with my second son.
__________________









Reply With Quote
  #3  
July 30th, 2013, 06:24 PM
navywifey2003's Avatar Home Birth Mama
Join Date: Dec 2007
Location: Clovis, CA
Posts: 36,846
Send a message via AIM to navywifey2003
I have no idea. My midwife charges 3000 for everything but insurance paid most of it. I hope you get it all figured out.
__________________



Reply With Quote
  #4  
July 30th, 2013, 06:49 PM
Mega Super Mommy
Join Date: Sep 2010
Location: Cincinnati, OH
Posts: 1,834
I have not personally experienced this but my brother and his wife had this happen to them. They were charged for the room (facility charges) for his wife and then his daughter. So, they were paying twice for everything even though it was the same room! It's just the way the insurance chose to handle the billing. Complete crap if you ask me.
__________________

'Scuse the bad typing, please. 'Breast is Best' but not when browsing the internet!


Reply With Quote
  #5  
July 30th, 2013, 07:07 PM
QueenCrafty's Avatar Courtney
Join Date: May 2007
Location: North Carolina
Posts: 25,843
I think my plan is similar to yours. We have separate bills for everything. The hospital wanted their fee before we even left the hospital. So the hospital charged us $900, and my midwife's office charged $700. My insurance company is still negotiating with the hospital for Henry's charges, and the pedi who saw him in the hospital has yet to bill. It's ridiculous. I looked at the EOB for me and it was over $5k. I don't understand why- I had no iv, no epidural, and a short labor. Does a bed, food, and a few Ibuprofens and maxi pads really cost $5k?
__________________
Reply With Quote
  #6  
July 30th, 2013, 08:04 PM
Mega Super Mommy
Join Date: Nov 2012
Location: Iowa
Posts: 1,511
Yikes. I have bcbs fed basic and me & babies are considered one admission unless baby needed a procedure like Cameron's circ...then he became he own paitent for that. I would call for sure. I know I am thankful for insurance because I have seen $30,000 in bills already!!!
__________________
My BABIES





Reply With Quote
  #7  
July 30th, 2013, 08:11 PM
Mega Super Mommy
Join Date: Apr 2012
Posts: 1,490
I have bcbs and me and baby did have separate bills, but I never saw them...because of my pre-eclampsia, the hospital billed it as an emergency, and my insurance covered everything 100% I cried in relief, because our plan kinda sucked, and we were going to have to pay about $4000 if that hadn't happened.
__________________

Thank you Vicki.. for the beautiful siggy
Reply With Quote
  #8  
July 30th, 2013, 11:40 PM
MrsLat's Avatar Sept 2014 DDC Co-host
Join Date: Oct 2012
Posts: 3,560
I worked in insurance for quite a while. There is a co-insurance amount(20%) for EACH person covered under a plan up to a maximum, called your Out of Pocket Maximum, which is the $3000. But the maximum you pay for the whole family is $6000 in your plan year. That is very typical that you will get separate bills for each doctor, billed under the patient they saw, and those amounts will apply to that patient's Out of Pocket.

Hospital rooms, imaging, pharmacy, surgery, and doctor visits while inpatient at a hospital are usually billed separately because insurance plans sometimes pay different amounts on different services. It makes for a lot of different bills, wasted paper and confusion on the patient's part.

I am sorry I hope you get it all figured out.
__________________
~*Valerie*~
JaxonJocelyn Gabriel Grayson and due in September!


Reply With Quote
  #9  
July 31st, 2013, 01:34 AM
mommy220's Avatar Mega Super Mommy
Join Date: Jul 2012
Posts: 1,191
Mine appears to be just one bill. What's killing me is the added on three hundred dollar bills for ultrasounds I needed for being overdue.
__________________

Reply With Quote
  #10  
July 31st, 2013, 04:21 AM
Mega Super Mommy
Join Date: Dec 2012
Location: Northeast USA
Posts: 2,111
Quote:
Originally Posted by QueenCrafty View Post
I think my plan is similar to yours. We have separate bills for everything. The hospital wanted their fee before we even left the hospital. So the hospital charged us $900, and my midwife's office charged $700. My insurance company is still negotiating with the hospital for Henry's charges, and the pedi who saw him in the hospital has yet to bill. It's ridiculous. I looked at the EOB for me and it was over $5k. I don't understand why- I had no iv, no epidural, and a short labor. Does a bed, food, and a few Ibuprofens and maxi pads really cost $5k?
I would be happy with 5k. My insurance paid the hospital $6200 foe Elli and I need to pay around $1200. The insurance paid around $8000 for me and I have to pay around $1600. That is over $16,000 actually paid (not billed) just to the hospital (not counting the doc, ped, and anesthesiologist) for an uncomplicated birth. Elli was in my room and I needed to beg (practically) for the nursery to watch her for me to shower. They literally walked her back in 30 minutes. With our sons 8 and 10 years ago we paid less than $500 so I was shocked at over $5000 when you add what I paid for ultrasounds, etc. On the other hand we sre blessed that everyone is healthy. A lot of parents would love the ability to be in our shoes with a gorgeous daughter.
__________________
Kimberly

Reply With Quote
  #11  
July 31st, 2013, 04:43 AM
princess136's Avatar Super Mommy
Join Date: Jun 2012
Location: Texas
Posts: 633
I have Cigna and same here. I'm paying the deductible to pedi at hospital. I called my insurance & they said yes baby has own deductible and her being born is her own deductible applicable event. So stupid! I agree baby should fall under my deductible event of labor. I'm a little lucky that mine is $250 deductible & $750 out of pocket. Buy point is that its stupid!
__________________


~Kristin~
Reply With Quote
  #12  
July 31st, 2013, 09:17 AM
MarylandMama's Avatar Mega Super Mommy
Join Date: Dec 2012
Location: Maryland, near DC
Posts: 1,145
I wish I knew what I was being billed for. I know my insurance was supposed to cover at 100%, but I have some serious bills arriving from the hospital. But they don't list what the charges are or what insurance paid. It just says, "You owe us this amount" and there are 4 of them. I had to call and request itemized bills. I am waiting on those. So annoying.
__________________
Karen





Reply With Quote
  #13  
July 31st, 2013, 09:44 AM
navywifey2003's Avatar Home Birth Mama
Join Date: Dec 2007
Location: Clovis, CA
Posts: 36,846
Send a message via AIM to navywifey2003
This makes me so frustrated! I get that hospitals have a lot of overhead or whatever but even in San Diego my home birth with a nurse midwife was 3500. That was for all my prenatals, my delivery, 6 weeks postpartum check, Everett's 3 or 4 newborn exams that they did until he was 2 weeks old, a vitamin K shot, ect. The insurance paid 100% for the ultrasounds and labs that I wanted done and paid part of the midwifes 3500 fee. The amount they charge for pads and those supplies is ridiculous because in reality they are so cheap. My birth kit or supplies used during the birth was only 45 dollars. Not saying everyone should have a home birth it just really has put it into prospective for me how much hospitals charge for an uncomplicated vaginal delivery. Crazyness.

I hope you get it all sorted out hun..
__________________



Reply With Quote
Reply

Topic Tools Search this Topic
Search this Topic:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off



All times are GMT -7. The time now is 06:34 AM.



Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO 3.6.0