Insane Cost with Blue Cross Florida to Have a Baby

Hire a midwife and stay at home. Should not cost more than 3000.00 for everything. Also it is safer and healthier for her and the baby. Reseach has proven this several times. Or head to a birth center that is run by midwives. Might cost a little more but not much more.

Lisa

I have blue shield and you have to pay the first 1500 bucks of the hospital bill and then 20% after that.

Really? Holy cow! I had BCBS and I think it might have been 2,000 max that wasn't covered.
I would call them and ask exactly how things are working because that just sound silly.

Sometimes the only insurance one can afford is one with extremely high out-of-pocket costs. The more out-of-pocket you pay, the lower your premiums (or the lower the employer's premiums). It's really more of a catastrophic care type of insurance. For example, you'd hit that $10,000 pretty quick if you were in a car accident and then (hopefully) the insurance would kick in and pay a portion (or all) of any remaining costs.

So, suggestions...I can think of two. One, marry her and add her to your (better) insurance. Two, don't marry her and make sure you have $10,000 on hand to pay for a complicated birth (one never knows). Both options have some pretty serious ramifications, such as blending families on short notice (difficult under the best of circumstances) or just not being able to have enough money set aside.

That said, you may want to start talking to the medical providers. Explain to them the insurance situation and see what kind of payment arrangements can be set up ahead of time. Over the past 10 years, I've dealt with 4 separate medical incidents which required payments to hospitals or other medical providers. With one exception (and it was a doozy), I have found all to be extremely helpful in setting up workable payment plans. In the case of the exception, I researched my state's medical payment laws, learned I was being treated in a way that bordered on illegal. When I brought this to the attention of the hospital's business office (and my state's medical ombudsman--sp?--organization), the hospital changed their tune and I got the payment plan I could afford. Ten years and nearly $30,000 later, I have only $500 left to go. If I learned anything from my experience, it was to be polite, persistent and proactive (polite being the most important component...no one is going to help someone who is rude, foul-mouthed and plain obnoxious, because I tried that option, too).

So, good luck. Hope things work out.

If she's under 20 weeks... why not try to get Pregnancy Medicaid? I'm on it now and it can be used for OBs, Midwives, homebirths or hospital births.

People believe OBs and even basic Drs are there to help them and became such a professional because of the love of human kind... but it's not true - the mightly dollar is their incentive.

Midwives cost about $4-6,000 for ALL prenatal visits, one ultrasound, the birth AND the postpartum 6 week check up!!

Now you can see who's really out there for Mothers and children! Go to a Midwife!

****FTR****

For those anti-medicaid/medicare healthcare... it is there to help those who need it. If you DO NOT QUALIFY for it, then you don't 'need' it. For those ignorant yappers who complain about those on it - it is HARD to qualify for and even harder to stay on. If you make so much as a PENNY over their hard limits of income you are immediately off all aid... and those one it usually are working 1-2 jobs or working part time and going to school part time. I really wish people would stop bitching about giving help - which they paid for in their taxes - just because those hardships haven't personally happened to them yet.

OK, people aren't going to like this but here it goes. First of all, the answer isn't to put the responsibility of your child on the state. This is one good reason why we all pay high taxes, why our states and our country are in debt, and why medical procedures cost so much in the first place. Everyone else has to pay for the shortcomings of people who don't pay at all and people who use Medicaid which short-pays. If you were adult enough to make a baby then be adult enough to pay for it yourself. If you couldn't afford this baby then you should have made sure you didn't get her pregnant. Call that harsh, but you can't deny it's true. It's not everyone's RIGHT to have a baby. If you think it is your right then it should be my right to deny you any "assistance" to have it and take care of it. It isn't my responsibility, and my tax dollars shouldn't have to pay for it. Now, before anyone gets on their soap box, it's a different story if people go into a pregnancy and/or parenting situation and things change that aren't their fault (i.e. they get laid off, a spouse dies, a spouse gets sick, a special needs child is born, etc.). These people are deserving of state help. If you are low middle income with kids on both sides already then what are you doing having more kids?? I realize this was not your idea and I'm not actually trying to attack you personally, but am trying to make a rebuttal against people who actually do these things and people who actually promote it as an answer.

You shouldn't complain about $3500 to $10000. Ask them what your costs would be with NO isurance. And you can't add coverage thru Blue Cross - or any private insurance for that matter - now that she is already pregnant. That's like adding more car insurance after you have had an accident. It doesn't work that way. Trust me - my father has sold all types of insurance for the same company for 40 years, my sister is the Director of the Risk Management program at a well known University, and I have a concentration in insurance both in my under-grad and grad degree.

If you can save a good portion up before the baby is born often times hospitals will settle with you for a fraction of the actual amount owed if you can give them one bulk payment. For instance, if your total to the hospital is $10,000 and you call them and tell them you have $5,000 you can pay them that day if they will take that as payment in full many will do it. They simply write off the other $5,000 so it ends up only being a $3,300 loss to them - which probably isn't a loss at all considering how far they mark up their service costs to help cover the people I mentioned above - those who son't pay and those who have Medicaid. If you think about it you are essentially doing what large insurance companies do with hospitals and doctors - you are negotiating a price for their services instead of paying their full price. Do you ever notice on your Explanation of Benefits how it shows how much the doctor or hospital charged the insurance, and how much the insurance actually pays (and the hospital or doctor takes as full payment)? That's because insurances have negotiated amounts they will actually pay for services and treatments. For instance, say you were getting an ultrasound. If you paid for it out of your pocket you may pay $225 for it. If the insurance pays for it they may only pay $100. It isn't uncommon for the insurance to only pay 25-50% of the actual amount a doctor or hospital charges. So there isn't any reason YOU can't negotiate with them. This is very powerful knowledge that most people don't have, and they pay full amounts when they don't need to.

So what I am saying is by doing this with the hospital and doctors you can be responsible for yourself while paying the same an insurance company would instead of paying the full amounts and your bucks helping to make up for those people who don't pay or use Medicaid! It might take a little more work, but at the end if the day this baby is YOUR baby and you should jump on board to do some work to lower it's expense.

At the end of the day, you could always negotiate with them on the total amount and then tell them you'll have to do payments if you can't save up a large chunk. Let them know that you understand how insurance works and how they get to negotiate rates and you want to do the same, and after you do that let them know you want to make payments on that amount. They WILL work with you on it. They would rather get payments than nothing at all!

Your girlfriend may also consider getting a job somewhere that has group insurance. Even though she is already pregnant the insurance would cover her since group programs do not consider pre-existing conditions as exclusions for coverage. She would have to make sure she got enrolled in the insurance in the required time period (usually 60 days) or else she would have to wait for the annual "open enrollment period" all group insurances have so employees who didn't join during their initial 60 day period can get in on the program (this is USUALLY in October, but not always). But before all that happens make sure the employer actually carries maternity insurance on their plan. Not all do because it is quite an extra expense that ends up being paid by all on the plan. She may take a look at Starbucks - they used to offer insurance to even their part-time people. I don't know if it includes maternity though. This was back when I was in school and that has been 10 years now! (YIKES! lol)

I hope that helps, and I hope no one gets too pissed! lol

Nothing in life is free. Obviously this wasn't planned but now you have to suck it up & either pay the higher cost or marry her.

And to the people that told you to go on state aide should be ashamed of themselves. Seriously being on aide is nothing to be ashamed about ONLY if you truly truly need it. BUT you should be ashamed of yourself if you are on it with no intention of getting off of it.

Hospitals are very easy to deal with in regards to making payment plans. So you make baby, you should have to pay for baby.

I don't know what plan she has, but I had BC BS with both pregnancies and never paid more than maybe $1500 out of pocket. HOWEVER, if she has a high-deductible plan, she would owe up to the deductible amount before anything is paid for by the insurance company. If that's not the case, then I bet you are mis-reading the policy. Have your girlfriend ask someone in the HR department where she works for help on this. They can help her figure out what's covered, and most importantly give her a contact at BC BS who can give her specifics on what you can expect to pay. You can also get pre-authorized at the hospital, and the hospital can figure out how much you're likely to end up paying. I'd definitely do some more research into this one. Good luck, and congrats, papa!

Yep, the insurance industry is quite the joke isn't it? First and most importantly, don't forgo any prenatal care, doctor's visits or anything else necessary to ensure a healthy baby is born to you and your girlfriend. Wait till after the baby is born and then contact the hospital and laboratories and ask for charity care. If you qualify and many low income people do, your entire bill could be wiped out. Most hospitals and laboratories are set up to take losses from people who simply cannot afford the outrageous prices they charge. Unfortunately, many people don't know this and end up on payment plans that never end and further and further in debt. If the debt cannot be wiped away completely, many places will provide a substantial discount. The doctor's bill will be different but I'm sure they will be willing to offer you a payment plan that you can afford. That's the key-- you have to tell them what you can afford and not what they think you can afford. Remember, you and your girlfriend both work and have health insurance, you're not taking advantage of the system. The system is broken.

I didn't have Blue Cross, but here's the only thing I can suggest. Different hospitals charge different amounts for delivery. You can look up all of the hospitals that are in her network and find the one that charges the least. Of course it's just an estimate because they will usually only provide you with "uncomplicated delivery" or "c-section" delivery...which doesn't include all the "extras" that may have to happen.
The cost of my uncomplicated delivery was 1,200 for the doctor. I had no copay for the hospital for my stay..but, my daughter was in the NICU and the out of pocket expense for her hosp stay was near 13,000. Which wasn't that bad considering her total charges were 27,000. I had a great PPO insurance, but still had my share to pay.
I wish you good luck. If anything there is always payment plans after the birth. Congrats on the baby!

Some companies, allow domestic partners to be added.. Check into that.

Try a midwife!! :)
http://www.hollywoodbirthcenter.com/

We have bcbs wa.. and I had 2 kids both c section.. our out of pocket expense were 6000 each birth.. I called the hospital and made a monthly payment plan with no intrest.. good luck

I don't know if anyone has made this suggestion already, but look into a midwife for your prenatal/birth care. Florida has wonderful midwives who offer excellent care to low-risk moms, and they charge much more reasonably than traditional OBs.

Well...you could always get married and then she would be on your ins.

When I had our first baby, we didn't have an ins plan that covered maternity, so instead of getting a maternity plan that would've cost us about $900.00 per month, we decided to pay out of pocket to the hospital. Hospital stay was anywhere from $1500-2200 for a two day stay. The earlier in your pregnancy you pay, the cheaper it is. Talk to your hospitals.

Please don't try to get medicaid as some have suggested. We have enough people using the system that do not need it.

I don't know how it works in Florida, but in California, you can sign a domestic partnership form and have it notarized in order to have a significant other on your group (employer sponsored) health insurance. Talk to HR and find out when your open enrollment period is.
Also, in California, we have a program called AIM (Access for Infants and Mothers). Qualifying is based on income, family size, etc. I don't know if Florida has an equivelant.
Some insurance policies are high deductible policies and some don't even cover maternity at all.
Contact the insurance carrier to have them explain, very carefully, how maternity is covered.
Ask if getting married would be a "qualifying event" which would mean you could get her on your insurance before the baby is born.
Just a suggestion.

I wish you the very best!

I think you ought to recheck that. That sounds ridiculous. Blue Cross is the best there is from what I know.

I second the pregnancy medicaid. It really saved us with our second child. Once the baby is born, s/he will be covered for the first year, which is also very helpful when your private insurance is so lame. I will warn you that the application process can be a pain, and is stressful waiting for an answer when you're pregnant. Good luck! And support health care reform...we really do not want it repealed in full.

Don't you just love insurance? I had BCBS for two pregnancies but different plans (different employers) and paid a lot more for one than the other. If nothing else, she should be able to claim the expense on her income tax next year.

yes, I had a minor melt down when I learned how much it would potentially cost to have my baby. I have universal maternity so I have very limited prenatal costs so at first I was like "man it's so cheap to have a baby." Then my health insurance talked to me about the actual labor and I think I was about to faint. However, I have learned from my ultrasound charges (the only thing they don't 100% cover under my universal plan) that hospitals are usually VERY nice about working with you on paying it off and setting up reasonable payment plans. You just simply explain to them what you need to do and as long as you make your payments each month or keep them aware of times your having difficulty, they won't send it to collections and they won't charge interest. I would become friends with them now :)

Oh and my in-network out of pocket is 4500 and I think I will be paying for all of it by the time I get done with having the baby

Can she afford to up her coverage on her plan? We had BCBS for all 3 of my pregnancies, and it cost us a grand total of $120! $20 for my initial copay (didn't have any copays after and $100 for hospital stay). We had an EPO through BCBS which was offered through his work. So, I would say she should put in a call down to her HR dept and see if she can change her coverage and how much that would cost paycheck wise. And Medicaid too :)

Hello!
Have your girlfriend apply for pregnancy Medicaid through DCF. She can do this online or in person. Google it to find out which documents she needs to bring. Only problem, not all OB's take it. But it will pay for whatever her primary insurance doesn't.
Good luck!!
H.

I'm not really sure I get this. I mean, I thought having a baby just cost between 3-8k! Both of mine cost me 6k all in, and I had one of them at home!

I have BCBS Texas... It is 80% they pay, we pay 20%.
Hubby and I were going to wait 5 years, well broken condom had other ideas. Surprise baby a year and a half after we married! We started saving every penny ASAP.
I ended up having an emergancy c-section, after 30 some hours in labor.
Stayed in the hospital 4 days, both myself and darling baby.
Think the bill came to about $12,000 (we only paid 20% of that). So your partner(?) insruance is figuring out all the costs. Start saving, take a look at ALL the hospitals that your partner's insurance covers and talk to the hospitals to figure out which one works the best for a payment plan if need be.

It's next to impossible and very expensive to get maternity coverage any more. I was told that ALL pregnant women in the state of Florida qualify for medicaid for the pregnancy and up to the 6 week check up. It saved our lives ($$$) as I had a high risk pregnancy with some complications and was at the Dr. more often and had more tests than normal. Thankfully, everything turned out fine, but we would still be paying hospital and Dr. bills if not for the medicaid insurance! Is Winter Springs near Orlando? If she needs a great Dr. I can HIGHLY recommend Dr. Jeannie McWhorter - she is AWSOME, and her office is walking distance to Arnold and Winnie Palmer Hospitals. (for women and children) Good luck!
PS: there is also another form of medicaid - called "Share of Cost" - if you don't qualify for the whole thing - there is another plan where medicaid pays AFTER you have paid a certain amount. Also - Arnold Palmer and Dr. McWhorter's office give 40% discount for self paying patients....because I was told "the insurance companies pay only a % of the rates for various procedures, so they raise their rate to get what they want in the end, and then pass the discount to self paying patients as well."

have her check with your states insurance for low income families at your local DHS office. Like in TN we have tenncare and if your pregnant you can get approve for like a family of 3 you cant make more then 2800 a month but when your pregnant you get to count as 2 people so like my family we get to count as a family of 4 so the cost of how much you can make a month goes up for however many people are living in your house. And even if she has insurance what ever your insurance doesnt pay for then your state insurance will pay for and the state insurance will be secondary insurance so hopefully doing it that way you dont have to pay anything out of pocket besides your monthly premiums.

Ok, go with a birthing center and a midwife if you can. Florida has some REALLY nice home-birth laws as well if you are so inclined. We went with a midwife and a birth center and all care including pre, birth and post, was UNDER 5000 total. I was uninsured and we payed it all out of pocket.

What?!?! Healthcare is not free??

Seriously though, that stinks! Is her insurance just for catastrophic care. I sure hope her premiums are really low. We have private insurance since my husband is self employed and I think I opted out of having maternity insurance because it was much cheaper and I am not having any more children (I think). congrats on the baby!

You need to make sure you are reading the policy correctly. We had BC BS with both of our pregnancies and it cost us $0. Nothing. Covered 100%, no deductible.

This was a few years ago, but the last I looked they still had out of this world coverage for maternity. Are you sure you guys are looking at the maternity coverage? It is a separate section, not the regular medical coverage.

Mid wife.
Get married.
best, k

I remember when my husband and I got married he put me on his insurance because his was better. He had to do it within 30 day window after marriage and all the preexisting conditions were covered that way. Same 30 day window applied after birth of each child. We were not expecting at the time and had no health problems... so we never actualy benefited from it at the time.
Maybe find out from your insurance if your wife will be eligible for maternity coverage if you got married? I do not know... Otherwise, you will have to pay.

I feel your pain! I'm home with my son right now and when we decided to start trying for a second I decided I'd better call BCBS to see if I'm covered...well I learned I needed to sign up for maternity coverage separately and it would prob cost me 8,000-13,000 to have a baby ouch! After 20 phone calls and quotes the best I could do was with assurant for 5000 (plus monthly payments). I was so disappointed and discouraged by the private insurance system! So I wish I had better advice for you, I really just wanted to write you're not alone in your shock:-)

In Texas, with my Blue Cross policy through work (I'm a teacher) the out of pocket expense was capped at $3,000 which seemed to be about what others with different insurances had to pay.

The good news is that you can set up payment plans, and pay off the bills a little at a time. Also, you can deduct it on your taxes - both years I had taxes, I got alot more money back than years I didnt.

congrats on the baby! You've got to remember that pregnancy is NOT an illness. It's a creation. I strongly suggest you check out the idea of a midwife. It's less invasive, less technical, more natural and real. It's also MUCH less expensive. A midwife can often conduct home visits and is well prepared. It's a much less toxic environment than a doctor's office or hospital. I know of (and used) a wonderful midwife http://www.conniemullenmidwife.com/
doesn't hurt to phone and ask questions. You don't have to sign on the dotted line unless you're both comfortable.

check into AFLAC. its pretty inexpensive considering what it is. i know we actually got money back for having our daughter.