Costs

Well this is what I get for exploring online...

Anyway, we have a PPO for insurance. It pays only 90% of medical costs wth a 5000 deductible per person. I am not a real savvy insurance person (they didn't cover this for us in nursing school )

I am hoping it means the most we will have to pay is 5k per person and then the rest is covered. I believe though, we have to pay the first 5k and then 10% after? Is that correct? Anyone know?

I am just panicked at what a NICU stay may end up costing us. How does anyone pay for this stuff?

This really sucks. If I would have continued to sit on my lazy arse and not go to nursing school, we would qualify for assistance.

 

Well this is what I get for exploring online...

Anyway, we have a PPO for insurance. It pays only 90% of medical costs wth a 5000 deductible per person. I am not a real savvy insurance person (they didn't cover this for us in nursing school )

I am hoping it means the most we will have to pay is 5k per person and then the rest is covered. I believe though, we have to pay the first 5k and then 10% after? Is that correct? Anyone know?

I am just panicked at what a NICU stay may end up costing us. How does anyone pay for this stuff?

This really sucks. If I would have continued to sit on my lazy arse and not go to nursing school, we would qualify for assistance.

 

I work for a health insurance company. It would be a 5000 ded. (that seems like a really high deductible) I think working for insurance 1000 is the highest I've seen. THen if it pays 90% you would pay 10%. Do you have an out of pocket max? If so does it include the deductible? Most times you pay 10% till a certain dollar amount is met. Sometimes it includes the deductible. If you have any other insurance ?'s feel free to PM and I'll help the best I can. I'm not sure what insurance company you have be I work for BCBS.

 

$5000 ded sounds really really high. (to me). What about out of pocket?

 

YEAH!! 5000 sounds very high!! that would mean you would have to pay
$5000 for you and $5000 per baby before they would pay a dime??

after you pay all of that - unless you or babies have a long stay
(hopefully not) what is left for the insurance to pay!!??
check w/ your insurance co. sometimes pregnancy/childbirth
is covered differently.
it was for us -
I only had to pay my copay once for all of my prenatal visits and
the hospital - check and make sure!

 

A $5000 deductible sounds really high - we also have a PPO and we have a $300 deductible - i would recommend taking a deep breath calling and talking to someone; there might be a misprint on their website.

I know that if we go 'out of network', meaning use doctors that don't accept their coverage, then we pay a much higher percentage, but normally w/in-network doctors we pay a small co-pay at visits.

Of course, they only pay a fixed rate - so, for example, if my doctor or dentist charges $600, but they only cover that particular service at $400, then we are stuck w/the rest.

But it's worth doing some more researh - and waiting on hold, probably!

Good luck

 

are you sure the $5000 isn't your out-of-pocket max? Because that's a huge deductible!

 

I think you all are right. I think it is out of pocket max. But to me that still doesn't make sense? If that is the max we pay for the year, then does insurance pick up the rest of the tab 100%? What is the point of a 90/10 plan then? If 5k, is the max, I am soooo much relieved. Not that that is cheap, but much better then what I was thinking

 

i know that this might sound like i am mooching off of the state but i have medicaid and i don't have to pay anything unless i have a
boy(s) for the circumcision which is $150 per boy. medicaid doesn't cover the epidural unless you need a c-section. and since i opted for the tubal i get the c-setion and other stuff without having to pay out. i do however have to pay $3.00 for a co-pay after delivery for any prescriptions or Dr. visits. the reason i am on medicaid is because the place my husband works for doesn't offer insurance and so we are screwed without medicaid. and because the health care in mississippi would tick off just about anyone that lives here. it is so sky high because of the stupid malpractice law suites. insurance for just me would cost us over $1000 per month just for this pregnancy. we can't afford that!

lots of love!
meshell

 

I have a similar plan. I have a PPO, covers 100% after the out of pocket maximum for pregnancy. That is $5000.00. They are making me pay that upfront before delivery, luckily my OB said it doesnt cost that much for her charges and is only charging me $2100.00 and the $250.00 for the circumcision. But, then I will owe the hospital the rest. Thank God they will take payments. Finding an extra $2100.00 much less $5000.00 before hand and getting ready for twins is tough.