Obamacare and having a baby-URGENT

amother

Mon, Nov 03 2014, 10:17 pm

We are iyh going to be TTC after the winter and because it is open enrollment we would like to research our insurance options. unfortunately only my DH gets insurance through work which leaves me to Obamacare or another low cost insurance.
I have a silver level plan and so far it it terrible. Every dr. visit is a nightmare with bills coming for weeks after- basically Obamacare barely covers for anything. I would like to know if anyone has had a baby using it. We cannot really afford to pay a higher premium than 400 dollars, but at the same time I worry that having a baby will cost me the full 6000 dollars in out of pocket costs. I would pay for a private plan possibly but because it would cause financial stress, I worry that I would be putting too much pressure into getting pregnant every month.
Any recommendations/advice/input or info about any affordable plans is greatly appreciated. Or any leads on someone who can advise us.
For those who do have Obamacare, which plan do you have? Are you happy?

Thanks so much!

amother

Mon, Nov 03 2014, 11:30 pm

I have Obamacare. I have Fidelis silver plan. It's not too bad.
I'm actually trying to find a good OB that takes Obamacare.
For my plan all prenatal visits are covered, but I will have to pay for the hospital. I think my plan says it's $1,500.

Also not every hospital takes Obamacare. I just found that out recently when looking for doctors.

amother

Mon, Nov 03 2014, 11:35 pm

op. thanks everyone. I found out my ob and the hospital hes affiliated with do take my plan but what if the other drs do not take it in hospital or the sonograms are not covered etc that is why I am reluctant to use it. also whatis thedifference between a deductible and out of pocket costs. if I have a baby does that come out of deductible oroutof theOOP costs? and besides for that there is a 1500 hospital copay so I am confused if that is in addition to the deductible....

nylon

Tue, Nov 04 2014, 1:44 pm

Out f pocket costs are ALL out of pocket: deductible, coinsurance, copays. So for example I pay the first $1000 a year which is the deductible, then it covers at 90% and I pay 10% till it hits a cap (my insurance is through DH but the new rules apply to it).

Odds are that for maternity you will not find a non-exchange plan that is better. Esp in NY. Out of network providers you did not request are becoming an issue for all insurance in NY (and some other places/specialties) not just ACA plans. I have Blue Cross PPO and got hit with that when I had to go to the ER in NY. When your OB does referrals check on it and ask at the hospital about their anesthesiologists.