Cost of hospital birth, after insurance?

groovy1224

Tue, Jan 08 2019, 4:17 am

amother wrote:

Right, I get that. I will need to pay 20% of hospital costs and deductible up to $1,800, but most of the deductible may be paid for by then. My ob/gyn is in network. Just trying to get an overall picture. It’s hard to understand why it’s not easier to get a clearer range of what you will be expected to pay from insurance companies.

20% of costs after deductible? Or before?

wow

Tue, Jan 08 2019, 4:19 am

saw50st8 wrote:

Costs range based on your plan. I've paid anything from $300-$2,000 and if I gave birth today I would be paying up to $9,000 based on the cost (I'm on a high deductible plan).

My most recent birth at Columbia Prebyterian was $70,000 for the OBGYN, hospital and all associated doctors and labs.

I'm curious about the 70k. Is this what the insurance paid, or was this your cost because you had no insurance?

wow

Tue, Jan 08 2019, 4:20 am

ectomorph wrote:

We recently had a hospitalization were a doctor was billed as out of network.

It turns out that if you don't get to choose the doctor they are not allowed to Bill it as out-of-network to you.

It took about three hours of phone calls but we didn't end up having to pay for it.

Correct. I had the exact same situation and I was going to post this in reply to one of the above comments.

saw50st8

Tue, Jan 08 2019, 4:21 am

wow wrote:

I'm curious about the 70k. Is this what the insurance paid, or was this your cost because you had no insurance?

That's what insurance paid. I paid a $1,000 deductible each for me and the baby.

amother

Orchid

Tue, Jan 08 2019, 4:44 am

I had 4 births. Zero dollar co-pays. Private insurance through work. My youngest is in grade school.

Since Obama Care, our insurance plan drastically changed. If I have a baby today it would cost alot. The min is $1,000 copay for the birth. You could upgrade to a more expansive plan and it would cover the birth, but the difference for the upgrade is more than $1,000.

thunderstorm

Tue, Jan 08 2019, 4:48 am

I had the same story with the anesthesiologist being out of network. This was 17 years ago and they charged me $1200. But because it came to us as a surprised we did a payment plan and paid $25 a month until it was paid off.

amother

Lemon

Tue, Jan 08 2019, 5:05 am

sky wrote:

They gave me a detailed itemized bill for my stay - with some really crazy total.

Well yes, they'll give you a detailed itemized bill AFTER your stay. But good luck trying to get even a ballpark estimate in advance. It is simply not possible. And this lack of transparency is a huge problem that needs to be fixed, likely by law.

amother

Azure

Tue, Jan 08 2019, 6:29 am

amother wrote:

Your insurance can tell you.
(The hospital as well. Legally they most tell you the cost in advance)
Maybe I can help, what hospital are your giving birth in? What plan do you have?

(I paid 0. NY. Vaginal birth. not Medicaid)

amother

Azure

Tue, Jan 08 2019, 6:30 am

amother wrote:

There's no way to know and the hospital won't tell you anything, they're notoriously secretive about prices. I had a natural delivery in the hospital lobby attended by a random resident that ended up costing more than the c section I had a few years later. Same state. Both times with private insurance (but different plans, obviously). There's no rhyme or reason to it. It's a huge part of why the system is so messed up, you can't shop and compare like you do for refrigerators or cars or strollers. You're at the mercy of the hospital and the insurance company.

Legally, the hospital must tell you the estimated cost in advance.

amother

Pewter

Tue, Jan 08 2019, 6:50 am

amother wrote:

Legally, the hospital must tell you the estimated cost in advance.

But it still doesn't mean the estimate is accurate since they have different contracted rates for each individual policy.

Amarante

Tue, Jan 08 2019, 7:01 am

groovy1224 wrote:

20% of costs after deductible? Or before?

There are three things to consider in terms of insurance payments besides premiums

1) Co-pay This is typically a fixed amount you pay for each visit to a medical provider

2) Deductible - This is the amount that you must meet before your medical expenses are covered although generally there is a combination so that doctor visits are covered except for the co-payment portion versus other types of medical expenses like an MRI which aren't covered until the deductible is met

3) Up To Out of Pocket Amount - This is one of the benefits of the Affordable Health Care Act as all insurance policies have an up to amount which means you would never have to pay more than this amount in any year. For most people, it's not relevant because they don't have such major expenses but if you have a chronic or serious disease like cancer, you will be spared huge medical bills every year as your expenses will be capped at a certain amount which theoretically won't bankrupt an individual or a family.

Obamacare is not responsible for high medical insurance costs - medical costs are expensive and if you don't have a good corporate plan which subsidizes the premium costs, it's expensive. And large corporations also have the benefit of a large risk pool which is spread between people of all ages and sexes. I always find it ironic that frum women complain about how wonderful it was before Obamacare because one of the big complaints about ACHA aka Obamacare is that it requires insurance policies to treat men and women the same AND include maternity care which a lot of men resent and complained about.

Regarding your specific costs, you can get a ball park figure but (without defending the hospital), they don't know if there will be complications. Also the "cost" depends on the rate negotiated with your insurance company. As posted upthread, anyone receiving a hospital bill (or really a doctor's bill at this point) is aware of the high price that is "charged" and then the amount that your insurance has agreed to be responsible for which is always significantly lower. And you are responsible for the percentage of the insurance agreed upon rate and NOT the huge amount the hospital theoretically charges.

Sometimes I am amazed at how little money a medical provider will actually get reimbursed for a visit or a procedure.

amother

Cobalt

Tue, Jan 08 2019, 7:04 am

I also had issues with the anesthesiologist being billed out of network and the insurance refusing to pay. In the end the anesthesiologist office got the full amount they billed. It seemed to me they did it on purpose and knew how to get the insurance to pay it.

amother

Burgundy

Tue, Jan 08 2019, 7:05 am

So thankful I live in Europe. Birth costs 0 money. Only if you want a private room and if you're friendly sometimes even that's free. I even got kosher food from a restaurant for free once. The nurse was really nice and said she'd put it on the hospital bill, the doctors also order there sometimes.