https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Fri, 10 Apr 2026 20:32:54 +0000 https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2654401 Fri, 18 Nov 2016 13:33:35 +0000 raspberries 2654401@https://boards.hellobee.com/ <p>@Mrs. Microscope: That's really good advice - thank you!</p> <p>@wheres_c: @NorthStar: @Emsmems: I'm planning to talk to BCBS next week, but this sounds like such a pain that I might just skip it and pay extra to stay on the HMO all year. Thanks for your insights! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653954 Thu, 17 Nov 2016 19:08:20 +0000 wheres_c 2653954@https://boards.hellobee.com/ <p>Just to echo what others have said. With DS #1 we moved him to hubs plan using birth as a qualifying event. Even though he had no health issues he was considered "admitted" for two days and his care and circumcision was billed to him towards a personal deductible. It was a nightmare because the hospital billed my insurance and all the claims were denied. We had to continually call to have it rebilled to hubs insurance. Never.again.</p> <p>This time hubby got a new job while I was pregnant. The insurance is better but I'd already met my deductible for the year. I plan on waiting 6 months till open enrollment rather than using the birth as a qualifying event. The last thing I want is the headache, plus starting a new deductible in Dec! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653892 Thu, 17 Nov 2016 17:59:43 +0000 Mrs. Microscope 2653892@https://boards.hellobee.com/ <p>Just wanted to pop in an say that when you call bcbs, get the full name and office contact information for the person you talk to, and record it and the date of your conversation. Bcbs will record the conversation, but knowing how to access that recording might be helpful. I called to ask coverage questions about baby vs. mama deductible stuff last time, and the customer service rep gave me the wrong information. When we got a bill for stuff we thought was covered, we had them pull up the recording of the rep telling me it was covered, and the bill was paid. It took 5 months, but it was several thousand dollars and worth it! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653870 Thu, 17 Nov 2016 17:28:58 +0000 Emsmems 2653870@https://boards.hellobee.com/ <p>@raspberries: I'm not an insurance expert by any means, but I do know all of baby's care is under the baby's insurance plan. A friend's idiot husband (she calls him that) forgot to add baby to their insurance and they had to pay for EVERYTHING out of pocket. Took her 2 years to pay off! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653824 Thu, 17 Nov 2016 16:44:49 +0000 NorthStar 2653824@https://boards.hellobee.com/ <p>@raspberries: gross. I would definitely call your insurance to see if they can be of any help in defining exactly what would happen. Health insurance can be SO dang stressful.. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653823 Thu, 17 Nov 2016 16:42:01 +0000 Miss Ariel 2653823@https://boards.hellobee.com/ <p>@raspberries: it sounds like everyone has outlined it pretty well. Your stay and the actual birth would be on your old plan, while the baby's care and stay would be on whichever plan goes into effect on his date of birth </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653821 Thu, 17 Nov 2016 16:41:35 +0000 raspberries 2653821@https://boards.hellobee.com/ <p>@NorthStar: Ha, well, that's part of the issue - under the HMO plan I'd be admitted under, there is no deductible, just a $250 copay, and then everything else is completely covered (you pay a lot of this cost in monthly premiums, but it makes actual medical events a lot less stressful because you know upfront what the copay is.) But under the new plan I'd be switching to after the baby is born, each person would have their own deductible (my care should continue under the HMO during the rest of my in-hospital stay since it's considered the same event, and I was assuming that the newborn's would too - but if he is considered admitted after leaving the delivery room, then it would be a different event and we'd have to pay on the new plan, which means he'd have an individual deductible, and the whole thing will be much more costly.)</p> <p>Ugh. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653815 Thu, 17 Nov 2016 16:31:03 +0000 NorthStar 2653815@https://boards.hellobee.com/ <p>@raspberries: I'm not sure since it's been so long. Under your current insurance, does each person have their own deductible? I haven't had an HMO plan before, so I'm not sure how that is different. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653814 Thu, 17 Nov 2016 16:27:46 +0000 raspberries 2653814@https://boards.hellobee.com/ <p>@NorthStar: Do you know if it's your hospital that bills that way or your health insurance? For DS1's birth, we were on the HMO and it was all billed under my name, but I'm thinking now that could have been because we didn't have individual vs. family deductibles?</p> <p>Thanks for all of your help, ladies - I feel like I have a whole new grasp of how confusing navigating health care is! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653812 Thu, 17 Nov 2016 16:16:08 +0000 NorthStar 2653812@https://boards.hellobee.com/ <p>@raspberries: For our DD, she was under her own deductible and I was under my own. we had a family max deductible, but anything related to her was under her amount. sorry, but I think that is pretty common </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653810 Thu, 17 Nov 2016 16:07:43 +0000 MamaG 2653810@https://boards.hellobee.com/ <p>@raspberries: I think it depends on the deductible situation. I have seen it go both ways. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653809 Thu, 17 Nov 2016 16:06:47 +0000 MamaG 2653809@https://boards.hellobee.com/ <p>@raspberries: yes. And exactly as @2PeasinaPod: explains. Health insurance is so much more complex than most of us realize. Some days I fee like I missed my calling to work in employee benefits. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653808 Thu, 17 Nov 2016 16:00:58 +0000 2PeasinaPod 2653808@https://boards.hellobee.com/ <p>@raspberries: I work in our benefits department, and unfortunately, I've seen this happen more than once. And the birthday rule is common when there is more than one insurance plan covering the child. Coordination of benefits has to happen behind the scenes, and to make it simple, they use the birthday rule! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653807 Thu, 17 Nov 2016 15:58:43 +0000 raspberries 2653807@https://boards.hellobee.com/ <p>@2PeasinaPod: Oh really? I was thinking DS's care (hospital stay, Vitamin K, circumcision, etc.) would be included on my deductible/health plan because it would still be considered my admission to the hospital - but what you're saying is that he'd be "admitted" after leaving the delivery room and start on his own OOP deductible for the hospital stay? I guess it'd be more than $6,000 then, because I was counting on him being included in my own deductible.</p> <p>@MamaG: When you say the birthday rule, do you mean it defaulted to your DH's insurance because his birthday was earlier in the year than yours? That sounds crazy! </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653784 Thu, 17 Nov 2016 15:28:51 +0000 MamaG 2653784@https://boards.hellobee.com/ <p>@raspberries: @sapphire: We had a similar experience. DH and I have separate insurance. When LO1 was born, it was always our intent to put her on DH's insurance. Everything was automatically billed and paid under my insurance (under the premise that a newborn is automatically covered the first 30 days under the mother). Then when DH's insurance when back to DOB, we ended up with dual coverage. DH's was primary coverage because of the birthday rule all insurance companies use (whose birthday is first in a calendar year, doesn't matter year). So everything had to be reversed, resubmitted and reprocessed. LO was over a year before it was all sorted. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653783 Thu, 17 Nov 2016 15:27:47 +0000 2PeasinaPod 2653783@https://boards.hellobee.com/ <p>@raspberries: You can definitely do it. The birth will be covered under you through the HMO, and your hospital stay should continue under the HMO until you're discharged, but you may have to fight for that.</p> <p>LO's care (like nursery care and the hospital stay) will start on the health plan right after he/she leaves the delivery room. So if the baby needs to be in the NICU, that will all be under the PPO and not the HMO. So you may need to end up paying the $6,000 anyway. Just something to keep in mind. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653753 Thu, 17 Nov 2016 14:43:16 +0000 sapphire 2653753@https://boards.hellobee.com/ <p>I'm no expert, but I can share my experience that is somewhat related. lO'a hospital stay was billed under my insurance, because billing on the mother's is the default. We then added her to DH's policy which was way better than my insurance. We had to contact the hospital and both insurance companies to get the bills adjusted. It took forever and was a nightmare but we did eventually get it sorted out. But nothing happened automatically because we added her to the other policy. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653751 Thu, 17 Nov 2016 14:42:23 +0000 raspberries 2653751@https://boards.hellobee.com/ <p>@2PeasinaPod: Yep, you got it - the birth will cost $250 under the HMO vs. $6,000 under the PPO. And unfortunately, open enrollment is 10 months away from the birth. I calculated out expected costs, and it would save around $3,000 over the course of the year (including premiums, copays, etc.) to switch right after the birth, assuming the rest of the hospital stay is still covered under the HMO. I'm hoping that since the insurance company would stay the same (just switching plans within BCBS) that it would limit the amount of confusion, but that is most likely just wishful thinking, ha. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653745 Thu, 17 Nov 2016 14:35:04 +0000 2PeasinaPod 2653745@https://boards.hellobee.com/ <p>It's usually a continuation of care from when you were admitted to the hospital. Is there a reason why you're switching when you are? Is it so the birth is covered at a higher rate with the HMO? If so, why don't you just stick with the HMO until open enrollment? It gets super messy when you switch plans during the birth, and you're risking a big headache of the insurance companies fighting over who pays the claim. </p> <p>Your LO will also be covered under the PPO as of day 1, so he/she will have a separate deductible if you switch plans. If you kept it all under the HMO, everything would be covered under you. </p> https://boards.hellobee.com/topic/hrinsurance-bees-childbirth-and-insurance-question#post-2653730 Thu, 17 Nov 2016 14:27:17 +0000 raspberries 2653730@https://boards.hellobee.com/ <p>If you switch health insurance plans after your child is born (i.e. the child's birth is a qualifying event, so you decide to change from an HMO to a PPO plan or something like that), my work will backdate the plan change to the date of the qualifying event.</p> <p>My question is: which plan is the child's hospital care charged to - the new one, since it technically falls after the qualifying event? Or does it count as a continuation of the mother's care from when she was checked into the hospital under the old plan?</p> <p>If this is something plan specific, should I be contacting Blue Cross Blue Shield or the hospital to figure it out? My HR department doesn't seem to know. </p>