https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Tue, 21 Apr 2026 23:47:24 +0000 https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24730 Wed, 30 Nov 2011 19:05:32 +0000 mamabolt 24730@https://boards.hellobee.com/ <p>So by my calculation, with the 80/20 plan, if you hit more than 16,500 in medical expenses in a year, the most you will pay is 4500 (1500 deductible plus 20% of 15000 = 3000. </p> <p>With the 90/10, you can have an added 3400 in expenses before you hit the max. You will still end up paying the max though if you get to 18,900 in total expenses. </p> <p>I think there's a good chance you'll hit the max, so I'd probably not upgrade as long as your deductible counts toward your total out of pocket. I hope I'm doing all this math right!</p> <p>I'm only 11 weeks pregnant, but I've learned this stuff is expensive! The bloodwork I had done at my first appointment alone cost me almost $500 out of pocket (it was what pushed me over my deductible for the year). Add in an ultrasound or two, more bloodwork for screenings and GD testing, as well as regular doctor/midwife visits, and a hospital stay on top of that? I can't even imagine what my total will be at the end of this journey. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24670 Wed, 30 Nov 2011 17:50:43 +0000 ecogirl 24670@https://boards.hellobee.com/ <p>If you can swing it I would upgrade :) </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24665 Wed, 30 Nov 2011 17:44:05 +0000 Meridian 24665@https://boards.hellobee.com/ <p>Wow, so many great responses, thank you!!</p> <p>@amy: Hrmm, that is a really good point... I have no idea if I'll actually deliver in 2012 or 2013, but 2013 is a definite possibility!! </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24654 Wed, 30 Nov 2011 17:27:24 +0000 tequiero21 24654@https://boards.hellobee.com/ <p>sounds like it's better if you upgrade. the deductible is less. and 10% on a bill can add up to a lot. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24624 Wed, 30 Nov 2011 16:52:34 +0000 amy 24624@https://boards.hellobee.com/ <p>One thing to also consider is time of year you are looking to conceive. Its hard to time everything but take into account if you get pregnant in 2012 but don't deliver until 2013 you max out of pocket expenses could be 9k since its 2 different calendar years. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24609 Wed, 30 Nov 2011 16:42:56 +0000 MamaMoose 24609@https://boards.hellobee.com/ <p>I actually disagree and I say don't upgrade.</p> <p>Confirm this with your provider but for my plan the out of pocket max is the most I pay. No matter what. If I have a baby, or if I have major surgery, or anything I will never be responsible for more than the out of pocket max.</p> <p>So even if you have pay the out of pocket max on top of the deductible, you save money by not upgrading. The deductible on the 90 plan is only $600 less but the premium payments are $960 more, so you lose out on $360. If you're having a baby, you are absolutely going to go above and beyond your out of pocket max this year, so that's the only piece of the puzzle that matters. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24586 Wed, 30 Nov 2011 16:27:05 +0000 HLK208 24586@https://boards.hellobee.com/ <p>I have BCBS as well and we upgraded to the 90-10 plan...with an $1000 deductible. But in my area (Seattle) hospital births without complications, a 2 day stay and no drugs is around $23k. So OOP, we'll pay around $3200 with the deductible. I'm sure doctor visits and ultrasounds bump that up.<br /> I was so hoping that bcbs would cover pregnancy massages -_- but I don't think so. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24570 Wed, 30 Nov 2011 16:13:19 +0000 T.H.O.U. 24570@https://boards.hellobee.com/ <p>We are on a BCBS 80 Plan. We paid about $500 to my OB plus about $40 for ultrasounds as needed. We paid about $1,000 for my natural delivery at the hospital, about $300 for babies stay in the hospital (no NICU or any complications). We are still waiting on the bill from the anesthesiologist for the epidural. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24555 Wed, 30 Nov 2011 15:59:24 +0000 Crisark 24555@https://boards.hellobee.com/ <p>I would say upgrade.<br /> I work with insurance daily.<br /> As far as the OOP(out of pocket) max, you need to find out if the deductible is included in the OOP or if it's in addition to.<br /> If it's included then the most you will pay OOP the entire year is $4,500. If not then you'd be looking at an actual OOP max of $6,000. </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24552 Wed, 30 Nov 2011 15:54:56 +0000 eupenmalmody 24552@https://boards.hellobee.com/ <p>Upgrade. You never know what unexpected expenses you are going to have. We have BCBS EPO - where as long as we use an in-network doctor, all is covered and it has been a life saver. Early on in my pregnancy I had 2 trips to the ER for bleeding, and I recently had to go to L&amp;D for monitoring due to no movement by the baby (all is ok). These three trips alone would have had you reach your max. To date, our bills just for the pregnancy have been about $30k (what insurance has been billed). And, we haven't even had the baby yet! Your hospital should have a fee schedule for what they charge if you have no insurance. Ours is crazy expensive (which is why I am grateful for insurance). </p> https://boards.hellobee.com/topic/anyone-knowledgable-about-health-insurance#post-24548 Wed, 30 Nov 2011 15:48:50 +0000 Meridian 24548@https://boards.hellobee.com/ <p>Ugh, health insurance sure confuses the hell outta me! </p> <p>We are under my husband's health insurance, and it is "open enrollment" time, when we have a week to make changes to our plan. We currently have Blue Cross Blue Shield PPO-80 plan, with an 80% benefit level. I figured that since we will TTC next year, it might be a good idea to switch the PPO-90 plan with the 90% benefit level (the highest his company offers), which is $80 more per month for the 2 of us. </p> <p>So with the 80 plan, we have a $1,500 deductible, and a $4500 out-of-pocket maximum. But then it says they only cover 80% of hospital visits? But I have no idea how much having a baby costs, including all the doctor's visits, hospital stay, etc. Or is $4,500 really the max I should expect to pay? </p> <p>The husband doesn't think it's necessary to upgrade to the 90 plan, which is an extra $960/year ($80 x 12)... but I'm not so sure. Will I end up spending more than that $960 if we stay on the 80 plan? FYI, on the 90 plan, the deductible is $900, but the out-of-pocket max is the same, $4,500. </p> <p>Are you still with me? All these numbers, haha... can anyone help shed some light? Thanks! </p>