https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Tue, 05 May 2026 14:33:57 +0000 https://boards.hellobee.com/topic/question-about-insurance#post-217516 Wed, 11 Jul 2012 12:41:08 +0000 Adira 217516@https://boards.hellobee.com/ <p>@lawbee11: You're welcome! I hope you can find all the numbers you need in order to figure out which is the best plan for you! :) </p> https://boards.hellobee.com/topic/question-about-insurance#post-217512 Wed, 11 Jul 2012 12:39:19 +0000 lawbee11 217512@https://boards.hellobee.com/ <p>@Adira: thank you!! That is very helpful! </p> https://boards.hellobee.com/topic/question-about-insurance#post-217496 Wed, 11 Jul 2012 12:30:41 +0000 DillonLion 217496@https://boards.hellobee.com/ <p>@Adira: Nice explanation!!! </p> https://boards.hellobee.com/topic/question-about-insurance#post-217475 Wed, 11 Jul 2012 12:13:16 +0000 Adira 217475@https://boards.hellobee.com/ <p>I agree with others. It's important to find out what your deductible, max out of pocket, and percentage covered will be with both insurances.</p> <p>For example, one individual plan might have a $400 deductible with a $2,400 out of pocket max and cover 80% of your prenatal care. Another family plan might have a $800 deductible with a $4,000 out of pocket max and cover 90% of your prenatal care. So depending on how much your prenatal care costs, you'll have to figure out which one is actually cheaper.</p> <p>Let's pretend it costs $10,000 to have a baby.</p> <p>With the first plan, you'd have to pay the $400, but after that, the plan will pay 80% and you pay 20%, until you reach the max. So that's:<br /> $10,000 - $400 = $9,600<br /> $9,600 x 20% = $1,920<br /> $1,920 + $400 = $2,320<br /> Since $2,320 is less than the out of pocket max, that's how much you would end up paying.</p> <p>Now the second plan:<br /> $10,000 - $800 = $9,200<br /> $9,200 x 10% = $920<br /> $920 + $800 = $1,720</p> <p>So even though the second plan has a higher deductible and out of pocket max, you still end up paying less because of the percentage that's covered.</p> <p>Keep in mind, I have no idea how much it costs to have a baby. It's more or less based on where you live, so you'll want a better estimate when you try to figure out which plan will actually cover more for you. I also just made up these numbers - I have no idea what the numbers look like for you. You'll also want to take into account how much it costs you and your husband each month for each plan, because that might be a factor in overall costs. Although once you have a baby, adding a child to an existing family plan might not be much, whereas turning an individual plan into a family plan and still having another individual plan might not make sense. </p> https://boards.hellobee.com/topic/question-about-insurance#post-217357 Wed, 11 Jul 2012 10:21:29 +0000 eeh 217357@https://boards.hellobee.com/ <p>Yes, definitely call your insurance provider and check your benefits...and then call again once you get closer. I called in September to check our benefits and then again in January once I was actually pregnant and they had changed because of a change in my husband's union contract. </p> <p>The first person I talked to about it wasn't very helpful and spoke medical-ese and didn't do a very good job of breaking things down. So, I hung up and called right back knowing I would most likely get a different operator. The lady I talked to that time was very helpful and did a great job of explaining our benefits. </p> https://boards.hellobee.com/topic/question-about-insurance#post-217343 Wed, 11 Jul 2012 10:15:16 +0000 ladyfingers 217343@https://boards.hellobee.com/ <p>@MamaMoose: Insurance plans are not allowed to consider pregnancy as a pre-existing condition, according to HIPAA. Also, usually if there is no gap in coverage between plans, pre-existing conditions are not an issue, even if going from group to individual. </p> <p>Some group plans do have a waiting period for other allowable pre-existing conditions, before they will cover it, if there was a gap in coverage. But mine stated in the literature that that was the case, and I had no waiting period for my pre-exes. </p> https://boards.hellobee.com/topic/question-about-insurance#post-217036 Wed, 11 Jul 2012 02:39:47 +0000 Teachermama 217036@https://boards.hellobee.com/ <p>We also got to look online. My insurance covered 100% midwives, 80% doctor, 80% hospital charges. </p> https://boards.hellobee.com/topic/question-about-insurance#post-216756 Tue, 10 Jul 2012 17:44:06 +0000 matador84 216756@https://boards.hellobee.com/ <p>Also looking at maximum out of pocket is critical! My MOP is 3k with 100% coverage after deductible met, but after I add the baby on mine it goes up to 6k out of pocket until deductible is met. Had I picked the wrong plan, it would have been 9k MOP! </p> https://boards.hellobee.com/topic/question-about-insurance#post-216696 Tue, 10 Jul 2012 17:11:35 +0000 Mrs. Jump Rope 216696@https://boards.hellobee.com/ <p>@lawbee11: I'd call and double check, like other posters have suggested. I'm able to see a very detailed description of everything, but we're currently covered so that may be why. </p> https://boards.hellobee.com/topic/question-about-insurance#post-216693 Tue, 10 Jul 2012 17:10:13 +0000 lawbee11 216693@https://boards.hellobee.com/ <p>@Mrs. Jump Rope: I was able to see general coverage costs (like deductibles, co-pays, prescription costs), but I wasn't sure if those applied to delivery/pre-natal costs as well. </p> https://boards.hellobee.com/topic/question-about-insurance#post-216689 Tue, 10 Jul 2012 17:06:40 +0000 lawbee11 216689@https://boards.hellobee.com/ <p>@highwire: @MamaMoose: Thank you both! I just graduated from law school (and I'm 26), so up until I got married a few months ago I was always just on my parents' insurance. Needless to say I am pretty clueless about this stuff. We are not planning to start TTC quite that soon (but it's still good to know just in case). I will definitely plan on calling both insurance companies to see if I can get detailed pre-natal costs then compare the two. </p> https://boards.hellobee.com/topic/question-about-insurance#post-216685 Tue, 10 Jul 2012 17:03:38 +0000 Mrs. Jump Rope 216685@https://boards.hellobee.com/ <p>@lawbee11: We are able to look up our benefits and coverage online, under our insurance providers website. Can you do something like that? </p> https://boards.hellobee.com/topic/question-about-insurance#post-216680 Tue, 10 Jul 2012 16:59:50 +0000 DillonLion 216680@https://boards.hellobee.com/ <p>@MamaMoose: @lawbee11: </p> <p>Here's my experience/understanding:</p> <p>I was pregnant before I got on my employer's plan and was covered. Legally, they can't deny you coverage for pre-existing conditions through a group employer plan (at least that is my understanding of how it works in Texas). The only thing that might happen is you won't have coverage for whatever time period they have you wait before the plan starts (like, say 90 days), but once it goes into effect they have to cover you. </p> <p>I just paid out of pocket for my first couple of prenatal exams/visits/blood draws before my plan went into effect. </p> https://boards.hellobee.com/topic/question-about-insurance#post-216675 Tue, 10 Jul 2012 16:55:32 +0000 MamaMoose 216675@https://boards.hellobee.com/ <p>@lawbee11: Something to consider is that you likely won't be covered by your new employer's plan until you have worked there for 90 days. And if you get pregnant right away they may not cover maternity care if the pregnancy begins before coverage begins. So check into that. </p> https://boards.hellobee.com/topic/question-about-insurance#post-216674 Tue, 10 Jul 2012 16:54:13 +0000 DillonLion 216674@https://boards.hellobee.com/ <p>DH called his insurance company and got a detailed outline of pre-natal costs that we used to decide whether it wold be cheaper to use my employer's plan or his. </p> <p>It was a $600+ premium for me to get on his plan, and my employer covered the monthly premium 100% so it was a no brainer for us. My plan also has a 2k out of pocket maximum, so there's no way his plan would have been a better choice (we'd pay 2k in just premiums alone after 4 months) </p> https://boards.hellobee.com/topic/question-about-insurance#post-216671 Tue, 10 Jul 2012 16:51:14 +0000 lawbee11 216671@https://boards.hellobee.com/ <p>I am currently on DH's insurance plan, but I am about to start a new job and I am trying to decide whether I should stay with DH's insurance or get covered by my employer. It would be cheaper monthly for me to be covered by my employer (DH's employer pays for almost all of his coverage, and my employer would pay for almost all of mine, so if we were each covered separately it would be close to nothing per month). I am just worried about costs of delivery since we are going to start TTC soon. </p> <p>Did any of you call your insurance company prior to TTC or once you got your BFP to see how much it would cost to deliver? Is that something you can even do? Is it just based on the deductible? I am just worried about switching to my employer's insurance then finding out that doctor visits/delivery would have been much cheaper under DH's insurance (or vice versa). Any advice would be greatly appreciated! </p>