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Oh shoot-- I don't know about this one! Our insurance doesn't have a deductible to meet. Last time, I was pregnant October-July, and I only paid for one office visit for my "condition," even though it spanned over 2 years.

Routine prenatal care is billed as a "lump sum" at the end of your pregnancy. Ultrasounds are often not included in that, and are billed individually, as is any testing you have done. So those will go towards this year's deductible. Your pregnancy and delivery fees will be processed when you deliver, so next year. Unfortunately you are right

One of my doctors once said that it is blatent discrimination against women/pregnant women, but because everything is run by these insurance companies, our hands are basically tied. It sucks.

I would call your insurance company for sure. Your mom is right about pregnancy being one condition, but you need to know how your deductible is calculated. Does it run (calendar year) Jan 1-Dec 31? Or does it follow a plan year say if your employer's plan is effective July 1, then it would be Jul 1-Jun 30 when you would have to meet your deductible so it wouldn't necessarily start again.

Sorry for all the insurance speak

We only had to meet our deductible for one year. But just a heads up, our OB and hospital required us to pay for all routine office visits and the estimated cost of labor/delivery/hospital stay in advance. We thought that was strange, but apparently it's pretty common. It got confusing with prepaying and then getting reimbursed by our insurance, but it all worked out in the end.

@jodyblair: We don't require it at our practice, but we do recommend it. Our billing department calculates what your expected total is (assuming you will be meeting your deductible), and splits that total up over the 10 or so routine planned visits. You can choose to pay everything at the end before your post-partum appointment, or you can pay a portion every visit. Most patients end up doing it this way so they don't get slammed at the end with a huge bill AND a new expensive baby! The payments are basically held "unapplied" on their account until we bill the prenatal care, and then we apply them.

I ended up paying two out of pocket maxes because I had five (count them FIVE) trips to the ER during my pregnancy which spanned two calendar years. This will all depend on how and WHEN your providers submit the bills.

@Mae: The two ultrasounds that were routine, I didn't even have to pay the copay for. But since I was high risk with twins, I had a lot of extra monitoring and ultrasounds. So for those, they would get billed to my insurance, but I only ever had to pay a copay at the office visit when I had them done. I think that the OB must have billed for those with everything else once I delivered, but by then, I had already hit my deductible with the delivery, so it was covered.

I got pregnant in Sept, delivered in June, and had to meet my deductible twice. All prenatal care was billed lump sum after delivery, but I had bloodwork and NT scan in the previous year that was quite expensive.

It really depends upon how your insurance processes things and when your insurance plan resets; I suggest calling and asking them. With DD I was pregnant across two calendar years but they process pregnancy/birth as one event so I paid my $10 copay at my first prenatal visit and then nothing else; however my insurance plan did not change although the insurance year restarts on Jan 1. Although DS did not cross calendar years if he had then it would have been different because I went from not having a deductible to having one so I would have had to meet the deductible had his birth crossed calendar years.

I would definitely talk to your insurance company.

For me, my insurance covers all prenatal care--appointments, labs, ultrasounds, etc. L&D is categorized as an in-hospital stay, and as such with my plan is not covered until the deductible is met ($2400), and then it's covered at 90% up to a max out of pocket of $4k. So even though I was pregnant during two different calendar years I only had to pay one deductible because all of my prenatal care was covered.

My OB told me what I was going to owe which was basically a low copay even though I had a $1000 deductible. So I paid that and then everything else came through after I had her. Didn't have to pay two deductibles. She was born two weeks into 2013 so I had ALL my prenatal care in 2012 minus 1 visit.

@Mae: Yeah, just try not to have an ER trip...I thought all I'd have to pay for were ultrasounds and such. Then I got kidney stones during my first trimester and ended up with an $800 hospital bill! Ouch. So if there is an emergency where you're worried or in pain, I highly recommend trying to see your regular midwife/obgyn. I couldn't believe how much more that ER visit cost!

Maternity was covered for me so I didnt have a deductable just a $150 a day copay for hospital stay