I am so confused with health insurance. my out of pocket max amount is 3,000 for myself only and 6,000 for the whole family out of pocket max. Does anybody know which amount I need to budget for, the 3k or the 6k? I will have to add the baby after delivery so it is covered for the rest of the year but still which amount should I expect for the delivery and hospital costs?
I always go higher just in case that way if it is cheaper you’ll be saving a bit more, also labor and delivery fees are costly so is newborn care
I think the baby is under your insurance for the first week or so but after that you have to call and ask them to add it to your plan. I think it’s up to them if they consider the baby another family member right away or not. Either way it has to be added to your plan.
Through delivery, it’s just you. Then once the baby is born you’ll probably have about 30 days to add your babe to your health insurance (as a life change), at which point your deductible will go up to the family one.
Do you know when your open enrollment is? Ask your insurance person or HR when the deductible is for - calendar year (so it would restart in Jan) or the enrollment year.
I lucked out and mine is for my enrollment year, which happens to be Feb-Feb, so it resets as of March 1 rather than Jan 1.
So from my experience and with working in hospital billing, you will have to meet your deductible and so will your baby. They will be separate. So you will get a bill from your dr, the anesthesiologist, and the hospital for you. Then you will also get a bill from the pediatrician and hospital for your baby since they will be a considered a separate patient after birth with their own deductible to meet. I’d plan for the higher amount and be pleasantly surprised when it is less. ��
this was my experience. Also a bill for the labs!
Your baby is typically covered under your plan for the first 30 days at which point you will have to add the baby to your plan
Mine is first 30 days
Expect it to be $6,000. You’ll meet the family amount with your labor and delivery and baby’s care. Save even more than that though as there will be co-pays for many appointments. For example my insurance covers my OB and pediatrician appointments but I have a $30 co-pay when I or baby see a specialist. Those $30 payments can add up really quick.
Make sure if your baby goes right into the NICU you call your insurance to add them! Thankfully we were informed we needed to do that with our first and she was covered or we would have had $100k+ bill we would have been responsible for. Also, plan for the higher amount.
With my first baby I called my insurance company and talked to a wonderful girl who explained all the maternity coverage. the insurance reps are usually much more knowledgeable than HR from my experience. My newborn was covered under me for 4 days. I also work with insurance and in the US it's usually a 30 day deadline to add the baby to your policy. I would plan for the higher deductible.
If you have Pregnancy Medicaid in Georgia you not only qualify for Newborn Medicaid without meeting ANY requirements or income limits. It is free for your baby if you had it during a majority of your pregnancy. You and your baby also qualify.
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