Friday, January 21, 2011

Baby and Bills!!


In May 2009, we were blessed with the sweeeeeetest little thing in this world! our baby boy. I remember those first moments, I did feel like crying, but I felt something wonderful that I cannot put into words. I just wanted to stare at him for as long as I could watching his movements ,mannerisms, facial expressions, and features. It was incredible, amazing, emotional and truly indescribable.
Our parents and friends were all excitedly trying to decide who the baby resembles.
The new adventure called parenthood had just begun and along with the happy announcement of baby's arrival came the much happier insurance company with the hospital bills! If only we could trash bills like dirty diapers!!!!

As we progress in our pregnancy our Bills only get larger and the Hospital bill is the largest one.
We take advices from our friends on choosing the best insurance policy, talk to friends who have already crossed this stage, get maximum info from internet and insurance guys. All this Exploratory research only to learn that  pregnancy, labor, delivery and babies are so unpredictable.
For eg: You pick a hospital that is in-network of your insurance carrier only to find out after discharge that the anesthesiology group was out of network.

I had quit my job in May as planned to take care of my baby. My husband and myself couldn't think of a stranger taking care of our baby and I particularly dint want to miss out on his 'firsts'. First smile, coo, roll over, first word, first steps……
We knew it would cut us down financially a bit but i guess we had saved enough as pregnancy was very well planned and we were  ready to compromise money for LOVE!
Firstly if you are planning to have a baby, Congrats. If you are planning to have the baby in US, Congrats again.
I would like to share some tips from my experience regarding time and BILLS!!!

1. Make sure you call for help. Be it friends, relatives for anything.. Don't overdo things and stress out during pregnancy. Invite your parents or in laws to come over. Trust me, you do not want to do this alone and regret later for not having had the chance to enjoy the initial precious moments of motherhood. Don't waste time washing clothes, doing dishes, cooking, cursing time and yelling at hubby. Give your heart to your newborn and spend every second with him. Call for help.
2. Make sure that wife is listed as a dependent in your insurance.
(Once you are already pregnant, its too late to apply for new affordable coverage).

3. Choose a hospital near to your house and office. But first make sure that its in-network. Make sure to choose a in-network facility. Out-of-network hospitals costs too much and the costs will really pileup. So go to the provider search screens of Insurance websites to check for in-network.
Additional info on hospital quality, avgerage procedure costs etc can be found in ahd.com

4. Choosing an obstetrician. Ask your colleagues and friends about their experiences. Next make sure she/he is in-network and they practice in the above hospital. Most Obstetricians are not part of the hospital (even if they practice there) and so they will bill you separately. Check with your insurance for in-network providers/doctors.
Additional info on doctors like Quality ratings, certifications and reviews can be found in healthgrades.com
The obstetrician might prescribe regular medicines. If those are regular ones, go for online PBMs like Medco is for UHG.  We went with Medco and saved nearly $120 a year on Prenatal vitamins compared to other Pharmacies. If B&M suits you..Walmart is the best…….. :D , yeah you are welcome.

5.  Register with your Hospital 1-2 months before due date. Hospital –> If you pay the estimated patient amount before you are discharged, you can ask for 10-20% discount.  Some hospitals offer it while others give it to you only if you claim.

6. Register for a Parent training class. Its very useful and cheap. @$55-70. Enjoy a good laugh at husbands wearing a fake big tummy. Also if its provided by the same hospital you get the chance to look at the rooms and facilities before the delivery so that you know what to expect and what to pack. Enjoy those free baby supplies and diaper bags.

7. Ask maximum questions to the nurse or doctor. Make sure you have everything in the baby bag before you leave. Most supplies are provided by the hospital including baby's needs.. clothes, soap, blankets, pacifier, formula (if needed). All i was asked to pack was a favorite onesie for my baby and a change of clothes for myself to go back home. I had packed my bags at 7th month itself. You never know when your water is gonna break.

8. Rush to emergency and to maternity section from there when you are in pain and contractions are timed as per obstetricians advice, else they will send you back home.

9.Anesthesiologist –> If you go for epidural then you get 2 line items. One for local Anesthetic and other for the epidural.

10. Yay, the baby has arrived… Congrats .. Nurses take care of mom and baby very well.  Don't forget to ASK for more help if needed.

11. We preferred to keep  baby at the nursery. They get special care and be safe away from unwelcome visitors.

12. Before leaving the hospital..get a copy of the birth certificate. Grab all free stuff.. diapers, mats, blankets, pads….Don't be ashamed. Those belong to you.

13. Car seat. Most of us know hospitals will discharge the baby only after you buckle him up in a car seat. The nurse walks you down till your car with the baby in the car seat and will not  wave goodbye until she hears the seat click on the rear facing base. Make sure you have the right one and is fitted facing rear.

14. Choosing a Pediatrician.. again who is in-network. Most Pediatricians are not part of the hospital and so they will bill you separately.

15. Bills..bills and bills
You will get several bills and payment will be different on each of these. Your out-of-pocket is calculated based on the benefit plan that you have like 90/10 or 80/20. etc. If its 90/10 then Plan pays 90% and you pay 10% up-to a certain limit (out of pocket max). You also pay a deductible for each member of the family. The hospital might/will bill you twice. Once for the Mother’s stay and once for the baby.

More Medical questions answered by hubby.

1. If I am planning a baby, which plan should I choose.
Ans: Depends. This applies for first child. Choose 100/0 if delivery will be in the last Quarter. If its first Quarter choose 90/10. Why? 100/0 has very high premiums and if you go from 1+1 to Family the increase in premiums is huge but in 100/0 there is no coinsurance which saves you $2,500-3,500K. On the other hand if you take 100/0 for a January baby you might pay more then 3,000K for the increased premiums.
If its your second child or thereafter, 100/0 or 90/10 both might be good though 100/0 might save more money.
Both Payers (Aetna and UHC) have same benefits and you can choose any of them. they also have very good networks.

2. Are medicines covered during the stay ?
Medicines during the stay are covered. If you get a prescription, then you have to buy it outside.

3. I am having issues with the bills. How can I reach help.
    •    Talk to hospital or Provider’s office and get the Insurance company’s questions answered.
    •    Talk to claims specialist at the insurance company.

4. Service to help you organize your bils and find mistakes
    smartmedicalconsumer.com
    healthchampion.net


Enjoy motherhood, enjoy parenting.. Being a mother is one of the highest salaried jobs since the payment is pure love.

11 comments:

  1. Great post, I too had my baby on May 2009.Now she is pulling my hair everyday.

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  2. wonderful post !!!!
    What you have done is exactly correct in sacrificing your job for pure love. Your new born needs your presence more than your presents.
    went through similar situation where insurance was not covered for my son who had to be in NICU.
    Probably thats the time, when I was using my credit card without even thinking twice. By God's grace my son got discharged before any of my backup plans for lack of credit limit had to kick in. As you said, the saga continues getting the right pediatrician in the right hospital in the network at the right time.
    Keeping going with you wonderful post :-)

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  3. Wow! You have an amazing blog. Thanks for dropping by mine and leaving a comment and helping me to discover yours! hope your blog will be useful for me in the near future!!

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  4. Congrats on arrival of your cute angel! Love you informative post, keep them coming...

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  5. The picture reminds me of my babies, when I had them couple of years back.. the same colour cap and towel to wrap them.

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  6. Lovley post, very informative too. Enjoyed browsing thro' ur space and glad to follow u.

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  7. Thanks for visiting my blog Rachu. lovely post. brings back so many memories for me as well...
    Love

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  8. Congrats! Your baby is cute. Your post bring me back fond memories.

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Thanks for your comments.