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Pregnancy Pregnancy

insurance vent*UPDATE*in green

Posted by on Jul. 22, 2013 at 1:49 PM
  • 55 Replies
1 mom liked this

i just got off the phone between our insurance company and my doctors office. even when you have good insurance and fork out a lot of money for it each month, the insurance company still screws ya and sucks! *this is just a mini-vent and no need for negative responses.

dh is home from work. hes been on the phone with our insurance (anthem bc bs) for the last hour. they have put him through 6 different people.  we just realized that we are actually paying 75% out of pocket. -on top of paying a load of money a month for it. they are basically useless. 

do i have any other options??

dh just called me. he was in a meeting with his hr manager. They looked into it and confirmed we will be paying $15k out of pocket for this pregnancy. HR called the insurance company and it came down hr felt it was unacceptable considering the preimiem we pay monthly in top of this. OK, heres the part that has me in complete tears, they (my husband and hr) disenrolled us today. I am now sick to my stomach about this. I didn't see this coming. i need a hug.

ok, so I did try to apply at mediciad and was denied. I am just wanting to get a private insurance company. -use the extra money from what we were paying from our old insurance to pay for something different. any recommendations of insurance companys that are affordable and will cover maternity-not just maternity but overall decent coverage? oh and not consider my pregnancy as a pre-existing condition?? thanks in advance. =)

by on Jul. 22, 2013 at 1:49 PM
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Replies (1-10):
Larsbug
by Laura on Jul. 22, 2013 at 1:53 PM

 ain't that the truth!! my 16 month old needs braces on his feet because he walks on his tippy toes and his tendons are too short...without the braces they could snap and he would need surgery and years of PT...insurance company says that the braces are "cosmetic"

amylou111
by on Jul. 22, 2013 at 1:57 PM
omg thats terrible!!! instead of forcing us to have insurance, they should regulate these insurance companies!
Quoting Larsbug:

 ain't that the truth!! my 16 month old needs braces on his feet because he walks on his tippy toes and his tendons are too short...without the braces they could snap and he would need surgery and years of PT...insurance company says that the braces are "cosmetic"

awilliamson
by Member on Jul. 22, 2013 at 2:03 PM
I have to mentally prepare myself to call the insurance company! I get different answers every time I call!! My doctor's office tries very hard to keep me up to date and help me understand the ridiculous amounts of money we spend, on top of good insurance, but those agents at the company makes me lose my temper.

We pay $200+ a month on top of what DH's company pays and it's still expensive. My first ultrasound took up my entire $400 deductible, with the insurance discount.
pregnantmama105
by on Jul. 22, 2013 at 2:04 PM
I am glad I am in canada.
I saw SO hospital bill from when he visited the states. I could never paying all that money just for tests they decided to run just to see what the outcome is.... I know its not the same as prenatal care. But I think SO had some sort of platnum coverage and they covered 98% i think
amylou111
by on Jul. 22, 2013 at 2:10 PM

we pay $500 a month for a family of 5. deductable is $1200, but we also have to pay 10% of the total bill. which this year it is $2500, but because my pregnancy goes into march of next year, the new fiscal year starts 1/1/2014. so it will be $5000+$2400(deductable for both 2013/20014) plus we pay for the ultrasounds out of pocket. this whole day has caused nauseua, heartburn and anger between me and dh. 

Quoting awilliamson:

I have to mentally prepare myself to call the insurance company! I get different answers every time I call!! My doctor's office tries very hard to keep me up to date and help me understand the ridiculous amounts of money we spend, on top of good insurance, but those agents at the company makes me lose my temper.

We pay $200+ a month on top of what DH's company pays and it's still expensive. My first ultrasound took up my entire $400 deductible, with the insurance discount.


amylou111
by on Jul. 22, 2013 at 2:14 PM
2 moms liked this

canada's healthcare is what america needs! I love our president, but his obamacare thing is not what we need. it doesnt solve anything. our insurance companys still make billions, deny people for tests and things patients needs. plus paying too much for such "healthcare". 


Quoting pregnantmama105:


I am glad I am in canada.
I saw SO hospital bill from when he visited the states. I could never paying all that money just for tests they decided to run just to see what the outcome is.... I know its not the same as prenatal care. But I think SO had some sort of platnum coverage and they covered 98% i think


amylou111
by on Jul. 22, 2013 at 7:24 PM

bump!

awilliamson
by Member on Jul. 22, 2013 at 7:42 PM
75% after you've met your deductible?? Sounds outrageous. We have BC BS Texas and we pay 20% after deductible, up to $2300 (individual).

Does your policy state otherwise and they're charging you wrong or does your policy say 75%?

I don't know much about insurance, but if it's through work.. you can drop it and get it privately. But I'm not sure how that works.
amylou111
by on Jul. 22, 2013 at 8:23 PM

It's because the new fiscal year starts 1/1/2014, my due date is march 2014, so we are responsible for this year and next year..

it ends us paying out of pocket-

$1200 (2 times=$2400)-deductable

$2500 (2 times=$5000)-prenatal (our part)

$5000-10% coinsurance

total: $12400.00 ---delivery is a total of $15000. 

I may be off (not by much) on some numbers...the point is that we pay all this money a month for healthcare and find out how useless it really is.

plus our insurance wont pay for ultrasounds, certain testings, and if i require something more during-like one pregnancy i needed to see a cardiologist and he had to run some tests--on this insurance they wont cover 2 of the 3 tests.... the presciption plan is awful as well. 

I never had awful insurance before! I was on United Healthcare with one-it wasnt like this at all and tricare for another and i was on (medicaid for a while on my last baby.

we are looking at our options tomorrow and see what we can do.


Quoting awilliamson:

75% after you've met your deductible?? Sounds outrageous. We have BC BS Texas and we pay 20% after deductible, up to $2300 (individual).

Does your policy state otherwise and they're charging you wrong or does your policy say 75%?

I don't know much about insurance, but if it's through work.. you can drop it and get it privately. But I'm not sure how that works.


Megan.Aber
by on Jul. 22, 2013 at 8:34 PM
Wow. Maybe u should look into medicadw too? Is that'l what it's called I get Medicare and medicade mixed up.
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