So among the many things about the American healthcare system that bother me is that there is no way to actually properly financially prepare for anything. You can't know the price of having a baby, for example, because there are so many people involved with individual fees.
Here's what we knew we could expect:
Doctor's fee (prenatal care and delivery): $2100
Hospital stay, 48 hours: $4900 (less if we only stay 24 hours, but if we're preparing, we may as well prepare for the most possible)
Epidural: $2000 (estimate)
So that is what we were looking at. About $9000 IF I get an epidural. About $7000 without. (NOW can you see why it's actually an issue of money to get one or not? It's not like it's a $2000-decision. It's a $2000-MORE-than-what-we're-already-paying decision.)
Only one thing that neither of us had accounted for were other costs that are not included in this. And these are things that you don't expect, necessarily, because no one has told you about them, and no one informs you, "By the way, we're going to do this and it's going to cost you $XXX.XX." They just do it and send you the bill.
Murray called me VERY concerned this week to inform me that we got a bill from Lab Corp for lab work that matched up with the date of my first visit to the doctor. Yes, I remember that they took blood. And yes, I remember that at my most recent visit to the doctor, she told me that all my work came back looking good; everything was positive that was supposed to be positive, and everything was negative that was supposed to be negative.
What Murray was most concerned about was an item on the bill called "Chlamydia Amplification." This cost $131.50. Now for someone who is one hundred percent sure his wife doesn't have any STDs, I'm sure this item came as an absolute shocker for Murray, because why does Chlamydia need to be amplified if you don't have it?? Of course I don't have it, and I explained to Murray that I'm sure this is a test that legally HAS to be done so that STDs don't get transmitted to babies. But still. It does suck to have to pay $131.50 for someone to test you for Chlamydia, which you've done a really good job of avoiding your whole life.
Anyway, the total bill was $616.70.
At my next doctor's appointment, we will have our ultrasound. For that to be done at our doctor's office, we will receive a bill from the ultrasound technician (anywhere between $220 and $400). The ultrasound tech will then send the ultrasound to a center that will view it and study it and send the results to my doctor. And send me a bill for who knows how much. Who knows, because when does anyone ever inform you of how much you can expect to pay, or even ask your permission?
Then there will be other things to expect (but not actually know how much they will cost). Like getting tested for Gestational Diabetes. I am pretty sure it's a separate charge, and guess what. That orange soda is about $60 a bottle. Not kidding. If I come out positive after the first test, I'm not going to ask for a follow-up test where I can spend another $60 on soda. In fact, I'm really just tempted to ask if I can mix my OWN sugar drink with the needed amount of sugar and substitute it for the soda. Let's face it. I'm pretty sure I'm going to be GDS positive again.
(Oh, and by the way, to manage my GDS myself, I will test my blood 4-6 times a day for the last three months of my pregnancy. The test strips cost $1 each, and since this is related to my pregnancy, I don't know that my insurance will help with any of that cost. So I might expect my GDS self-management to cost an extra $300-$400. That's AFTER I got permission from my doctor to manage it myself and forego the biweekly visits to the Diabetes Management Clinic.)
Another thing. I will have to get a shot because my blood is rH negative. How much does that cost?
What about the hospital stay itself? Yes, I know how much the hospital charges for me to stay there. But what tests are done at the hospital that they charge me for separately? How much are they going to charge me for a Tylenol? What are the extra costs that one might incur while staying at the hospital (that again, you're not informed of as they happen; you're only sent the bill afterwards and you realize that that Q-tip cost you $8).
So it's really frustrating. I hope to get together with a friend soon who had a baby last year and also went to my doctor, and paid for everything in cash. I think she's pretty financially organized and I hope that she's got a folder of all her expenses so that I can add it up and get an idea of what we might have to pay for the baby.
Because we have NO CLUE and I think that a system where you can't actually properly financially prepare for service SUCKS.
(And just to let you know so that I don't start getting anonymous donations in the mail, we've saved lots of money and we do have Aflac that will kick in a little help, and we are 100% confident that we have the money to cover everything [and if there are expensive complications, then my insurance will kick in]. It's not that I'm worried that we don't know if we can afford it, it's just that it's frustrating not actually knowing how much something like this will cost us.)
(And just to be clear as well, as a reminder, if you are self employed in Utah there is NO MATERNITY COVERAGE AVAILABLE in any healthcare plan. It's not that we're in this mess because we chose a bad plan. We're in this mess because we chose to start our own business and make our own way in the world.)
(That's why I like to travel lots, so that I can take advantage of the perks of self employment as often as possible to remind myself that I really do actually prefer this.)
10 comments:
We just got our (pre-insurance) hospital statements on Friday. One 800 mg Motrin is $3.05. The bassinet that they put baby in was $280/day. My bill was $4500 and baby's was $2500. Then there's the midwives, the OB (since things went a bit crazy at the end), the anesthesiologist (again, since things went a bit crazy), and the pediatrician.
With the STD testing, apparently it's also something they automatically do with every pap smear. Before age 28 (I think) you can refuse the extra tests and charge, but after 28 it's legally required. Dumb, huh?
This is so weird to me. We are (Kiff is) self-employed and we have maternity through private insurance. I can't believe you can't find a plan out there that does. That is so weird to me. What do students do who have babies while working jobs that don't provide benefits? Suck-o.
My doc strongly recommended a c-section due to Roman's size and it's a conversation we didn't have until I was already 5 days overdue. I agreed and it was scheduled for the next day. It was considered a non-emergency c-section so we are paying way more than we originally thought. Total unexpected expense. I hear ya sista.
And you are a Halloween scrooge.
Yes, yes, and yes. I also have private insurance that doesn't cover anything baby-related, and I recently underwent a procedure that wouldn't be covered because it involved birth control. I wanted to know how much to expect to pay for it, so I called around to various OB/GYNs to get an estimate. I had the HARDEST time getting a straight answer from anyone, and when I finally did get an answer, the bill was $40 more than they'd told me it would be, even though everything went completely normally. What the heck? This kind of thing makes me SO mad.
Yeah, that sucks.
I agree with Kristeee, don't forget the baby expenses. I think our babies total bill was around $4000 but I'm c-sections and stay 3days. Maybe the insurance covers baby expenses just not pregnancy, though.
To the Holyoaks-- poor students get on medicaid and don't pay a dime.
We went through the same thing last year and learned the same lessons. I did manage to get UT insurance with maternity coverage, but only because it was a 'conversion plan' from my student coverage in CA. Otherwise we would have been royally screwed. I still ended up paying large amounts of money, especially for stuff like ultrasounds and lab tests.
Yeah, definitely remember that they bill the baby's hospital stay separately from yours. I think that's a bit lame. There are also some tests they do on the baby at the hospital. And they will keep track of every medication you take and charge by the pill.
Planning for medical expenses is so difficult and almost impossible. When you do get your bills, make sure you read them carefully before paying and even negotiate. I had a procedure done during my c-section this last time that I had already arranged with my doctor. Then I got a $500 bill for it (and my insurance only wanted to cover $100). I freaked out a bit, then talked to the billing person at my doc's office. I mentioned that the doc said he would do it without an extra charge, since I was in surgery anyways; she said they had to bill it since it was done, but that we could negotiate the charge down to just what the insurance would cover. Whew!
Holy crap, Kristee. (Note to self, bring own Costco-sized bottle of ibuprofin and just take 4 at a time while mentally flipping of The Powers that Be.) That is insane. All of it. Insane.
It's so freaking stupid.
STUPID.
Also, you might be able to negotiate a better rate with the Dr and the hospital. I have a friend who did that. Call and ask them to give you the insurance rates.
So with you. It is ridiculous that there is no way to get a firm quote on a price. My mom had some stuff done recently, and they tried to charge her twice the price they originally quoted her. Not cool. And had I known that I was going to be charged for everything my hospital room was stocked with, regardless of whether I used it, I would have taken it all home. Or given it to hobos. Or set it on fire. Something.
As for insurance . . . I think it should never cover anything foreseeable. Not that that will stop me from making full use of my insurance coverage of all kind of foreseeable crap.
I read your post a few days ago and just had to comment. Thanks for reminding me why I'm paying so much taxes, I don't mind it one bit right now. I'm having a baby soon and it costs me about $200 including every test, drug and anything that goes into this.
And sorry, this was not meant to brag or anything, I'm sure I pay as much in taxes. Just saying that those sums are totally absurd!
Brozy,
I can actually see the logic in insurance covering only unforeseeable things, but where is the line between foreseeable and un?
It's pretty easy to argue that a pregnancy is foreseeable. But what if a girl is raped and gets pregnant?
Is cancer foreseeable? What if it runs in your family? And what if you have a personal history of it?
Currently this is actually the way that the private insurance system is set up. That's why it's impossible to be insured if you have diabetes, cancer, or a number of conditions that they list at the beginning of any application form. But instead of foreseeable, they call it "preexisting condition."
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