Great writeup telemachus
This was significant for me at first. But now, after a few years of having this plan, I no longer think it clouds my judgement. It also helps to have a healthy HSA balance.
What do you mean by “roll it over periodically?”
So the only option then becomes ACA plans and foregoing employer coverage–use the QLE to re-instate employer coverage. That’s more than I want to deal with at this point. I’m going to just plug along with HDHP for the L&D and aftercare.
I’m looking at $1k a month for Jan/Feb plus a partial month of Feb on employer plan (Call it $100) with a platinum ACA plan that has a $4400 OOP max.
Oh well.
I don’t know that this is even relevant anymore as it was prior to obamacare. At the time my wife became pregnant 8 years ago, she was uninsured so sh was considered “pre-existing” and didn’t qualify for normal health plans. We found a WA state catistrophoc plan that was $500/mo with no deductible. For her pre-natal bleeding ER visits, ultrasounds and after birth ER visit for our child, we saved thousands going with that plan that was about $5k oop.
Not sure if any catastrophic $0 ded plans are offered anymore but this was a life saver for us. In the end mom and baby were healthy but don’t plan for things to go right. Plan for worst case as costs can completely skyrocket for unforseen circumstances. We had great care of our choosing and ensured there were no issues with healthcare costs beyond our (at the time) expensive premiums. The only request was a written explanation of our newborn requiring post natal care 2 weeks after being born, still covered under the plan. Does anything like this still exist in our current healthcare system?
These were mostly killed off by Obamacare mandates. The payout ratios are bad for any rare event insurance coverage. Most of the short term stuff probably excludes preexisting or some voluntary conditions, wouldn’t be surprised if you couldn’t get catastrophic pregnancy coverage. I mean, I’d buy catastrophic general coverage but they don’t sell that on the exchange or anywhere in my state thanks to the ACA…
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The opposite is certainly true. They wouldn’t even entertain my billing complaint and just kept saying that I have X amount in my HSA which can be used to cover the charges, as if this was somehow free money. This happened on several occasions with different reps.
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Transfer it to a custodian that’s not linked to your insurance plan.
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Are you talking about providers, or your ins. company customer service people, or someone else? I’m shocked if it’s the first, and still pretty surprised if the second… Our insurer doesn’t know how much is in our HSAs, and the hospital doesn’t even know that we have HSAs, as we pay with a points card and then reimburse ourselves from the HSA.
Edit —>> Come to think of it, I’m not certain our insurer doesn’t know our HSA balances, but they’ve never indicated that they did. Will check next week if I get time.
Edit 2 —>> Thanks for bringing this up. I was wr-r-r-r 'er not correct. While speaking with BCBS today, I asked if they could see my HSA, and much to my surprise, they can readily see the balance.
Consequently, I will be draining it to my other HSA account early in the year. By the time the balance builds up toward the last quarter of 2019, I will already have hit my max out of pocket.
My employer’s HSA provider wanted me to sign a form giving them access to my insurance claim data. I told HR to pound sand, they told me i couldn’t open the HSA without it.
After i filed a complaint with the state, they found a way around it…
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It’s rare I hear about things I’ve never heard of before, but you sir just told me something I didn’t know about. I did a very cursory search and it doesn’t look like there are many options out there without fees, so I don’t know if it’s worth it for me to switch. But things change pretty quickly these days, so I will keep my eyes peeled for better options.
So, this is the HSA provider getting your claims data not the vice-versa (HDHP plan getting HSA data). I find that I get claims via HSA much faster than HDHP provided info. I usually use my rewards card to pay bills then reimburse via HSA and even the HSA website indicates this option (to get reward points), but I find it very convenient to dispatch unpaid amounts directly via the HSA because they have the balance and info to pay the provider.
What is especially helpful is you usually get real cost data from the PBM rather than the made-up numbers provided with dispense documents (the fake “cash price” or even covered amount).
My new strategy is to hold off on a few things I was going to get done this year for early next year. Should chew through our family oop max next year, saving me a little.
Pre delivery costs are higher than I expected, around $1300 so far.
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I never updated this thread.
Update: Birth was successful.
2 nights in L&D room, nurses, all IV, and needs, etc.
1 night in the regular hospital post delivery
Prenatal and post visits
Baby’s day 1 needs
Total hospital bill was $13,800. (negotiated rate off of $28k ‘billed’ amount). My charge was ~$5300
I received a separate bill for 1650 from our OB, for delivery. Ob did not do the delivery due to time of day, I never got anything from the Dr. who did the actual delivery. So I guess there’s some kind of sharing agreement there?
Surprised it wasn’t more.
Some takeaways:
Our OBGYN made us prepay them $2k, but because they billed us late they could only charge us 20% of everything. I had to chase them down for a refund of $1500+.
The insurance bungled adding our baby to coverage. I had similar issues with kid #1. Took me about 8 weeks to finally get everything fixed and bills sorted out for baby.
We had some followup work on baby, very glad our deductible was met and we did not change plans (start a new ded.) This would have been 4x more expensive and probably eaten any benefit up.
As mentioned upthread we’ve had the rest of the family get what they needed taken care of this year so as to take advantage of the deductible being met.
Amazing that OOP max was not hit.
Had enough in our relatively new HSA (2 years old) to cover everything.
Healthy and happy baby.
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Congrats on the new addition and thanks for the the detailed update. 2 nights in L&D? Give your wife a bottle of something - she deserves it.
I’m not sure I understand about the OBGYN. Are you saying that you paid prior to the billing and that the bill came after you’d hit your deductible?
FYI, we had a child in the early 80’s. Although I don’t recall the exact OBGYN amount, the total hospital bill was <$2500. This was only “slightly” negotiated, and included 1 night in L&D and one night in a regular room.
Again, congrats on a future grass cutter.
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Unless she’s breastfeeding!
She’d probably appreciate more sleep and cooked food more than anything else.
Thanks for the update and congratulations!
And thanks for the reminder about this thread. My wife is due in September (yay for the pregnancy not spanning two years), so I will update on my experience after we receive all the bills. So I guess November or December.
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Thanks all. it was a little bummed about spanning the year but given how much we’ve had done since the baby was born as a family I feel like it’s about a wash.
forgot to add there was no anesthesiologist in the mix here so that probably reduced our cost at least a few thousand dollars.
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Yes. They insisted on giving us an estimate of what we would be spending with them and then wanted a down payment towards it. I knew that it was going to become a mess but given how late in the pregnancy they presented it I just paid it.
I guess one small wrinkle is that I paid them out of my HSA. So I held off on paying the hospital until after I finally got the refund and then deducted it from what I took out of my HSA to pay the hospital. From what I read that was the best way to handle this with minimal effort.
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Shoulda paid with a rewards CC and reimbursed yourself from the HSA…
I did that. Just wrote a smaller check from the HSA to cover it.
Actually applied for a new card just to hit min spend.