Navigating HDHP Insurance for childbirth

Navigating HDHP Insurance for childbirth


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…


In CA there’s MCAP.


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.


Transfer it to a custodian that’s not linked to your insurance plan.


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…


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.