Out of Pocket Costs- Delivery & 1st Year

[SpunkyMom]

Hi folks,

I'm due in Sept. (first child) and am trying to figure out a ball-park range for out of pocket expenses for pregnancy (Dr. visits, testing, etc.), delivery and also the 1st year of pediatrician visits.

I know the range will vary, but if anyone has some ballpark figures based on a PPO plan from either BlueShield/BlueCross or Aenta, I would appreciate your feedback. I will use this information to plan for our flexible spending account.

Thanks!

[eniese]

Out of pocket for prenatal care and delivery can vary a lot based on your plan. Expect to end up paying your entire deductible for the year, and then probably some coinsurance on the rest. As far as ped visits go, there will be roughly 6-8 well visits in a year. Some insurance has well-visit copays, some does not. Also, plan on several sick visits, especially if your baby will be going to daycare. Our blue cross plan pays for all well visits, including all required vaccinations, so our well-visit expenses are limited to paying for things like flu shots. You should be able to get some ballpark figures from your doctor on how much prenatal will cost total and then estimate how much of that you will pay out of pocket. For example if total prenatal care runs about $1000 and you have a $500 deductible with 20% coinsurance, you will end up paying $500 (deductible)+100 (coinsurance).

[lena241]

I have Blue Care Network (Michigan). My out of pocket expense for delivery was a $200.00 co-pay for the hospital. I then pay $15.00 for co-pays at the pediatricians office. Since a baby sees the pediatrician every 1-2 months depending on your office and thier well child policy, you can expect to pay for that visit, if your insurance doesnt cover well baby visits without a co-pay. My pediatricians offices sees babies every 2 months for healthy babies, and immunizes at those visits. With my insurance, I will pay $90.00 in co-pays for her visits to 1 year, plus another $15.00 for her new baby check up, so total $105.00. This of course does not include any "sick child" visits, which unfortunately nobody can predict. My husband and I are using a medical Flex Spending account through his employer. We loaded the card with $1800.00 this year and expect it all to be used by our family of (4). Your insurance provider can provide you with a breakdown of what is covered and at what percentage.


My policy has no deductible we have to meet 1st.

[SpunkyMom]

Thanks for the feedback! Greatly appreciated!

[ra11en]

I have BCBS HMO, and my delivery / 1st year costs were around $3500. You never know what might come up that you have to do tests for - we had to pay copay on 3 different types of procedures, each copay was $200 each. Delivery was $500. All the many pediatrician visits, each with a copay. Having to see different types of specialist that run $40 per visit copay....it adds up. And don't forget all the actual baby supplies! We were spending about $600 / month on special formula as our DD had a cows protein allergy so she couldn't breastfeed or use regular formula.

Best of luck!!

[RLTMommy]

I pay for private insurance through Anthem Blue Cross. They do not cover any pregnancy costs without a full years notice. With the notice, they double your rates for the year leading up to the birth. We paid entirely out of pocket for our son's birth. It was $3000 for the doctor and around $8000 for the hospital. The doctor offered 10% off if you paid in full and the hospital offered 30% off because our insurance did not cover the birth. Make sure your policy covers birth. The services for my son are covered under Anthem. The first year of visits to the pediatrician ran about $800. This is because the new year started around his 6 month birthday and the deductible started over.

[3mama]

I can't help with estimated hospital costs, but I paid about 1500.00 for my homebirths.

[craftyashley]

I know my situation is unusual- but all the testing and perinatal vists, plus the hospital, etc. probably cleared the 100k mark. But I made $10 co pays for the first OB visit, and then every other perinatal visit. (Thank goodness for good insurance)
My cousin, who had pretty poor insurance, paid about $100/visit and about $300/blood draw. I'm not sure what she payed for the hospital- I think it was a flat $1,200 for the birth. Hope it helps.

[mylifeishunter]

i had 2 insurances and it covered everything, i have aetna and my husband has cigna. you pay a lot for the premnium but it is worth it when you dont have to pay anything for dr visits or for the birth. my birth alone was close to 15000.00 not including my sons dr, he was about 2500.00.

[Jill_at_StorkRadio]

So the co-pay are something that we totally did not think about as much as we should have. Thank God, I am on a 100% plan for the hospital etc but each time I go to a dr or get blood drawn I have a co-pay of $10, which isn't huge but it is DEFINITELY adding up, especially depending upon the number of tests you chose to do. I have Aetna.

[Fishman]

Just make sure you seek help if you encounter any child behavior problems (http://www.thetotaltransformation.com).

[craftyashley]

So the co-pay are something that we totally did not think about as much as we should have. Thank God, I am on a 100% plan for the hospital etc but each time I go to a dr or get blood drawn I have a co-pay of $10, which isn't huge but it is DEFINITELY adding up, especially depending upon the number of tests you chose to do. I have Aetna.

Those co-pays do add up! When the twins were newborns we were taking them into the pediatrician every other week or so- at $20 a pop it really does add up. Then every ear infection, etc. is another $10! One of the "hidden" costs of having a new baby. :)

[H.Starr]

Just make sure you seek help if you encounter any child behavior problems (http://www.thetotaltransformation.com).

First of all, that was not even close to relevant. I really hate all the spam/ads on here.

Anyway, our current insurance covers 100% of everything including perscriptions, but I know with my old insurance (Blue Cross) there was always a co-pay of $10 - $20 for every single dr visit, plus I had to pay 10% of the total cost of the appt. That was before I was pregnant, but I believe it would have been the same during pregnancy had I had that insurance still. I can't remember what I paid for prescriptions then...I think it was always different depending on what it was for. I just remember birth control was $6 per month.