4 ms·

What do folks in the US with health insurance have to pay? Insurance companies get huge discounts on the artificially inflated listed prices.

votepaunchy 8y ago
Our out-of-pocket has been $175 including delivery and postpartum care. We’ve needed to stay 48 hours in recovery for medical reasons at no additional cost (cesarean recovery allows 96 hours). The article conflates per-night and per-visit costs.
chx 8y ago
In "normal" cases, roughly, 500 USD or less if you have insurance. But it's really awfully complicated -- often the baby gets a separate bill too to muddle the waters. The ACA ("Obamacare") set a cap on in-network yearly out of pocket payments on family plans which, if memory serves, was around 11k in 2017. A complicated birth can hit this! Consider the costs of NICU, for example. (Oh and if an NICU nurse reads this: thank you, thank you, thank you for the life of my niece.) As to what the insurers pays, I do not know.
- smcl 8y ago
  The baby gets a bill?
  - chx 8y ago
    YES! I haven't the luck to this because I am Canadian (actually, Canadian-Hungarian) but I heard from my friends across the border and read the stories. For eg. https://community.babycenter.com/post/a46638358/insurance_issue_baby_billed_separately https://community.babycenter.com/post/a46638358/insurance_is...
  - ubernostrum 8y ago
    For services provided to the baby, yes. The expectation is that the baby will be added to the insurance plan effective as of birth, so it's correct to bill services provided to the baby as... services provided to the baby.
    - smcl 8y ago
      Oh I understand how the situation arises ... but billing a baby for being born is never going sound normal to me.
      - TomMarius 8y ago
        I think it's not the birth itself, it's the post-birth services.
        Symbiote 8y ago
        To most Europeans, billing a child is never going to seem normal. And that includes dental and optical treatments. Braces and glasses are free, at least the basic type. (I've generalized all of Europe; there may be exceptions in some countries.)
        alxlaz 8y ago
        Am European, can confirm. The idea that the first thing a kid gets in this world is a bill for healthcare services is amusing in a chilly sort of way. I mean, it's not like the poor kid had a choice in the matter of whether he's born or not. What happens if the parents can't afford it? Does he, like, get to go back in until the parents pay? If he had an ailment, and it got cured, do they give it back to him? Do they put him in suspended animation :-)?
        TomMarius 8y ago
        It's the same in Europe though. The hospital will send a bill to the insurance company (usually there is one default and you can switch your children to another any time) in the name of the child.
        Symbiote 8y ago
        There is no "insurance company" in Britain or Denmark, the two countries I've been/am eligible for state healthcare as a resident. I've never seen any paperwork in either country regarding billing or other costs, and that's as an adult.
  - partycoder 8y ago
    The baby is a patient too. In fact, it is not rare to have a baby referred to as "the patient".
  - grahamburger 8y ago
    The baby doesn't 'get a bill' in the sense that I think you are suggesting (based on this on your comments down thread.) The parents get a bill with line items listed for services provided for the baby.
  - ensiferum 8y ago
    First the baby gets a bill, then they can also open a bank account and start saving for their university tuitions and future home loan.
  - baldeagle 8y ago
    Each person tends to have a max yearly limit. By billing the baby separately, the yearly max for the mom and the baby can be hit (or the family max). This is especially important as the mom may have already received a good amount of charges leading up to the birth.
sitharus 8y ago
The article suggests the end payment is around $3,000 after insurance, which is still more than the ~US$2,000 + 500/night you’d pay for a non-resident birth where I live. I’d be free if you were a resident, unless you want a premium room with a bed for your partner to stay in when it would be ~US$300/night.
throwaway2016a 8y ago
This is completely anecdotal of course but... my insurance covered all but $700 of the birth. The total cost was over $15k. What it did not pay full for was ultrasounds. Which aren't technical part of the birth. They only paid full for the first one and we needed 5, which was about $300 each out of pocket for me. But I hear my experience is not typical. Usually out of pocket costs (even with insurance) are much higher in the US.

votepaunchy 8y ago

Our out-of-pocket has been $175 including delivery and postpartum care. We’ve needed to stay 48 hours in recovery for medical reasons at no additional cost (cesarean recovery allows 96 hours). The article conflates per-night and per-visit costs.

chx 8y ago

In "normal" cases, roughly, 500 USD or less if you have insurance. But it's really awfully complicated -- often the baby gets a separate bill too to muddle the waters. The ACA ("Obamacare") set a cap on in-network yearly out of pocket payments on family plans which, if memory serves, was around 11k in 2017. A complicated birth can hit this! Consider the costs of NICU, for example. (Oh and if an NICU nurse reads this: thank you, thank you, thank you for the life of my niece.) As to what the insurers pays, I do not know.

smcl 8y ago
The baby gets a bill?
- chx 8y ago
  YES! I haven't the luck to this because I am Canadian (actually, Canadian-Hungarian) but I heard from my friends across the border and read the stories. For eg. https://community.babycenter.com/post/a46638358/insurance_issue_baby_billed_separately https://community.babycenter.com/post/a46638358/insurance_is...
- ubernostrum 8y ago
  For services provided to the baby, yes. The expectation is that the baby will be added to the insurance plan effective as of birth, so it's correct to bill services provided to the baby as... services provided to the baby.
  - smcl 8y ago
    Oh I understand how the situation arises ... but billing a baby for being born is never going sound normal to me.
    - TomMarius 8y ago
      I think it's not the birth itself, it's the post-birth services.
      - Symbiote 8y ago
        To most Europeans, billing a child is never going to seem normal. And that includes dental and optical treatments. Braces and glasses are free, at least the basic type. (I've generalized all of Europe; there may be exceptions in some countries.)
        alxlaz 8y ago
        Am European, can confirm. The idea that the first thing a kid gets in this world is a bill for healthcare services is amusing in a chilly sort of way. I mean, it's not like the poor kid had a choice in the matter of whether he's born or not. What happens if the parents can't afford it? Does he, like, get to go back in until the parents pay? If he had an ailment, and it got cured, do they give it back to him? Do they put him in suspended animation :-)?
        TomMarius 8y ago
        It's the same in Europe though. The hospital will send a bill to the insurance company (usually there is one default and you can switch your children to another any time) in the name of the child.
        Symbiote 8y ago
        There is no "insurance company" in Britain or Denmark, the two countries I've been/am eligible for state healthcare as a resident. I've never seen any paperwork in either country regarding billing or other costs, and that's as an adult.
- partycoder 8y ago
  The baby is a patient too. In fact, it is not rare to have a baby referred to as "the patient".
- grahamburger 8y ago
  The baby doesn't 'get a bill' in the sense that I think you are suggesting (based on this on your comments down thread.) The parents get a bill with line items listed for services provided for the baby.
- ensiferum 8y ago
  First the baby gets a bill, then they can also open a bank account and start saving for their university tuitions and future home loan.
- baldeagle 8y ago
  Each person tends to have a max yearly limit. By billing the baby separately, the yearly max for the mom and the baby can be hit (or the family max). This is especially important as the mom may have already received a good amount of charges leading up to the birth.

sitharus 8y ago

The article suggests the end payment is around $3,000 after insurance, which is still more than the ~US$2,000 + 500/night you’d pay for a non-resident birth where I live. I’d be free if you were a resident, unless you want a premium room with a bed for your partner to stay in when it would be ~US$300/night.

throwaway2016a 8y ago

This is completely anecdotal of course but... my insurance covered all but $700 of the birth. The total cost was over $15k. What it did not pay full for was ultrasounds. Which aren't technical part of the birth. They only paid full for the first one and we needed 5, which was about $300 each out of pocket for me. But I hear my experience is not typical. Usually out of pocket costs (even with insurance) are much higher in the US.