Our New Baby and Health Insurance: What’s Covered?
THIS POST MAY CONTAIN AFFILIATE LINKS. PLEASE READ MY DISCLOSURE FOR MORE INFO.
Have you ever looked up how much it costs to give birth in the US? Hint: It’s expensive.
According to a new study, the cost of giving birth in America is now more than the average month’s salary.
So when I found out that Josh and I were expecting, a whole new world of health insurance was opened to me.
I knew my company had excellent insurance benefits, but I didn’t know the inner workings of my insurance. I’m currently on the CDHP plan with an HSA.
A CDHP, or Consumer Directed Health Plan, is a high-deductible plan paired with a HSA, or a Health Savings Account. That means that I don’t have a monthly insurance payment, but my deductible is higher and has to be met before my insurance will pay anything.
I switched to the CDHP plan from the PPO plan last year. With PPO, or Preferred Provider Organization plans, you have a monthly payment and your deductible is lower. Since we became debt free, we opted for the higher deductible with no monthly payment.
If one of us didn’t work at the company, we’d all be covered under the family plan with a $3,000 deductible.
Since that’s not the case, whoever covers the baby will need to meet the $3,000 deductible and the individual will have to hit the $1,500.
We’ll have to pay $1,500 more, as there is no other option from our employer.
HR provided valuable information, but for all of those specific questions above, they referred me to my insurance company. Anthem answered all of my questions, and gave me peace of mind when it came to the birth of my son.
Here are all of the answers:
Will the whole birth be covered under my insurance?
The birth and hospital stay will all be covered under my individual plan.
The cost will be $0 because I’ve already hit my deductible.
If Baby Williams ends up in the NICU, that would be covered under the family plan and we would need to hit the $3,000 deductible before insurance pays anything.
When exactly will we have to switch to the family plan? And how much will we have to pay?
Our insurance requires Baby Williams to be added within 30 days of birth.
That’s when our plan will change to the family plan. If the baby goes under my insurance plan, we would need to fulfil the remainder of the $3,000 deductible - $1,500.
If the baby is added under Josh’s insurance, the full $3,000 would need to be satisfied.
What is the best way to go about insuring the little one?
It’s really up to us, but we have to pick who’s insurance plan Baby Williams will go on.
Right now it makes sense for the baby to go on my insurance plan. There’s a lot of things up in the air though, so we’ll see what we decide.
When does my deductible reset?
My deductible resets August 1st. I initially thought it was May 1st. With my April 27th due date, I was worried that I would give birth in May and have to hit my deductible before any birthing costs were covered. This really worked out in our favor and gave me a big sigh of relief.
I was impressed with how helpful Anthem was. I thought it would be like pulling teeth to get my specific questions answered.
There were a few things the representative had to double check on, but for the most part, she knew the answer right away.
The representative even pointed me to a cost estimator, where I entered my hospital and birth type, and it gave an estimate of what I’m expected to pay.
A vaginal delivery at my hospital costs $14,545. Shocking to see how much childbirth costs!
Fortunately for my family, I won’t owe anything since I’ve already hit my deductible.
A C-section delivery at my hospital costs $15,215. I was surprised by this number. I thought it would be much higher than a vaginal delivery - since it’s surgery.
I am beyond grateful that Josh and I work for a company that values the work- life balance and backs that principle up with benefits. My maternity leave will be 12-14 weeks depending on how my son is delivered. If you deliver vaginally you are given 12 weeks of leave. A C-section is 14 weeks.
Have you looked into your company's policies? How do they compare to the average?
I'm Amanda. My husband and I paid off $133,763 of debt in less than four years! During our journey, I realized what my true passion was in life: helping others become debt free and reach financial independence. You can learn more about us here.
Join thousands of monthly readers!
About Amanda Williams