Cost of Hospital L&D in NY? (X post)

[Faliciagayle]

Cross posted from the FYT New York Forum

Hi mamas
I've been on the phone all morning with various local hospitals trying to get an average price of maternity and NB care in NY state. I'm having no luck.

Does anyone have a reliable link or source? I am drafting my letter of appeal to my insurance company...

Much thanks!

[wombatclay]

Does the NYHealth site have any financial info? I'd imagine that there isn't really a statewide average cost... rural upstate and urban NYC probably have very different price tags. But it seems like a newspaper or magazine article might have a number you could use? Perhaps search the NYTimes archives?

If you need numbers for a specific region though, the hospital billing dept or customer service should be able to help if you tell them you're paying out of pocket (even if you're not). And the care providers I've used all had prices listed in their offices for oop patients.

[AlexisT]

The problem is that there are several sets of figures.

There's list price, which you'd be charged if you paid cash (might be able to knock it down)

There's the private insurance company definition of "usual, customary and reasonable" (aka "provider's reasonable charge") which is what they will pay (and which a hospital will accept as payment in full if they are participating providers). Insurers can be very cagey about releasing this--you need to see someone's bill to find out. Example: I had my IUD removed a few months ago. OB/GYN billed $250. Blue Shield decided it was worth $125, they paid it and the rest was tossed out.

Then there's what Medicare and Medicaid pay. Medicare is lower than private insurance, and Medicaid generally lower still.

There was actually a lawsuit in NYS about UCR--the AG said they had tried to keep UCR low to avoid paying out of network expenses.

[Faliciagayle]

Thanks for the tips. I'll check the mentioned sites.

I was on the phone with billing/records/customer service/admin at 2 different hospitals and NO ONE would give me information, despite saying I was paying out of pocket.. blah blah.

And according to my insurance, Reasonable and Customary for a HB is $1993. My MW regularly charges $7500, and from Medicaid (which we do not have) she will receive $6500.

NY law requires it to be covered - I am trying to get an in network exception since none of their in network providers are HBMWs.

Ahh, the joys of insurance

[honey-lilac]

Hey - look on the bright side - at least you have insurance!

[Faliciagayle]

Yes, this is true. And this has not always been the case. I am fortunate.


NYHealth was eye opening.... I checked procedures done at the first hospital I called this morning: 732 C-sections and 100 vaginal deliveries