Update: Financial issues with transfer & no maternity coverage

[NortheastSuperstar]

I wanted to check in with an update of our insurance situation. We paid $3500 to the midwife out of pocket and have a high-deductible health insurance plan ($5600/person) with no maternity coverage. The policy covers "complications of pregnancy" and "emergency childbirth."

Birth story is in post #8 in this thread: http://www.mothering.com/community/forum/thread/1275077/fear-of-transfer-neonatal-problems-for-financial-reasons

After the transfer and 11 hours at the hospital we had these bills: approx. $11,000 for room fee, delivery care, and baby care; $1250 for five minutes in the ER; $2600 for the OB; and $500 ambulance ride. We let the hospital's financial dept. know that our insurance would only cover it if it were clear that it was emergency childbirth so they needed to code it that way. The hospital sent all the bills to the insurance company and let them know that we are requesting coverage under emergency childbirth. Kudos to the hospital for being helpful about this. The insurance company required all of my medical records for the birth to be sent to them, and it went to a review panel. They approved it as emergency childbirth services! I'm so relieved.

They are going to re-process all the bills and we will be required to pay the deductible. I can get a payment plan through the hospital and maybe even a little financial aid since it's over $5000.

This process has taken a while, and I have gotten 1st, 2nd, and 3rd invoices for the bills demanding payment, so it has been a bit stressful trying to wait it out.

Anyway, that's the story. The insurance adjuster is supposed to call next week with details so I'll update then if there's any new info.

[CookAMH]

I'm glad it went your way! That is a huge relief considering the level of expense you'd have.

That was my financial situation going into this year if I hadn't gone off on my own plan with maternity in Jan, at 24 weeks. DH and DS stayed on the high-deductible HSA plan. I wouldn't have had maternity if we moved over with all the plan changes that our insurance company did for this year and if we had taken what they suggested (HSA with no maternity).

Anyway, I'm glad you got it sorted well. And I'm sure you can do a payment plan. Do you have an HSA?

[NortheastSuperstar]

Yes - we have an HSA and DH's employer contributes to it so we should be able to pay it off this year. The reason we did the high deductible plan with the HSA is so we could pay the midwife out of the HSA. I was already pregnant so we couldn't get individual insurance except through our state's high risk pool (it's a "pre-existing condition"). DH's employer doesn't have a group plan, but would pay for individual insurance and an HSA.