HOLY MOLY that was expensive!!! - Page 2

[justmama]

My 34 weeker had an 11day stay plus 5 days in the hospital for me and she cost $175K(that's including the apnea monitor for 6 months after birth and a lumbar puncture in the nicu and multiple ekg's).

My 33weeker also had an 11 day stay and I had a 3 day stay and she was transferred and she cost $75K.

I really think it's all the procedures that rack up the cost. The lumbar puncture for Sara alone was $4K. That's not to mention the ekg's and the apnea monitor. Gracie's hospital transfer alone was over $400. 15 minutes down the road in an ambulence, no oxygen, and just her head nurse riding with her.

I know a little girl who capped out her private insurance at $1million and now is required to be covered on state medicaid. This isn't due to her income or her health, but the fact that she capped out her insurance policy before she hit age 1. She was a 29weeker with a 3 month stay and epilepsy that wasn't well-controlled until 11months so countless mri's, ct scans, meds, doctor's visits, etc just killed the insurance company.

[susienjay]

I'm feeling like mine were cheap now but none of my 3 were ever on a vent or had any procedures done. They were all basically grower/feeders.
3.5 yo ds- $77,000 (32w3d- room air from birth, 36 day NICU stay)

3.5 yo dd- $78,000 (32w3d- nasel canula for 2 weeks, 36 day NICU stay)
We paid $200 copay for each baby and after that it was covered at 100%. We qualified for Medicaid at the time but I never got around to filing for it so we paid the $200 each but it took us months to come up with it.


1.5 yo dd- $99,000 (29w3d- 6 hours on c-pap, 5 days on canula, 41 day NICU stay)
Hospital bill was $60K and Neonatologist was $37K plus a couple small bills. After we had dd home we found out the Neo was Out Of Network. It's not really something you ask during a medical emergency. Our insurance paid the reduced rate of $25K and they came after us for $12K because there was no negotiated discount. Insurance finally coughed up another $11K after filing a bunch of appeals but it was a gigantic headache.

Our insurance has a 5 million dollar cap per person.

[sparklett]

[QUOTE= After we had dd home we found out the Neo was Out Of Network. It's not really something you ask during a medical emergency. QUOTE]


Wow! It never, ever occurred to me to consider which of our providers was in-network and which wasn't. I mean REALLY! What do they expect you to do, say "I'm sorry, you seem to be a really great doctor, but before you place that life-saving PIC line or write out that script for TPN, do you know of someone who could possibly be in my network?" Goodness!!!

[dbsam]

After the PPO adjustment, my son's NICU bill was ~$600K and my daughter's was~$300K. Unfortunately our per person lifetime cap is $750K. Something I never thought of prior to their NICU stay.

[irangel]

Originally Posted by justmama

I know a little girl who capped out her private insurance at $1million and now is required to be covered on state medicaid. This isn't due to her income or her health, but the fact that she capped out her insurance policy before she hit age 1. She was a 29weeker with a 3 month stay and epilepsy that wasn't well-controlled until 11months so countless mri's, ct scans, meds, doctor's visits, etc just killed the insurance company.

My daughter was in the same situation. She reached her lifetime maximum a few months into her stay and didn't qualify for medicaid due to my husband's income. We ended up having to get into a medicaid waiver program through a backdoor so that we could skip the 8yr waiting list and bring our daughter home with her ventilator, feeding pump, oxygen, monitors etc. She is still in the waiver program because she's medically fragile but my husband switched jobs about a year after her discharge and we got her into a new private policy with a higher maximum limit but unfortunately she made the entire companies premiums double...

[Jilian]

Wow, our bills are still rolling in and so far the total is somewhere around $175,000 for emergency transfer and emergency open heart surgery followed by a 9 day CVICU stay. He was only on the vent for 3 days (including prior to surgery). I think the surgery itself was $65,000 not including anesthesia or anything else. Thank god we had Medicaid and likely will not have to pay much. But DH's insurance only covers 90% so if we had put DS on that we would have had to pay a fortune!

Medicaid is still denying many of the bills and it amazes me what they actually pay versus what is billed. Sometimes they pay half! I'm pretty sure I am going to get stuck with the transport bill which is BS. WTH did they expect us to do? Transport a baby in heart failure to a hospital 90 mns away in our minivan?! He was intubated with 100% oxygen with sats in the 80's at that point. It really gets me angry!

[Jilian]

Originally Posted by dbsam

Before the PPO adjustment, my son's NICU bill was ~$600K and my daughter's was~$300K. Unfortunately our per person lifetime cap is $750K. Something I never thought of prior to their NICU stay.

What happens in that case? Are you expected to pay the difference? It is scary because many of us don't know this info beforehand. But what is a mama to do when the situation comes up? Our children NEED the care. There are no other options.

And all of that stuff about out-of-network providers is just horrible! When a child is dying there is not time to search for providers, etc. Insurance companies really make me angry with that BS. They don't care about people's lives, they care about making money. It is really sad.

[dbsam]

Originally Posted by Jilian

What happens in that case? Are you expected to pay the difference? It is scary because many of us don't know this info beforehand. But what is a mama to do when the situation comes up? Our children NEED the care. There are no other options. .

I think about the lifetime cap every time we see a new doctor or a new 'issue' comes up. In hind site...I was going to continue with my COBRA until I had the babies and I s/h. (I stopped working before they were born.) My insurance was primary and we w/n/h used up so much of their current insurance. However, I never even thought about the cap. (I s/h thought it through because I was a controller for many years and knew how insurance worked. I just never thought it would apply to my family.) I also never realized my husband’s insurance has such a low lifetime max. I inquired about our lifetime max while they were still in the NICU because I asked what a typical day was costing.

Irangel…I’m glad your daughter was able to get coverage with your husband’s new job. I know how awful companies can be when their premiums go up and they blame an employee. I hope they are treating your husband well. I remember sitting in an insurance meeting and someone actually said…’Great, thanks to x our premiums have skyrocketed.’ I was appalled considering she was a valued employee – who died of cancer. (Not all companies are like this – I did work for a few compassionate firms.)

[bitobsessive]

One of the surgical assistants in my c-section was out of network. I was never even sure who it was, but it was ridiculous. The hospital and all the doctors were in network, and the bill for this one guy was going to be the same price (about $1,600). My husband ended up calling the surgical assistant's company and negotiating with them personally. Apparently that happened a lot, and we were able to work it out.

[miche28]

I used to work in U.S. benefits (well before I had kids) and it was always amazing to me to see the bills... Biggest ever claim that I saw was $1.4 million for mom and preemie twins.

At one company I worked for, we had 600 US employees and within that had three sets of very premature twins and one set of triplets within 6 months. It was very unusual and the NICU costs were crazy. But the happy ending is that all the babies and mamas ended up being just fine and the next year's family picnic had lots and lots of babies!

As for out-of-network, that's one of the dumbest things about PPOs - in an emergency, most policies don't apply network restrictions anyway, but the insurance companies need to do a better job (because they can control that, they just don't spend enough time working on it).

Here in Canada, no one would ever have any idea how much a hospital stay cost... unless they accidnetally had their baby in the US (as also happened to a British employee once - 29 weeker born on a business trip...).

Wow, you know, I never realised how much NICU-knowledge I had before the kids were born (not that you really know unloess you're there)...

[jamiew]

It's insane what insurance companies charge in this country.

If there's ever a revolution, it'll be over health care costs.

[purplepaisleymama]

My youngest was around $80,000. as far as I can tell, we did get an itemized bill from the hospital with most of the charges, but a few of the specialists were separate. He was born at home and then we transferred in, UC and they tried to charge me for the birth and for the epidural, after I noticed it on the bill I called and debated with the hospital and the insurance company. The conversation was very interesting:
hospital billing employee: Hi
me: Hi, I received a itemized charge list and I noticed that we were charged for an epidural, I didn't have one so I would like that removed from the charges.
hbe: Um, well I would like to remove that for you but we have to charge for services rendered, so I will have to leave it on the charges.
me: Yeah, well it never happened so I would like to have it removed. I gave birth at home and I did not have an epidural.
hbe: Um, well you must have had an epidural, it was charged and they are routine.
me: You must not have heard me correctly, my child was born at home and I did not have an epidural, in fact I did not have any medication and there was no doctor or nurse present, so I am very sure that there was no epidural. I am relatively sure that if the hospital persists in this type of charge it would be considered fraud and I wanted to give you all a chance to rectify it before I call my insurance company.
hbe: Well, I am not sure what is going on here, I am looking at your bill here and it says that you had an epidural, so I will have to make a notation on your record and I will have someone get back to you. Are you sure that you didn't have an epidural, I mean it can be very confusing during labor and birth?
Me: ARE YO KIDDING?????? I did not have an epidural, the only person who would have had the ability to place one at my birth would have been my husband and he is an electrician, not an anesthesiologist!!!! I think that I would have remembered having an epidural at home, so no, I don't think that I overlooked it.

This was followed by a very similar conversation with the people that finally called back about the issue and then I called the insurance company and they were for some reason very happy to hear that they had been overcharged. This was not the only thing that was charged for that never happened, they charged for including the birth and postpartum care, which since I was admitted to the hospital they had a right to charge for ( so they claimed) and the insurance company made them split it and charge separately for everything, which I reviewed and made sure it was legit.

I can say that I do have some fear about ever having to have to go through more medical bill ever again, I wasted many hours having to deal with incompetent and useless people who were not especially polite.

[Fyrestorm]

Wow...must be wicked expensive here...My & DD's stay less than 48 hours for both of us, my section and her NICU stay $62,000.

Less than 48 hours!

They did nothing for her in NICU...2 hours on a CPAP, NOTHING else!

[sparklett]

Originally Posted by purplepaisleymama

Me: ARE YO KIDDING?????? I did not have an epidural, the only person who would have had the ability to place one at my birth would have been my husband and he is an electrician, not an anesthesiologist!!!!

[happyblessedmama]

wow... I just read this thread and calculated out my baby's stay cost, was $694/hour (200,000 medical bill; 12 day stay). She was on a ventilator for a week, IV feeds til she could nurse, etc... but that seems amazing compared to what I'm seeing here.

[fairejour]

6 weeks and over $750,000 for us.

My DD's private ECMO room was $30,000 a day! Just the room. Crazy....

Oh, and by the way she was full term with medical issues other than meconium asperation!

[uccellina]

Our twins' 2-week NICU stay cost $102K and $115K respectively. Reading the other posts here, I'm starting to think we got off easy!

[MollyD]

I have learned on thing through all of this is that if the services are performed at an in-netowrk hospital for your insurance, then all services reguardless of whether the DR. is in-network, should be paid at the in network prices, and you are not suppose to be billed for the difference.

I have had a few times where I have had to take DS or DD to the ER and while the hospital is in network the ER docs aren't. I have argued that I had no shoice about the doc performing the procedure, and since I was at an in network hospital it should be covered by the insurance at the same rate.

I believe it is called the Rapps (or wrapps) admendment

Such a pain that everyone is coverd for a procedure, but the anthe. isn't so I have had to go argue with them for that. I think that hospitals and insurances make it as hard as they can, and hopes that you won't fight them on it. Little did they know thatI had all the time in the world to argue this stuff while the kids were in the NICU.

Molly

[CorbinsMama]

Maybe I shouldn't post this and risk jinxing us, but DD was born almost 14 months ago in an emergency c-sec and stayed in the NICU for a month. We have never received a single bill.

She was born in severe distress and nearly dead. No one ever had any idea that anything was wrong with her even though I was very closely monitored because of my thyroid issues. I think they knew they screwed up and they swept it all under the rug.

[mousebandit]

OUr bills aren't so high as many of yours, but they are all out of pocket - no insurance. We're at just under $11k for the first 48hours when my water broke, then at $30k for the 2nd hospital when I finally went in and had c-sec and baby stayed in NICU for 5 days. We're over-income for every assistance program we've tried so far (still waiting to hear back on two of them - you never know). So much for buying our property this year (or next, or the year after that!). As we speak, I am hunting up private insurance for me. Through hubby's work is it is $985 per month, and we simply can't pay that. Just for me (if they'll take me) it will be a little over $200 per month. Other than this blasted water breaking, we NEVER go to the doc, never get sick, have 1-2 injuries per year requiring treatment (football fracture or something like that). We were planning an UC and had been doing UP with no problems. ARGH!

Tracey Mouse