HMO charges associated with birth - Mothering Forums

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#1 of 4 Old 05-20-2011, 04:03 AM - Thread Starter
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I called my HMO (United Healthcare) last night and got the skinny on how the birth is covered. The part that worries me is that while it's a percentage for the provider's fee, and a flat rate for my hospital stay, it's a percentage (they pay 80% and I pay 20%) for the baby's hospital stay as well. I have no idea at all how much to expect that'll be, and it worries me a little because if there are complications with her, then what? I know we'd eventually hit the out-of-pocket max but I'd kind of prefer not to, you know? They do have an estimator on their website but it's telling me it thinks it'll be $50, and that the care is administered in an office, so I am not sure it's correct.


Obviously all plans and providers are a little bit different, but I was wondering if anybody could volunteer me a ballpark figure for the costs of baby's stay in the hospital? I'm just trying to figure out if I want to plan for paying 20% of $100, or 20% of $2000, or somewhere in the middle.


(I'm debating putting the "I do not consent to" language in my birth plan, which I didn't initially have in there, but as if I didn't want certain procedures for baby already, now I want them even less, and if I've stated up front that I don't want them, then it would probably be easier to get out of paying for them if they charge me.)

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#2 of 4 Old 05-20-2011, 06:42 AM
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I didn't have insurance when my 4 year old was born. Our hospital bill was $4000 for a 48 hour stay (for both of us), I wish I could find the itemized bill now though to break things down. There was no provider fee because we were a home birth transfer. I didn't have a epidural or IV but I did have pitocin to help birth the placenta. She had 48 hour monitoring for GBS, Vitamin K, and eye ointment. She also had a hearing test and blood work up.

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#3 of 4 Old 05-20-2011, 06:44 AM
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I had a C-section with my last, my bill was well over $30,000.  LO's bill included a $1700 per day charge for the nursery...that he never stayed in. 

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#4 of 4 Old 05-20-2011, 07:58 PM
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There's the hospital's full price charges and then there's the negotiated rate that United Healthcare will actually allow them to get away with.  That's a huge benefit of having insurance.  Even if you have to pay 20% it will be of a much smaller total than if you paid out of pocket. My son was 2 born years ago, uncomplicated vaginal hospital birth with 48 hour stay after, nothing extra at all, and I want to say his portion of the hospital bill was around $700 at the negotiated rate.

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