HOLY MOLY that was expensive!!! - Mothering Forums

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#1 of 51 Old 05-12-2008, 02:38 PM - Thread Starter
 
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DS was born a year ago, and yesterday I got a letter in the mail from our insurance company summarizing the cost of care. I guess they received bills from various providers up until last month!

It turns out that our relatively short NICU stay (21 days) cost $175,486.71. That's over $300 an hour! My six day stay cost over $65,000. wow. How do people with less (or no)insurance actually afford this? I can't beleive it. We only spent $500 for the co-pay, and that was it. I can't even begin to fathom having to worry about costs when your babe is in the NICU. Terrible.

I have a question about this- becuase DS was a preemie, is there any chance that he could be denied health coverage later on? And becuase I had pre-eclampsia, could I be denied coverage of my next pregnancy?

Oh, and the breast pump company just sent us a bill for the entire cost of the hospital grade pump. They say we failed to return it! This is going to be interesting. I've been fighting with them for the past year about this.

Just wanted to share.....

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#2 of 51 Old 05-12-2008, 04:12 PM
 
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Wow! I think ours came down to something like this:

My hospital stay (10 weeks including c-section): $75,000

Ds's hospital stay (42 days including a surgery, nitric oxide, and an oscilating vent): $292,000

We paid $380 out of pocket for the entire thing.

I would be interested to see who had the biggest hospital bill!

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#3 of 51 Old 05-12-2008, 05:37 PM - Thread Starter
 
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Interesting.... your bill comes to just around $300 an hour, just like mine. I think yours is 289 or something. I wonder if that's the average?

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#4 of 51 Old 05-12-2008, 05:55 PM
 
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We call our preemie the $100,000 dollar baby. I guess our insurance company got off cheap based on you folks. We had a 2 month stay, but she did relatively well (no vent, no surgery, no dire medical conditions to treat). This last baby who was born at home by comparison will cost $2400 (the midwife's full fee IF she charges me that since we are friends and I assist her in a pinch at births or doing post partum visits on mamas if she gets swamped).
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#5 of 51 Old 05-12-2008, 07:30 PM
 
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My niece was in the hospital for 17 months. She was born at 28wks and stayed the first 6 months in the NICU. After that she was transferred to the PICU. My SIL jokes that they upgraded her after the first million.

I have no clue what the financial aspect of this is, but since niece needs continued care outside of the hospital they've applied for SSI or something similar to help with cost adn then on top of their regular insurance (which is already expensive!) they get medicaid for the medically fragile.

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#6 of 51 Old 05-12-2008, 07:49 PM
 
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So weird about the $300 an hour! Our stay was 225 days long and was 1.6 million dollars and I just plugged it in and it was a little over $300 an hour.

Now, if we could break it down to who is worth what.

Nurse = $20 - $24 an hour.
Respiratory Therapist = $16 to $18 an hour
Doctor = $150 an hour????
Electricity $11 an hour lol (I figure they use a lot of it)
Pharmacist $100 an hour

Any other ideas?
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#7 of 51 Old 05-12-2008, 08:51 PM
 
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The NICU stay at the hospital was 309K. That included the transfer, vent, nurse care, breastmilk storage and adding formula to it, rx, o2, blah blah blah!

That didnt include the Drs bills which was about 150K.

MY c section and hospital stay was about 35K. The anithos was about 5K, the OB billed about 15K which would have been about 3.5K for a normal delivery. Maggie was at that hospital for about an hour and that was 35K for those services. Then for Feed and Grow, she came back to this hospital and stayed for about 3 weeks. They charged 95K.

So we paid our 5K deductable out of our medical savings acct which is part of our insurance and the $141.54 wasnt covered for her hearing test.

We always say shes our almost millon dollar baby!

I have the bill from our nicu in the scrapbook.

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#8 of 51 Old 05-12-2008, 09:54 PM
 
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My DD's 2-month stay was $400,000. My own stay (1month in-hospital bedrest, c-sec) was $80,000. My family always says we hit the jackpot. (The year after DD was born, our insurance carrier also declared bankruptcy . . . coincidence? Hmmm . . . )

I thank God every day that we had great insurance then. If that happened again now with our lousy insurance, our lives would be ruined, at least financially.
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#9 of 51 Old 05-12-2008, 10:33 PM
 
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The cost varies greatly depending on the hospital I've found. We have two big hospitals in town and the one my kids were at is far less expensive than the other. My son had a 63 day stay that was completely uneventful, 24hrs on the ventilator 5 days on CPAP and then a cannula for 8wks. His bill was 195,000. My daughter had a 225 day stay complete with ventilation the entire time, several weeks on the oscillator, 4 surgeries and over 10 infections. The cost of her stay is still being debated but we hit 1M at 4mos. It looks as if the final pay out is going to be about 1.9M. But those numbers only include hospital stay, nursing, medications. Radiology, doctors/surgeons, anesthesia, EMS, etc all bill separately.
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#10 of 51 Old 05-13-2008, 12:35 AM
 
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I can't find the exact numbers right now, but I believe Lilly's 63-day stay cost about $440,000 and Kate's 65-day stay about $460,000. I think my own 19 (I think) days (20 if you count one night at another hospital) were about $35,000, though I may be confused. I know the total came to just shy of a million, and I figure with the Synagis and Kate's O2 requirements, we definitely hit the million mark that first year. Luckily halfway through the year we ended up switching insurance because we transferred off mine and onto my husband's, so we didn't run into lifetime benefit issues.

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#11 of 51 Old 05-13-2008, 10:24 AM
 
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We got off pretty cheap for our two. And we were in the NICU for 78 days/
DS was $163,350 ($90/hr) for the hospital portion of it, not too bad, but then he was only on the vent for 24 hours and had no major issues at all. Also for 3/4 of that time in there he shared the same bed with his sister, yet we were charged for 2 beds... This doesn't include an additional $60,0000 or so for the neo bills.

DD was on $156,000 ($83.33/hr), for the hospital portion only. This doesn't include the $65,000 for the neo's bills
and my 4 day stay with a c-section the hospital portion of the bill was only about $9000.

Our insurance was great. I only paid the $35 co-pay for a hospital stay for me and DS. Since DD was so small she was considered disabled at birth and medicaid covered her.

I would think that if the insurance companies get picky enough that they might not cover certin conditions because of prematurity.. who knows with them.

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#12 of 51 Old 05-13-2008, 01:51 PM
 
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DS's 37-day NICU stay cost $120,000 (so $135/hr, but I don't think that bill included doctor fees). We ended up paying the $5,000 out of pocket maximum. I know that his isolette alone cost $1,100 PER DAY. And his stay was uneventful, just on a vent for a couple days, cpap for a couple days, then cannula. No surgeries, no surprises, no complications.

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#13 of 51 Old 05-13-2008, 02:13 PM
 
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Our boys' NICU stays of 82 and 90 days totalled well over a million dollars. Frightening.
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#14 of 51 Old 05-13-2008, 10:20 PM
 
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For 8 days in the NICU we paid very close to 5k out of pocket for peanut's medical bills. The total bill was between 25 and 30K. However, we got many bills for things separately.

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#15 of 51 Old 05-13-2008, 10:43 PM
 
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My DS was literally one of the million dollar babies. We got him on to my BCBS right after birth: we didn't know better. In NC my 25w preemie qualfied for long term medicaid thru his SSI. We recieve $30 checks every month b/c they consider him disabled. ( Hah!, he's just small and catching up- to us, but every lttle bit counts! )

We have since learned that BCBS will cut him off at a certain million $ mark.

We are moving out of NC to VA and are now told we have to reapply for medicaid which seems totally bogus to me.

Seeing as he is doing better, and it is not so constant w/ the doctors/ surgeries etc. in the past year I feel a bit better about this. I don't think we would "qualifiy" for medicaid now. And I REALLY don't know how we would have stayed afloat w/o the medicaid as a secondary insurance in the past.

We'll see what happens. Hopefully NC and VA just have their signals crossed!!

As a foot note: neither BCBS or Medicaid would pay for my 5+ m of pump rental, even w/ notes from the doctors explaining that my DS was critically ill and could not breastfeed and would most likely die on formulas w/ his intestinal condition!! Makes me sick to my stomach! If I had had more time or energy I would have gone on a war-path.
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#16 of 51 Old 05-14-2008, 12:21 AM
 
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My uncomplicated c-section and 3 day stay: $21K
DS's 40 days in Special Care (3 days vent, 6 hours CPAP, 4 days cannulae, no complications, iron and caffeine for meds): $100K (20K for his neos)

our out-of-pocket: about $1,600 including 6-months hospital pump rental and a Medela PIS Advanced purchase that BCBS wouldn't pay for.
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#17 of 51 Old 05-14-2008, 01:03 AM - Thread Starter
 
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Wow mammas! I'm glad I'm not the only one who had sticker shock, and it's great that it looks like none of us actually had to cut a million dollar check to foot the bill! It's really interesting to see the different costs; there's probably so many different things that influence how much the bill was, from geographic areas down to the kinds of diapers and syringes they use!

Does anyone know what I should do about this stupid breast pump issue? Basically, a medical supply company rented me a lactina breast pump (requested by the doctor and covered by insurance) for 21 days. The day after DS came home, someone called at 8 in the evening, saying that they were from the supply company and that they would be by at 8am the next morning to pick up the pump. It made me sick to part with my pump, but they insisted that the rental period was over. The next morning, some guy came to the house and took the pump. In our new baby daze, we didn't ask for any paperwork. The bills started coming in a few months later. The supply company said that they never sent anyone to pick it up, and they even checked the courier records. So apparently, someone from the hospital found my address and impersonated a courier to get the pump. It sounds so crazy, but that is the only conclusion we can think of thus far. The supply company admitted that this has happened before (someone outside of the company making off with a pump), but they have sent us a bill for the cost of the pump. I was thinking of filing a police report, but there is no way of knowing that it was actually stolen, and it was not my property. What else can I do?

Thanks!

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#18 of 51 Old 05-14-2008, 01:59 AM
 
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Id say thats kind of on the cheaper side... My 27 weeker racked up 80,000 in just 2 days in one hospital!! I said WTF were they doing to him?? He maxed out medicaid a few times all within 2 years.. He is also one of the million dollar babies... two or three times. He had a LOT of long stays. His entire first year except for maybe 4 weeks and like 80% of his second year was in the hospital :/ His first year he had 13 surgeries, vent, feeding tube... lots of tests.. his second year vent, more surgeries, more tests.. He has the SSI medicaid.. which pays for more than the regular medicaid but even with that medicaid still wanted to kick him out of the hospital a few times.

I just got a bill the other day from my last stay.. It was almost 2 weeks... The bill was only 35,000.. They even sent an itemized list of every single thing that was charged to me.. Every toothbrush, every pad, every test.. I found it kind of interesting. BTW That included c-section, transfusion, everything..
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#19 of 51 Old 05-14-2008, 02:03 AM
 
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Oh yeah and an interesting thing about medicaid.. My sons current home vent.. To buy it off of the shelf it would cost around 8,000... Instead medicaid pays 9,000 a month and has been for almost 2 years... Imagine how many vents they could have bought and owned instead of rented? Instead of just paying the 8,000 and doing the hundred or so dollars worth of repairs and tests on it every year they pay way more... Funny how insurance works. Its almost like with the synagis..
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#20 of 51 Old 05-14-2008, 06:40 PM
 
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I have no idea what my Little Bit cost total. Everybody around here bills seperately. The hospital did wind up refunding most of my stay and waived our portion of hers because they dropped the ball when she was born and didn't tell us that she qualified for SSI/medicare. I found out the day before she was released and it wasn't retroactive. I didn't even ask that they do this, and I keep waiting to get another bill.

As far as pre-existing conditions, and keeping insurance coverage, we have changed companies since she was born, and I am pregnant again and we didn't have any trouble. I did wind up on someone's list to be monitored closely and a nurse from the insurance company called once a month for a while to ask questions, but I'm a less than a week from my due date now, and I haven't heard from the nurse at the insurance company in a while. The questions weren't really rude, they were more along the lines of has your doctor checked this or that. I took it to mean that they wanted to be sure I was being monitored as closely as possible.
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#21 of 51 Old 05-14-2008, 10:02 PM
 
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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.

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#22 of 51 Old 05-14-2008, 11:26 PM
 
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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.

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#23 of 51 Old 05-15-2008, 01:32 AM - Thread Starter
 
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[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!!!

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#24 of 51 Old 05-15-2008, 01:44 AM
 
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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.
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#25 of 51 Old 05-15-2008, 02:44 AM
 
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Quote:
Originally Posted by justmama View Post
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...
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#26 of 51 Old 05-15-2008, 12:21 PM
 
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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!

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#27 of 51 Old 05-15-2008, 12:24 PM
 
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Originally Posted by dbsam View Post
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.

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#28 of 51 Old 05-15-2008, 12:50 PM
 
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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.)
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#29 of 51 Old 05-17-2008, 12:47 AM
 
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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.
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#30 of 51 Old 05-18-2008, 11:13 PM
 
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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)...

Michelle, mama to Isabelle (03/04) and Tom (02/07)
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