Author Topic: Health Insurance for New Baby  (Read 1036 times)

KJStrube

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Health Insurance for New Baby
« on: August 27, 2017, 10:30:30 PM »
Iím in a unique situation.  My wife and I are expecting our first baby (a girl) at the end of September and weíre trying to figure out health insurance, primarily for the baby, but ultimately for all of us.  We live in Central California.

Iím now self-employed (as of last December), currently on COBRA from my old employer.  Iím paying about $460/mo for medical (PPO $750 deductible)/dental/vision, which I understand to be a decent deal (cheaper than joining my wife's plan).  Iím eligible to stay on there through June 2018.
 
My wife is on an HMO through her work, but will be a stay-at-home mom when the baby comes.  Sheís on protected leave through approx. the end of January 2018.  She pays nothing toward the premiums for her own coverage as an active employee, but adding a spouse/dependent is about $600-700/mo, so thatís about what we expect the per-person COBRA to be.  The insurance has been fantastic for pregnancy: we had one $20 copay to the OB office, weíll have a $500 hospital copay, and thatíll be it!  Thereís a low chance weíll have to repay the employer portion of my wifeís premiums since she isnít returning to work.  Sheís leaving on great terms and the company has not historically asked any other employees to pay that back, but they always retain the legal right to.
 
Iím getting conflicting info about whether I can add the baby to MY COBRA insurance.  On one hand, Iím not an active EE, and therefore unable to add/change covered family members.  On the other hand, the birth will be a qualifying event.  I've reached out to my old company's broker about this.
 
Iím trying to do the cost-benefit analysis of a HDHP and putting us all on it to save on premiums (and have the opportunity for an HSA).  I did some searching online and am seeing premiums for the three of us on a HDHP in the range of $700-800/mo (Iím 33, my wife is 32).  We're non-smokers.
 
Weíre in decent health, but we do go to the doctor.  I just met my deductible for the year due to various one-off things.  My wife has allergies, asthma, sleep apnea, and arthritis in her knee.

My main question right now is whether the HDHP is right for a baby.  With all the newborn stuff, assuming no complications, is that just a stupid move?

Thanks in advance for any insights you can provide

yachi

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Re: Health Insurance for New Baby
« Reply #1 on: August 28, 2017, 07:01:39 AM »
Keep in mind the birth will have charges for mom and charges for baby, so you'll want to know by then what insurance you're using.

I'm a red panda

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Re: Health Insurance for New Baby
« Reply #2 on: August 28, 2017, 07:50:02 AM »
I just had a baby in March.
So far, her charges have been $10,780.  The only two that I'd say were non-routine were a $220 charge for a tongue tie to get clipped (a dentist, but charged as medical) and $440 for a speech language pathologist to access her suck.

Before we left the hospital, the baby's charges were $7,280.60.  She had no NICU time.
Does that help with knowing if a HDHP would be good for the baby?



(My hospital charges were $34,931. I had an emergency c-section under general anesthesia.)


Note- these are the charges, not what I paid.
I have a PPO.  I've nearly met my out of pocket max of $3,000 for myself. (This year- I had some appt charges last year too, of course. But almost $2,000 of that was for the birth, as I have a $500 copay, plus coinsurance. Most of my appts were fully covered, I've had some other medical care too. Most importantly - my insurance fully covered genetic testing.)
I've only paid $467.27 + $220 (dentist was out of network) for baby.

historienne

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Re: Health Insurance for New Baby
« Reply #3 on: August 28, 2017, 07:58:51 AM »
I was able to add a newborn baby to my COBRA insurance; I believe, but am not 100% sure, that it's a legal obligation on the part of the plan.

For the HDHP, you will want to find out how your insurance/hospital bills newborn care.  My hospital billed all the standard charges to my insurance - including the baby's hospital fees - and my insurance paid that happily.  However, the baby's NICU stay was billed to his own insurance.  I don't remember exactly what the charge was, but it was many thousands of dollars for a five-day stay without significant complications (he was in the NICU for low birth weight, having been born 5 weeks early, but had no other issues).

mm1970

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Re: Health Insurance for New Baby
« Reply #4 on: August 28, 2017, 11:05:03 AM »
Keep in mind the birth will have charges for mom and charges for baby, so you'll want to know by then what insurance you're using.

With both my kids, they were immediately added to my insurance upon birth (I'm the one who gave birth).

And by the way, it will depend on your insurance, but I had to pay 2 deductibles - one for me, one for the baby.