Choosing a Hospital- Part 1

This is a biggie. I am blessed to live in the Greater Orlando where there are hospitals galore. My doctor delivers babies at several of them, so really the decision is up to me (us actually). I have delivered babies at three of them and had good experiences with each one. So what is a girl to do? I decided to find out as much as I could about each hospital's labor & delivery and then to compare the costs. So here are my findings:

1. Winnie Palmer Hospital- A state of the art hospital just for women and babies, built in 2006. Level 3 NICU. Ideally suited for high risk pregnancies.

-vaginal delivery $3,200- 24 hr stay
-vaginal delivery $4,500- 48 hr stay

*These prices are for the pre-paid package rate that includes hospital care for Mom & baby. Must be paid in full before discharge from the hospital. Must have had pre-natal care throughout pregnancy and be low risk. Length of stay is based on the birth time of the baby. Not included: obstetrician, pediatrician, anthesiology, labs, and antibiotics charges/fees.

-cesarean delivery $7,600- 3 day length of stay

*Epidural included, but not cost to administer epidural. Anesthesiology charges are $1050 if paid up front and approx $2,000 if paid later. These prices are for the pre-paid package rate that includes hospital care for Mom & baby. Must be paid in full before discharge from the hospital. Length of stay is based on the birth time of the baby. Not included: obstetrician, pediatrician, anthesiology, labs, and antibiotics charges/fees.

2. Florida Hospital- same pre-paid price to deliver at Winter Park or Orlando locations. Florida Hospital Winter Park is considered the new boutique hospital. It has been remodeled, offers free massages, and brings in scones and other yummy non-hospital food to new mommies. NICU is Level 2. Florida Hospital Orlando has a Level 3 NICU and even has NICU rooms for Mom and baby to be together. One great thing about the Florida Hospital system is that they are owned by Seventh Day Adventists, so the staff can pray with you openly and encourage you as a brother/sister in Christ.

-vaginal delivery-48 hr short stay $4,240- covers Mom & baby care for 54hrs. starting at time of admission
*Not included $850 epidural, anesthesiology charges, $850 circumcision, physician charges, outpatient charges

-cesarean delivery- 72 hour short stay- $6,890- covers Mom & baby care for 78hrs. starting at time of admission- epidural included
*Not included anesthesiologists $750 pre-paid (afterwords $1500), $850 circumcision, physician charges, outpatient charges

HSA Maximum Contribution Going Up!

I just found out that the maximum Health Savings Account contribution is going up for 2012! As you avid readers will recall from a previous blog post, the 2011 family maximum was $6150. The new maximum family contribution for 2012 is $6250. Not a huge increase, but an increase none the less. In these tough economic times, $100 is nothing to sneeze at. Hurray, for $100 more tax free money to save for my family's medical expenses!

3rd Sonogram

The time had come. Third and hopefully final sonogram. Would the heart be okay? Would we get to find out the sex of  the baby? The cost... $200 for another detailed sonogram. The heart looked much bigger, and it had only been four weeks since the last one! The tech was able to zoom in and give us a great view of the heart. All four chambers were pumping strongly and nothing looked out of place. I was greatly relieved! There was still a very small slightly less bright area on the heart muscle. However, there was no abnormality that we could see and since it was less noticeable, we were encouraged. Neither the technician or our doctor seemed alarmed and sent us on our merry way, after the scan was complete. We did get to find out the sex of the baby too! I am happy to announce that we are expecting a baby girl in November!

Health Savings Account Heads Up!

Each year the IRS set a maximum contribution limit for Heatlh Savings Accounts, since these are tax free accounts. For a family the maximum allowed contribution in 2010 was $6150. Up until I found out I was pregnant, I had only deposited $20 in our HSA.

I figured I would just add money to it when we needed to go to the doctor. However, upon realizing that I was expecting, I knew we would want to deposit the full contribution amount. So I went to the IRS website to verify the maximum contribution amount for 2011 and found out some very important information. Even though the year 2010 was over, I still had until April 18, 2011 to contribute last year's total contribution of $6150!

So we quickly scrimped and saved. I went to the bank and deposited last years full contribution, making sure the bank credited it correctly for 2010.We still haven't used all that money in the HSA up yet, but I am so thankful to God that it is in there and tax free.

We are currently saving up to add 2011's contribution, which the IRS didn't change the amount on, so it is still $6150. I am sure that my hospital stay and newborn care will eventually use up the full amount. But isn't it great not be taxed on $12,300! I really like that HSA money rolls over every year, is tax free, and can be passed on to my kids. I also really like not throwing away all that money on insurance company premiums!

5th Month Visit- Is the Sugar Test Necessary?

This was the easiest and quickest appointment yet. No bloodwork, no money due. Just the usual- blood pressure, weight, urine sample, and listening to the heartbeat.

All was well! I took this opportunity to ask my doctor about the sugar test, that I was scheduled to have on my next visit. It is the glucose tolerance test. I have had the test five times now, with my other pregnancies, and each time I did not have gestational diabetes. I asked him if it was really necessary for me to take the test again. I am frugal, and so I thought that maybe I could save some money, and just not have the test done.

I asked my doctor for his opinion. He said that the more pregnancies you have, the higher your risk goes up, to get gestational diabetes. He then added that it is important to know for sure if a mother has it or not, because it can cause problems for the baby during and after delivery. So I told him that I would have it done and explained that I was asking because I am cheap. My doctor laughed and said that he is too.

Lab Bill #2

I received the lab bill from my last appointment. My blood was run through about 10 different tests: Rubella, RH, HCG, Viral antibody, Hep B, etc. The total charge was $619.83, but because I get my insurance company's contract rate, $506.86 was deducted. This made my final bill $112.97. Not bad, not bad at all!

Second Sonogram

Had to pay more for this sonogram...$175. It was a very detailed in office sonogram that took around 50 minutes. Lots of measuring of the baby's body parts and inputting of data. We were not able to determine the sex of the baby as he/she wasn't cooperating.

A thickening of the heart muscle was noticed on the sonogram, and indicated by a white spot on the heart. Our doctor came in and explained that this could be a sign of a chromosomal abnormality in the baby. However, since everything else had measured correctly, there were no other known markers for an abnormality. He said in 99% of these cases, that the thickened muscle is just a normal part of this baby's development, and would probably go away in several weeks.

He then that he would send us over to Winnie Palmer Hospital to have a more detailed ultrasound. My husband asked what this would accomplish, if anything was discovered. Our doctor said that if an abnormality was found, that they would recommend an amniocentesis to get more specific results. He then said that no matter what they found, there was nothing the hospital could to fix a chromosomal abnormality. He said that sometimes people decide to abort the baby, which he knew that we we would not do.

We told him that we weren't interested in going to the hospital. He said that another option would be to have a sonogram in his office in four weeks.We could then look at the heart again and see if the thickening had gone away. That would also give us another chance to hopefully find out whether we are having a boy or a girl. We decided that we wanted another sonogram, that we would wait four more weeks, and that it was worth the cost.

4th Month Check-up & No Co-Pays

I love going to the doctor and having no co-pay! My usual appointments go like this: blood pressure taken, urine sample analyzed, and weight recorded. Then the doctor listens to the baby's heartbeat.The nurse asks me about any unusual symptoms that I am having and then I discuss any concerns I have with the doctor. On this appointment, I had my blood drawn for more tests. I was charged $10 for the in house blood draw (versus driving to a lab, waiting in line, etc.) and $5.89 for the urine test.

Right of Refusal

Here is something I have been thinking a lot about. As a pregnant woman, I do not have to have every test created for pregnant women. Since I am paying the bill, I only want to pay for tests that I think are needed.

When I had full coverage insurance I didn't care what the tests were or what they cost. I now ask the nurse or doctor questions.What is the purpose of the test? Is it required by the state? Do you recommend it for me? I have refused the cysystic fibrosis and HIV Test (because I have already been tested with each of the other pregnancies, am not a drug user, and am faithful to my husband).

I also am not interested in having any blood work to detect chromosomal abnormalities or having an amniocentesis. I will not be aborting my baby, therefore these tests are not needed. I am interested in paying for sonograms to check on my baby's developmental progress, to look for anything unusual, and to find out the sex of the baby. So to me, these are worth the cost.

So be a savvy shopper! Do your homework and don't pay for tests you don't want or need.

Lab Bill #1

     My first lab bill arrived today. It was from my first prenatal visit, when I had blood work done to confirm my pregnancy. It is called the HCG test. The charge on the bill was $110. My insurance discount on the bill was $91.25. So I only owed $18.75! Not bad, considering I have no maternity coverage!! I expected to pay around $120. I am a happy camper!

Third Prenatal Visit- Paying for the Doctor

So now it's a week later, and it's time to see the doctor to discuss the sonogram. Before the visit though, I received a call from the billing department. I was told that since I didn't have maternity coverage, that when I came in for the next visit, they would set up a payment plan with me. I was asked what kind of delivery I thought I was going to have. Since this was baby number six, and since I have had two c-sections already, I said c-section. I was given the price...$4000 for a c-section. This includes all pre-natal visits, hospital visits by the doctor, the surgery itself, and my post natal care. I was curious and asked what a normal vaginal delivery cost. The price was $3500.
   
Hubby and I arrived for the third visit and met with the billing specialist. She had been my OB nurse years before and greeted us warmly. She showed us a very simple contract and explained what she had over the phone. The quoted cost did not include lab work, sonograms, or my hospital stay. She also let us know that our doctor was required by law, to have another doctor assist him during the surgery. We would need to budget for that separately and it would probably be around $500 for the assisting doctor. She also let us know that we would need to pay my doctor his full amount by my 20th week of the pregnancy. She then politely asked us how much we would like to pay today, and then in what increments.

My husband said that we could pay $1000 today. She said great and starting figuring out a payment plan for us. Then my husband asked if we could get a discount if we paid the whole amount ($4000) today. The billing specialist said that she wasn't sure, but that she would go check. She actually went and checked with the doctor!She came back and said that we could pay the discounted price of $3600 if we paid it all today. That's a $400 discount!! I quickly pulled out my Health Savings Account debit card and paid the full amount.

So the lesson learned here  is...don't ever be afraid to ask for a discount!

Second Prenatal Visit- First Sonogram

I scheduled my first sonogram. A few days later, I received a call from the doctor's office letting me know that the cost would be $115, and that I needed to pay it in full the day of the sonogram. I had no problem with that and actually expected it to be higher. I had spent at least $200 at an outside lab for a basic sonogram in the past, and this one was done in my doctor's office!

The day arrived. We paid the money and had the sonogram. The baby was moving all around and looked great. We could see both arms at legs and I was only 9wks 4 days! It was amazing! We got some little pictures to show our dear children, and then went out to lunch to celebrate this new life. Another precious gift from God!

My First Prenatal Visit

There was no question about which doctor in Orlando I was going to see. He had delivered three of our other children and had done an excellent job. He explained things well, had a great bedside manner, is well respected at the hospitals in town, and was there for us when I almost lost a baby.

So I scheduled my first office visit. I was told by the receptionist that the cost would be $175 for the visit. This was called the pregnancy confirmation visit. I was weighed, had my blood pressure taken, had a in office pregnancy test, and was examined by the doctor. He was glad to see me and heartily congratulated me on being pregnant again. He asked how my husband was doing and how the kids were. It was good to see him, and to know that we would be spending our money wisely, by hiring a doctor that cared about us. He said he wanted me to come back next week for my first sonogram, for dating and measurement purposes.

We shook hands and then I went to see the nurse. She drew my blood for the routine blood work that is done at the beginning of a pregnancy. I happily paid a blood draw fee $10 to have my blood drawn in the office, versus having to drive across town and wait in line at a lab.

The Murky Waters of Insurance

My husband is self employed, so it was up to us to find the right insurance for our family. We have a large family, two adults and five kids, and have no major health problems. We go to the doctor only when necessary, but wanted to make sure that our family had insurance coverage in the event of an emergency. We discussed our insurance options and decided that it didn't make sense financially to pay for a full coverage policy costing us over $1000 a month for our family of seven. We saw it as throwing money down the drain. Instead, with our frugal and conservative leanings, we looked at Health Savings Account options.

I took the plunge and delved into the murky waters of the insurance world. I searched the internet for days, comparing policies, looking at fine print, and trying to figure out what exactly we needed for our family. I liked the HSA policies that I saw, and especially the price flexibility that accompanied them! My only concern was that none covered maternity expenses. I am thirty-four and still have some child bearing years left. My husband and I see children as a blessing and would gladly welcome more children to our family.

We talked it over and decided that we could manage with an HSA if I got pregnant, that we would probably even save money paying out of pocket, versus paying for full maternity coverage. We are frugal and can ask questions. We can save money for pregnancy expenses, without having to just give all that money to an insurance company each month. So we did it! We signed up for a high deductible policy with an HSA for a mere $391 a month! Not bad for a family of seven.

So here we are a year later and I am pregnant. The journey begins.

Welcome

Welcome! I have decided to write this blog, because there seems to be a lack of information out there about what it is really like to go through a pregnancy without traditional maternity coverage. I have a high deductible insurance plan with an HSA (Health Savings Account) instead.

I have searched the internet and have yet to find anyone writing about what it is like to use an HSA to pay for their pregnancy. What does it cost to have a baby with an HSA (high deductible plan) instead of traditional maternity coverage? We will unearth this together! Consider me your guinea pig. Just kidding. I am not a writer, or an insurance agent. Just a mom, who wants to share her experience, in hope that it will help and encourage others.  Health Savings Account. Unearthing the truth through personal experience.