How much to deliver, with BCBS PPO?

[Anonymous]

Will it all be covered?

What happens if I lose my job and am on COBRA? Will I automatically have the same coverage?

And what is VBAC - vaginal birth/anti-cesarian?

[Anonymous]

VBAC = Vaginal Birth After Cesarean (ie, first baby is born by c/s, second baby is born vaginally)

[Anonymous]

Thanks, PP.

I guess my delivery cost question is kind of stupid, huh? I just see all these costs in the thousands range and I wonder- that is for uninsured folks, right?

[Anonymous]

The costs that you pay will differ from others with BCBS PPOs, as each employer negotiates different plans with the insurance companies. My costs, and I have BCBS through the Federal Government, were virtually none--no copays for maternity visits, nothing for the delivery, hospital stay, etc. But you should call the number on your insurance card and ask them about your benefits--or, ask at your OB, on my first maternity visit, I sat down with the billing department and they explained the costs I would be responsible for.

Can't answer the COBRA question.

[Anonymous]

Thanks!

[Anonymous]

If you are on COBRA, the coverage is the same.

[Anonymous]

On the COBRA issue: you will be able to change coverage from the PPO to BCBS HMO or POS when you have your baby, as this is a qualifying event. (You can only change coverage "down" to the HMO plan and not up to the PPO -- but that's irrelevant in your case since you're already on the PPO). You might consider doing this since the HMO or POS plan will be a hundred or so cheaper under COBRA (but still probably around $700/month).

From what I've found, ironically you pay more (at least with my employer) to have a baby with the PPO plan than with the HMO or POS plan. I say ironically because you'd think that with the seemingly better plan (since you're paying more for it), you'd have better coverage, but not so. In my case, the PPO plan covers about 85 to 90% of the delivery and all associated costs, which means that yes, absolutely you can be paying at least a thousand or two for everything (but consider that w/o any insurance you might be paying upwards of 10,000). With the HMO and POS plan, it's much, much cheaper (I think there's no charge for delivery, some charges for other services).

[Anonymous]

Anonymous wrote:Thanks, PP.

I guess my delivery cost question is kind of stupid, huh? I just see all these costs in the thousands range and I wonder- that is for uninsured folks, right?

I have a Blue Cross PPO plan and with the Hospital charges, OB charges, etc, I will pay likely $3,000.00 before all is said and done.
My plan covers 90% of all charges for L&D and Maternity and I have a 10% Out of Pocket cost.

You need to call your plan and see what your hospital deductible (if you have one) is and if you have any co-insurance. Just call the number on the back of your insurance card.
If you have Federal BC/BS then you'll be fine. You'll hardly pay anything (and I'm SOOOOO jealous!)

[Anonymous]

Depends on your individual coverage, if you're a 90/70, what your out of pocket max is, etc.

I have a BCBS PPO, 90/70. I had a homebirth. Out of pocket was something like $1k as I was covered at the out of network rate after my $250 deductible.

[Anonymous]

If you're self-employed in DC and have BCBS PPO, you have a $5k max in maternity benefits. Thus my c-sections cost nearly $10k each out of pocket.

[Anonymous]

My pregnancy and delivery were covered 100% (not even a copay/deductible, nothing at all) with my BCBS PPO plan. As you can see from some of the responses here, everybody's plan is different (even though it's the same name) as each employer negotiates its own package. You need to call the BCBS customer service and find out what yours is. If you want to be on the safe side, plan to spend your annual out of pocket maximum.

[Anonymous]

My BCBS PPO plan also covered 100% for both kids. 20 co-pay for first pre natal visit only. Call the 800 number and ask about your benefits.