Federal Employees Health Insurance - which has the best maternity coverage?
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Anonymous
| Hi, I currently have Aetna Open Access (due to IVF coverage which I won't need anymore) and wondered if there is a better plan for maternity coverage? The part that concerns me is the copay of 10% on hospitalizations vs. other plans like Blue Cross which is a set amount. |
Anonymous
| I did very well on BC/BS standard a few years back, then switched to a plan with 10% copay and had a lot of out pocket last year. Just a thought. |
Anonymous
| I have BCBS Basic and I pay ZERO for my prenatal care and a $150 flat fee for the hospital. I think it's pretty great. |
Anonymous
| I have the Aetna HMO open access high like you have, and they said the most I will pay for the hospital staff for a c-section is $450. They cover some lactation consultants (must be on their list) and also the breast pump rentals from hospital in 2013. |
Anonymous
| I also am interested in this topic, thanks OP. I am with Kaiser and happy to be paying zero for maternity care. But, there are things they won't do (like the blood draw for MaterniT21, even if I offer to pay out of pocket) so that is frustrating. Considering changing during the current open season. |
Anonymous
| I have the BCBS standard plan and paid 0 for everything (that included a planned c/s). I had switched from a plan (not federal) that had a 15% copay and my c/s was going to be close to $3K based on their online calculator. |
Anonymous
| I have BCBS basic and have been very happy with it so far (26 weeks). I don't have co-pays for pre-natal care. Just have to shell out $30 for the vitamins every 90 days. It's covered all additional tests the doctor wanted, and will cover the cost of an Ameda breast pump in 2013. |
Anonymous
| Also have BCBS Basic and am at 24 weeks. I have really been happy with it thus far. I was previously on GEHA (before I was pregnant), and I felt that I was always getting billed for things (I have a 2 year old so it was mostly for his visits). It really seemed like it was adding up. So far BCBS has covered everything including extra ultrasounds due to placenta previa and Materniti21 (I believe, as I haven't yet received confirmation that it was completely paid). The only thing I have paid for was $25 for the blood draw for MaterniT21, $15 for my FMLA forms to be filled out at Georgetown, and the initial co-pay at my first appointment. So far, so good. |
Anonymous
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Two pregnancies with BCBS Basic. Maternity care was 100% covered, except for the $150 hospital co-pay for my two c-sections. I don't know about the MaterniT21 test as I was never offered this test.
Good luck! |
Anonymous
| Have GEHA. Low premiums. Didn't pay a dime for maternity care for my first and haven't for the second either. The prescription drug plan is not great, but I think we've still saved money because of the low premiums. Look at well-baby care too, as you will be going to the pediatrician a lot. I think the well-baby visits for GEHA are free. Otherwise, sick visits are 10 (haven't looked at 2013 rates yet though). |
Anonymous
| I delivered in March with BCBS Standard and I think everything was covered except my $20 fee for a private room at FFX (this included about 20 sonograms etc due to high risk issues) |
Anonymous
| Sounds like BSBS standard is very good. It was one of the highest ranked according to consumer checkbook. Has anyone had any issues with prescription coverage? I also have Aetna and dealing with the mail order pharmacy is a nightmare. |
Anonymous
BCBS Standard is very good, but it is also more expensive than most other federal plans. I have had it five years. Overall, I am satisfied, but not because of prescription coverage. I only use in-person pharmacy. Their mail order is a hassle (and the pricing system is completely different, see the brochure). For in person, prescription coverage depends very much on the type of medicines you get because you pay a percentage. I've paid everything for 78 cents to $350 in co-insurance. Obviously, I would have been better off paying a set co-pay at the high end, and drugs can get very expensive if you use expensive name brands. Also, they have gotten a lot more aggressive of late on charging you a higher percent co-insurance for "non-preferred" brands and expanded the list of "non-preferred" brands, including my prenatal vitamins. This did not used to be an issue with BCBS Standard. I'm a little peeved with them. I feel like they are strong-arming me into the brands of their choice, rather than my preference. |
Anonymous
Unless you have known issues that require an out-of-network doctor, you are better off with the Basic than the Standard... no deductible, cheaper premiums, and a huge network of doctors. I used to have the Standard but switched to the Basic when I realized that a laparscopy I needed to have would cost 3x as much under the Standard plan (on top of the higher premiums). Beyond the excellent prenatal and delivery coverage, all pediatrician visits are free until age 22. |
Anonymous
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We have BCBS Standard and love it. Used it for both pregnancies with no out of pocket costs. Mail order perscriptions were not the hassle people have said...really quite easy and much cheaper. The premiums are higher but I appreciate knowing that I'm fully covered for just about anything. We've had our fair share of unexpected health challenges post babies and it was nice not to have to wonder if our insurance would cover it.
Something would seriously have to change for us to leave them. |