2015 Federal BCBS vs Aetna for Maternity Benefits?

[Anonymous]

Hi everyone, bumping up this thread since open season is about to end and I'm torn about what to do.

I was on Aetna for infertility benefits and am now pregnant, trying to decide whether to stay on Aetna basic or switch to BCBS basic.

Premiums are about the same, and both plans have no deductible.

For maternity stay, BCBS is a single $175 copay, everything else covered. If baby needed the NICU beyond my stay, it would be $175/day up to $875 max under BCBS. Aetna seems like it's $200/day up to $1k max for my hospital stay (big disadvantage for Aetna), everything else covered. If the baby were in the NICU for longer, they would be billed $200/day up to $1k max (so not much difference between Aetna and BCBS on the NICU issue).

However, Aetna has other big advantages over BCBS:

1. Ability to go out of network
2. $6850 vs. 11k catastrophic limit per family (I belive, if I understand correctly, this could end up being very significant if baby had a prolonged NICU stay and associated costs)
3. Greater dental and vision coverage
4. Breastfeeding Center is in Aetna's network (I needed a lot of breastfeeding support the first time around, and it is expensive!). BF Center is not a BCBS provider, but I don't know what percentage they cover.

Aetna also only provides a pump every 3 years, BCBS provides every year (but it's an Ameda not a Medela).

What do people think?

[Anonymous]

Bumping this thread back up with open season coming. Are there any fed plans that cover maternity 100% or close?

[Anonymous]

Anonymous wrote:Bumping this thread back up with open season coming. Are there any fed plans that cover maternity 100% or close?

You should start a new thread with the correct year in the subject.

[Anonymous]

Anonymous wrote:Bumping this thread back up with open season coming. Are there any fed plans that cover maternity 100% or close?

Aetna used to but doesn't anymore. It's something like you pay 10% which is outrageous as it used to be fully covered. BCBS is $175 flat.

[Anonymous]

In case anyone is wondering about breastfeeding support, last I checked the only Preferred lactaction consultant in the DC/MD area is Metropolitan Breastfeeding (don't know if there's anything more on the VA side).

[Anonymous]

Anonymous wrote:Bumping this thread back up with open season coming. Are there any fed plans that cover maternity 100% or close?

You want FEP BCBS Basic.

[Anonymous]

Anonymous wrote:In case anyone is wondering about breastfeeding support, last I checked the only Preferred lactaction consultant in the DC/MD area is Metropolitan Breastfeeding (don't know if there's anything more on the VA side).

Just realized I didn't specify this is for BCBS Basic, sorry!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Bumping this thread back up with open season coming. Are there any fed plans that cover maternity 100% or close?

Aetna used to but doesn't anymore. It's something like you pay 10% which is outrageous as it used to be fully covered. BCBS is $175 flat.

Agree. Used Aetna with my first in 2016; we switched to BSBC basic last December due to the 10 percent conisurance from Aetna. I paid the hospital $175. Separate bill for my son’s circumcision of $160, but I imagine any insurance would bill that separately from l&d.

ALSO, our decision was based on plans offered in 2019, you will need to check the 2020 plan details (changes may make past experiences irrelevant.)

One bad thing about BCBS basic in 2019 is that the only pump option is Ameda. I bought a spectra with my FSA money.

[Anonymous]

I’m the PP: to clarify I delivered my second this August.

[Anonymous]

Anonymous wrote:

Anonymous wrote:In case anyone is wondering about breastfeeding support, last I checked the only Preferred lactaction consultant in the DC/MD area is Metropolitan Breastfeeding (don't know if there's anything more on the VA side).

Just realized I didn't specify this is for BCBS Basic, sorry!

Yup, mine is 100% covered except the $175 copayment at the hospital admission.