I’ve shared our experience with making maternity insurance decisions and everything we’ve learned since Milly was born.  When Milly was born, that started a 60-day timer following the “qualifying event” of her birth for us to figure out how we wanted to structure our insurance.

What kind of insurance did we want to pay for for Milly?  What kind of expenses were charged to her during the hospital stay?  Out of the over $10,000 in charges billed, how much were charged to Nancy, and how much were charged to Milly?  Going forward, what kind of coverage did she need?  That information would be extremely valuable in our decision-making process for her insurance coverage.

It’s important to understand that when you choose your own insurance (because you’re self employed or maybe have different plans because you and your spouse have different plans through your employer) that the plan you choose for your little one will determine how the insurance claims for their neonatal care are processed.

Here’s why that’s important.  We were very lucky with Milly.  She spent 2 nights at the hospital, just received basic care, and was completely healthy.  Therefore, she incurred a very small amount of charges (relatively) for all the care she and Nancy received at the hospital.  Because of that, we put her on my high-deductible, lower-premium plan.  This requires us to pay for more of her expenses out of our pocket, but they’re relatively low because she was healthy.

But let’s say that if we had a special case that required additional significant medical attention, and the bills were significantly more.  We would have put her on a higher-premium, low-deductible plan that had greater coverage.   That would have required us to pay a higher monthly amount for the rest of the year, but it would have cost much less for the neo-natal care than if we had been on a high-deductible plan.

So how’d we figure all this out?

I called the insurance provider to make sure I had a good understanding of our plans.  Then, I called the billing department for both the hospital and our physician, and ordered a full set of charges/claims on both Milly and Nancy to be sent to our home.  It arrived in the mail a few days later.

When I reviewed it, I saw all the charges for both Milly and Nancy, and I was able to see what was charged to Nancy (and what it cost), and what was charged to Milly (and what it cost).  I hadn’t seen any of that information yet because I hadn’t even received a bill at this point, about one month after Milly’s arrival!  When I saw that the majority of charges were billed to Nancy, we made the decision for Milly to go on my lower-cost plan.

It’s also important to note that all of your well-baby visits to the doctor (and immunizations if you do them) are covered under any new plan you would enroll in that conforms to the Affordable Care Act.  That was helpful for our decision-making as well.

Question: What challenges have you run into handling insurance for your kids?