Conference moira::parenting_v3

    Carol,
    
    I was delivered of (C-Section) a baby girl back in May.  Although
    everything worked out just fine, she was 3 weeks late which
    resulted in anumber of additional charges as well.  Breakdown
    
    2100 for obstetrician  (would have been 1900 without c section)
    300 for additional non-stress tests, ultrasounds etc due to 
        her being 3 weeks late
    1500 for amneocentesis
    1300 hopitilization for baby (5 days)
    2500 hospitilization for me
    580 for 2nd obstetrician
    400 for pediatrician attending birth
    300 for anesthesiologist
    250 extra for private room because after 59 hours of labor - 9
        forced with Pitocin and no progress (I never dilated) and 
        a C-section, I felt I deserved it.
    
    9230 total 
    
    These may not be exactly right, but pretty darn close.  I had the 100%
    coverage which costs more, but all of the hopital charges were covered
    in full so I think I did OK.  
    Julie

    I have not sat down and figured out the numbers, but when we found out
    that Richard was going to be born at least 10 weeks premature, it sure
    was nice to know that we had 100% hospitalization coverage for the 
    family.  
    
    We figured that the total hospitalization (abut 3 months) was about
    $150K... and he did not have any complications!
    
    If you are going to have a planned event, I always say you should go
    with the maximum benefit..  It is little money wasted if everything is
    OK, but it is MAJOR money saved if things go wrong...
    
    cheers,
    jeff
    

    
    
    	Boy, after seeing those numbers in .1 and .2, for peace of mind
    alone, I would think that anyone contemplating pregnancy would chose
    the maximum coverage.
    
    	I, personally have not gone a full year since I was 17 without
    being in the hospital at least once. Lots of that was surgery, lots of
    that was complications. Had I not had full coverage, I would literally
    be penniless right now. As it is, I have spent *tons* of money
    throughout my life for my health care. (80% coverage outside of the
    hospital)
    
    	My husband has only been in the hospital once and does not get sick
    often. It makes no matter to me, I know how expensive hospital visits
    are, just one car accident and at partial coverage, we would lose the
    house.
    
    	The choice has never been an issue for me. Baby concerns aside, I
    want to keep the house I live in. I would never consider anything less
    than 100% for our family.
    
    			Wendy

    re: .3
    
    There is an out-of-pocket maximum for the Digital Medical Plan so
    I don't think you'd lose your house....
    

    If you are planning to have a baby I'd say get the 100% JH, family
    plan.  You must be on a family plan to have any child covered from
    birth.  If you are both DEC employees, for instance, you're husband can
    pick up the family coverage @ $34/week, and you can choose to Opt-Out
    and receive $20 per week in your paycheck.  You are covered, your
    husband is covered, and any child would be covered also.
    
    As for costs, that's a tough one to estimate.  I'd say most of my
    deliveries ran around 5 to 6K.  But one ran much more, when my son was
    born with pneumonia, ended up with a collapsed lung and in neonatal
    intensive care down in Boston.  That ran 25 to 30K.  You cannot predict
    things like that. And 20% od 30K is 6K.  Can you afford that?
    
    

I belong to an HMO, which covers everything 100%.

I seem to remember, when I delivered Matt 2� years ago, my hospital bill was
around $2500, which was covered in full by the HMO, but that did not include 
any doctor's charges.  (Since the doctors are affiliated with the HMO, there 
was no charges listed for them.)  I had a normal delivery, no drugs, and a 2
day stay in the hospital.

In HealthNet areas, DMP 1 will be $21.75 a week and DMP 2 will be $34 a week
for family coverage.  That's an annual difference of $637 in payroll deductions.
Ignoring (for the moment) the out-of-pocket maximum, that means that DMP 2
is a better choice than DMP 1 only if your hospital and surgical expenses
are more than $3185.

Here's the worst case scenario under DMP 1.  Both mother and twins (!) have
major complications.  Father has no medical expenses at all.  All expenses
are hospital/surgical (i.e. expenses that are covered 80% under both plans
don't contribute to the out-of-pocket maximum of $1500/$4500).  The
out-of-pocket difference between DMP 1 and DMP 2 is $3863 (the entire
family out-of-pocket maximum of $4500 less the savings of $637 in payroll
deductions).

In more realistic cases, some expenses will be 80% covered under both plans,
and will thus contribute to the out-of-pocket maximum.  If you hit the
out-of-pocket maximum, it will probably be for one or two individuals,
so you won't hit the $4500 max, but the $1500 individual max.

    My cost were almost identical to noter .1 for Kelly who was born in
    February.  She was a C-Section and two weeks late.  The only thing we
    had to pay for was 20% of the Ultrasounds.  Otherwise John Hancock
    picked up the whole thing, and we have the 100% plan.  Kelly had a
    slight heart murmur that cost an additional couple of hundred dollars.
    I cannot IMAGINE not having 100% last year!!
    
    Good luck!
    

    Carol,
    
    I chose the JH 100% coverage plan when we were planning
    our addition to our family...
    
    Steven was born at Newton-Wellesley Hospital last year.
    John Hancock covered all hospital charges...( I think the 
    bill was somewhere between $2400-$2900 for a normal, no
    complications delivery)
    
    By the way, the new maternity wing there is WONDERFUL!
    
	Good luck! 
    
    	Linda

    
    	I have to throw my two cents in....
    
    	Matthew was born in June via C section at Worcester Memorial.
    	I have the 100% plan covered by John Hancock.  I believe they
    	covered everything 100%, except for the ultrasound, and Matthew's
    	circumcision.  Our total out-of-the-pocket cost was about $300.
    	Of the $2400. Dr. visit bill, I believe they paid all but $130.
    
    	I liked the flexibility of being able to choose the Dr. and
    	hospital I wanted. Wouldn't change my insurance for the world.
    
    	Ellen
    
    	BTW, Newton-Wellesley has great birthing rooms!  It was great
    	being able to hold my nephew, noter .9 when Linda delivered
    	Steven! 

    I'll add my $.02 here.
    
    One thing I was absolutely surprized at was the cost difference
    between a private and semi-private room.  JH will only cover the
    cost of semi-private.  BUT, JH agreed that I could get a private
    room if I paid the cost difference.  I called the hospital I was 
    going to deliver at (Lowell General) and the price difference was 
    only $5 per day!  The extra $15 I paid for the 3 days I stayed was
    well worth it.  
    
    					Maryann
    

    Carol, 
    	I would like to share my experience with you.  I realize that it 
    is a rare experience, and I don't want to scare or worry you, but I 
    planned on having a nice normal pregnancy and birth, but since my 
    experience, I believe in preparing for the worst.
    	From day one of finding out I was pregnant I had one complication 
    after another, which required ALOT of doctor and hospital visits.  Then 
    my son Shayne was born and all H*ll broke loose.  He was born with 
    Down Syndrome which we have him in therapy weekly, a heart problem, he
    was in the intensive care nursery for a week, was on oxygen for 2
    months after we brought him home, at 5 months old he was diagnosed with 
    diabetes, at 10 months old had to have tubes put in his ears and he 
    requires monthly doctor visits because of these numerous health
    problems.  
    	I am on John Hancock plan 2 and wouldn't change it for the world.
    I realize the expense each week of paying for the coverage seems to be
    a lot, but when I see that in just one year we have had approximately 
    $100,000.00 in medical expenses, the weekly cost is nothing.  There is 
    a maximum out of pocket expense which we have reached with Shayne so 
    now they are paying 100% of everything, which includes all the supplies
    needed for his diabetes.  
    	My hospital stay and Shayne's was covered 100%.  The cost of his
    being in ICN for 1 week, not including all the tests, etc was $10,000.
    HMO's usually have a limit on the therapy, however JH has been great
    and covers 80%, now that we've met our out of pocket, they are covering
    100%, considering his therapy is $150.00 an hour, I think we have saved
    a lot of money going with Plan 2. 
    	Hope this has been some help	 

re .12:

>    	I am on John Hancock plan 2 and wouldn't change it for the world.
>   I realize the expense each week of paying for the coverage seems to be
>   a lot, but when I see that in just one year we have had approximately 
>   $100,000.00 in medical expenses, the weekly cost is nothing.  There is 
>   a maximum out of pocket expense which we have reached with Shayne so 
>   now they are paying 100% of everything, which includes all the supplies
>   needed for his diabetes.  

    If you've reached the out-of-pocket maximum, you would have been better
    off on Plan 1.  You just would have reached the out-of-pocket maximum
    sooner, and you would have paid less on payday.

	To clarify that last reply...

	By reaching the out of pocket maximum "sooner"  Gerald really does mean
*sooner*  i.e. since you pay more per visit with  Plan 1 the TIME it takes to 
reach the max is shorter.

	The DOLLAR amounts of the OOP Max's are exactly the same.  

Tracey

    Carol,
    
    I went through the same scenario exactly a year ago!  I opted for 100%
    based on the fact that I knew for sure I would be in the hospital. 
    Prior to that I only had JH1.  I had a pretty normal pregnancy with
    just a couple ultrasounds and non-stress tests right at the end.  I
    think my total out of pocket expesses were around $400-450.  These
    expenses came from meeting the deductable, charges being more that
    reasonable and customary, and tests only covered 80%.  I'm not
    positive, but I think the pedi charges were covered 100% too for the
    check ups your baby will get at the hospital.
    
    When our little girl was born, we had the option of putting her under
    JH1 or JH2 because I had JH2 and my husband had JH1.  We chose JH2 for
    her too.  Of course, this current year of medical coverage does not
    give you the option of "opting" out.  Now for next year, we just have
    to decide who's going to pay and who gets the $'s back.
    
    All in all, the result is well worth the price!
    
    Good luck on your addition-to-be!
    
    Jane

    The costs of having a baby are incredible.  When that is done, you then
    have to contend with the regular visits (2 week,4week,8 week, 16week, 6
    month, 12 or 15 month, etc.) and anything unforseen (like dislocated
    elbows, ear infections, etc.)  Of course, then there is the neat things
    that go along with certain sexes, like circumcision, or hernias (two
    of my three boys had the hernias, and I've been told this is not
    uncommon!)  In the first year alone, you are looking at about $6000 for
    everything textbook normal, and then the costs explode.
    
    If anything is wrong, you could easily be looking at a newborn ICU. 
    That's about $1000/DAY for the bed, and hundreds/day for doctors and
    supplies.  My third boy had problems breathing (about 50% of c-sections
    will have this due to fluid in the lungs) and was otherwise normal. 
    When we were done at Children's hospitol the birth was $45K - only 5
    days in Children's!  2 months later we were in for the hernia repair,
    another $5K, and at 4 months we were back at Children's to have a penny
    removed from his throat, another $10K.
    
    Bottom line here is to get good coverage.  We have 80% coverage on both
    mine and my husbands plans, but cover the entire family on both.  This
    way the coverage is essentially 100% for EVERYTHING, we only pay 1
    deductible (careful, even the 100% plan doesn't pay 100% on
    everything!)  The other company pays the extra 20% after the deductible
    is covered.  It comes out to only about $18/week total from both
    checks, and that's cheaper than 100% on one plan.  I'll admit at times
    it is a pain because you must submit for the balance.  For all the
    above we paid a total of $400 because some charges were over a maximum
    allowable amount (and John Hancock is not very generous here).
    
    One last note:  You do not need to pick up family coverage now.  You
    can change to this within 30 days of delivery and the delivery is
    covered.  This can be done anytime of year, not just during the "open
    enrollment".  That way you'll only pay when you need it.
    
    -Laura
       

    I have an HMO - the family plan because my husband has no insurance.
    I pay about $22 per week (regardless of the size of my family), there's
    no deductible, and a co-payment of $3 when I go to the doctor.  I
    had surgery a few years ago...  total cost:  $3.  When I had my
    baby last year...  total cost:  $3.  And that included *all* of my
    pre-natal visits and the delivery and hospital stay.  The best thing
    about this plan is NO BILLS.
    
    - Kathryn
    

    re: .16

    I assume you meant that $6000 includes the hospital bills for the
    pregnancy and normal delivery, not just for the baby?  If it's
    just for the baby, it's way too high -- including circumcision,
    David's bills wouldn't have been more than $2000 for the first
    year. 

    For the years in which I knew I was going to be pregnant, I'd
    definitely want the most comprehensive coverage, just because, as
    other noters have pointed out, you never know what's going to
    happen.  But after that, I don't know.  In the 10 years I've
    worked for DEC, we've received more benefits than the premium we
    paid in only  3 times -- my two pregnancies, one of which
    coincided with Kat's broken arm, and the year Neil had knee
    trouble and Kat had a lot of miscellaneous minor problems.  Even
    last year when Kat started having migraines and had to have things
    like head x-rays and a CAT scan, John Hancock came out ahead.

    I personally would like to see an option that let us have coverage
    for extreme conditions like broken arms but let us pay for the
    routine stuff like ear infections and such.  Catastrophic
    coverage, I think they call it.  
    
    --bonnie