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11-09-2012 at 2:05 PM
Fweetie
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Insurance Coverage!! :)

Hi ladies!  I just had my yearly check up today at my OBGYN, and I told them we are TTC #2.  They told me that starting in Janurary 2013, all insurance policies are required to cover 100% maternity!!  I don't know if this applies to all states or not, I live in FL, so check your state.  But I just wanted to share that bc I was soooooo shocked!  Our bills for DS were a little over $10,000!  <-- Long story, my insurance with my employer didn't cover it and everything was just a mess :(  So hopefully we all have 2013 babies that are 100% covered!! GL everyone! :)
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11-09-2012 at 2:08 PM
GhostMonke...
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The person that told you that is a moron.

 

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11-09-2012 at 2:08 PM
ngarciabyu
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It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

ETA: in California all programs have maternity coverage, but there are still deductibles and such.
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11-09-2012 at 2:09 PM
GhostMonke...
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ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

And mandatory coverage =/= 100% paid.

 

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11-09-2012 at 2:11 PM
ngarciabyu
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GhostMonkey:

ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.


And mandatory coverage =/= 100% paid.


&nbsp;



Yes, I just added that to my post before I read this.
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11-09-2012 at 2:14 PM
Fweetie
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ngarciabyu:
GhostMonkey:

ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

And mandatory coverage =/= 100% paid.

 

Yes, I just added that to my post before I read this.

Well, I'm just telling you what they told me.  I have a $0 deductible, so maybe that's why she said that.  But she made it sound like it was for everyone.  Just thought it was good news I would share. :)
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11-09-2012 at 2:15 PM
BellaLux
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GhostMonkey:

ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

And mandatory coverage =/= 100% paid.

 

This! OP, be sure to do more research, you will have some expenses.

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11-09-2012 at 2:20 PM
Fweetie
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BellaLux:
GhostMonkey:

ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

And mandatory coverage =/= 100% paid.

 

This! OP, be sure to do more research, you will have some expenses.

I will def call them again and ask more questions about it.  But still, at least pregnancy (I'm assuming the hospital portion) is 100% covered.... whereas it wasn't before for me.  She said this was new and wasn't in affect yet, so I thought I would just share.  Even if I have to pay my $20 co payment each visit I am frecken elated! lol.   
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11-09-2012 at 2:22 PM
aragosta
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My prenatal costs will be 100% covered (that's necessary stuff - not like an optional ultrasound or anything) but I will still owe out of pocket for delivery.

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11-09-2012 at 2:24 PM
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Fweetie:
BellaLux:
GhostMonkey:

ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

And mandatory coverage =/= 100% paid.

 

This! OP, be sure to do more research, you will have some expenses.

I will def call them again and ask more questions about it.  But still, at least pregnancy (I'm assuming the hospital portion) is 100% covered.... whereas it wasn't before for me.  She said this was new and wasn't in affect yet, so I thought I would just share.  Even if I have to pay my $20 co payment each visit I am frecken elated! lol.   

It isn't in effect because it doesn't exist.

Your policy may have that change coming and they were aware of it, but it is not a state wide mandate.

Seriously- shut your hole and do a little research before running off at the mouth.

 

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11-09-2012 at 2:29 PM
GhostMonke...
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I will bet good money someone totally misconstrued what was covered under this:

http://www.hrsa.gov/womensguidelines/

 

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11-09-2012 at 2:42 PM
Fweetie
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GhostMonkey:
Fweetie:
BellaLux:
GhostMonkey:

ngarciabyu:
It is state by state. As of July 1st 2012 maternity coverage was mandatory in the state if California. I moved to Washington this week and it definitely is not.

And mandatory coverage =/= 100% paid.

 

This! OP, be sure to do more research, you will have some expenses.

I will def call them again and ask more questions about it.  But still, at least pregnancy (I'm assuming the hospital portion) is 100% covered.... whereas it wasn't before for me.  She said this was new and wasn't in affect yet, so I thought I would just share.  Even if I have to pay my $20 co payment each visit I am frecken elated! lol.   

It isn't in effect because it doesn't exist.

Your policy may have that change coming and they were aware of it, but it is not a state wide mandate.

Seriously- shut your hole and do a little research before running off at the mouth.

 

I'm sorry.  Why did you have to be so mean? -- I'm sorry if it offends you and if it doesn't apply for you, that's why I said in my OP to check your state... she said all insurance polices...  Maybe she was mistaken, but I just took what she said for correct because it is her job to know this.  -- Again,  I didn't mean to make anyone angry.       

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11-09-2012 at 2:42 PM
LADY324
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I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 
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11-09-2012 at 2:43 PM
thekikimon...
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GhostMonkey:

I will bet good money someone totally misconstrued what was covered under this:

http://www.hrsa.gov/womensguidelines/

 

but but but, her doctor's office said!!!
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11-09-2012 at 2:46 PM
MsCrispy
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You should also check if plans can be grandfathered in.

For example, Obamacare required that all plans cover 100% of prenatal care starting in 2012 (current year). However, my work's plan was grandfathered in, so it still does not cover it this year.

So I don't know the specifics of your case, but I wouldn't jump for joy quite yet.
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11-09-2012 at 2:47 PM
Fweetie
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LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

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11-09-2012 at 2:48 PM
Fweetie
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MsCrispy:

You should also check if plans can be grandfathered in.

For example, Obamacare required that all plans cover 100% of prenatal care starting in 2012 (current year). However, my work's plan was grandfathered in, so it still does not cover it this year.

So I don't know the specifics of your case, but I wouldn't jump for joy quite yet.

She said it will apply to all plans started after Aug 2012.  We got our plan in OCt.  So we are good.  :)

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11-09-2012 at 2:50 PM
Fweetie
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thekikimonster:
GhostMonkey:

I will bet good money someone totally misconstrued what was covered under this:

http://www.hrsa.gov/womensguidelines/

 

but but but, her doctor's office said!!!

Holy cow.  People on this board are really nasty.  Just forget I said anything if it pisses you all off.  Gheeeeeze. 

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11-09-2012 at 2:50 PM
Shayliz
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Fweetie:

LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

uhh, wut.

first you say 100% coverage, now you say you're sure there will be co-pays and deductibles.

I'd suggest you not make posts about what coverage is when you don't actually know.  
 
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11-09-2012 at 2:52 PM
thekikimon...
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Fweetie:
thekikimonster:
GhostMonkey:

I will bet good money someone totally misconstrued what was covered under this:

http://www.hrsa.gov/womensguidelines/

 

but but but, her doctor's office said!!!

Holy cow.  People on this board are really nasty.  Just forget I said anything if it pisses you all off.  Gheeeeeze. 

 

You don't know my lyfe!!!1!!!111!!
​


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lap June 2012, stage II/III endo & adenomyosis
Lupron 7/26/12 & 10/18/12
pelvic venogram 11/12/12(all clear)-12/19/12-lap with presacral neurectomy, endometrial excision, hysteroscopy & uterine uplift
2/19/13- starting bcps to bring this biitch back around
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11-09-2012 at 2:58 PM
Fweetie
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Shayliz:
Fweetie:

LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

uhh, wut.

first you say 100% coverage, now you say you're sure there will be co-pays and deductibles.

I'd suggest you not make posts about what coverage is when you don't actually know.  

Just because something has 100% coverage doesn't mean that you don't pay a deductible or co-payments.  My sisters insurance, for example, was 70% coverage AFTER deductible of $1,000 was met.  MY deductible is $0...my co payment is $20.  So I suggest you not make posts about what YOU don't know.   
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11-09-2012 at 2:59 PM
Fweetie
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thekikimonster:
Fweetie:
thekikimonster:
GhostMonkey:

I will bet good money someone totally misconstrued what was covered under this:

http://www.hrsa.gov/womensguidelines/

 

but but but, her doctor's office said!!!

Holy cow.  People on this board are really nasty.  Just forget I said anything if it pisses you all off.  Gheeeeeze. 

 

You don't know my lyfe!!!1!!!111!!

LOL........
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11-09-2012 at 3:12 PM
Shayliz
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Fweetie:
Shayliz:
Fweetie:

LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

uhh, wut.

first you say 100% coverage, now you say you're sure there will be co-pays and deductibles.

I'd suggest you not make posts about what coverage is when you don't actually know.  

Just because something has 100% coverage doesn't mean that you don't pay a deductible or co-payments.  My sisters insurance, for example, was 70% coverage AFTER deductible of $1,000 was met.  MY deductible is $0...my co payment is $20.  So I suggest you not make posts about what YOU don't know.   

You clearly do not understand what 100% coverage means.  
 
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11-09-2012 at 3:16 PM
Fweetie
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Shayliz:
Fweetie:
Shayliz:
Fweetie:

LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

uhh, wut.

first you say 100% coverage, now you say you're sure there will be co-pays and deductibles.

I'd suggest you not make posts about what coverage is when you don't actually know.  

Just because something has 100% coverage doesn't mean that you don't pay a deductible or co-payments.  My sisters insurance, for example, was 70% coverage AFTER deductible of $1,000 was met.  MY deductible is $0...my co payment is $20.  So I suggest you not make posts about what YOU don't know.   

You clearly do not understand what 100% coverage means.  

I guess not.  Sorry to offend anyone.

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11-09-2012 at 3:27 PM
GhostMonke...
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Fweetie:
Shayliz:
Fweetie:

LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

uhh, wut.

first you say 100% coverage, now you say you're sure there will be co-pays and deductibles.

I'd suggest you not make posts about what coverage is when you don't actually know.  

Just because something has 100% coverage doesn't mean that you don't pay a deductible or co-payments.  My sisters insurance, for example, was 70% coverage AFTER deductible of $1,000 was met.  MY deductible is $0...my co payment is $20.  So I suggest you not make posts about what YOU don't know.   

YES IT DOES!

I have 100% coverage. I pay no deductible and zero copay for anything maternity related. That is 100% coverage.

Your sister does not have 100% coverage.

Shut up already. You don't have the slightest idea what you are talking about.

 

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11-09-2012 at 3:31 PM
Fweetie
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GhostMonkey:
Fweetie:
Shayliz:
Fweetie:

LADY324:
I am in NJ and my company is now going to cover prenatal visits at 100% however I am sure I will be forking over money for something that is "not" covered each visit.  Also I don't think it includes birth at the hospital which would be my deductible and out of pocket maximum. 

Yea, I guess I should have explained more.  I'm sure we will have to pay "co-payments" and "Deductibles" but this was wayyyy better news than with my frist pregnancy and I thought it was good news to share. GL! :)

uhh, wut.

first you say 100% coverage, now you say you're sure there will be co-pays and deductibles.

I'd suggest you not make posts about what coverage is when you don't actually know.  

Just because something has 100% coverage doesn't mean that you don't pay a deductible or co-payments.  My sisters insurance, for example, was 70% coverage AFTER deductible of $1,000 was met.  MY deductible is $0...my co payment is $20.  So I suggest you not make posts about what YOU don't know.   

YES IT DOES!

I have 100% coverage. I pay no deductible and zero copay for anything maternity related. That is 100% coverage.

Your sister does not have 100% coverage.

Shut up already. You don't have the slightest idea what you are talking about.

 

Ooook.  I've appologized. I thought I understood it, but I don't.  You win. 

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11-09-2012 at 3:33 PM
GhostMonke...
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MsCrispy:

You should also check if plans can be grandfathered in.

For example, Obamacare required that all plans cover 100% of prenatal care starting in 2012 (current year). However, my work's plan was grandfathered in, so it still does not cover it this year.

So I don't know the specifics of your case, but I wouldn't jump for joy quite yet.

Negative. That is not a part of what passed in August. If only someone would link to the provisions of what was passed...

Since one link wasn't enough, let's try another.

http://www.healthcare.gov/law/resources/regulations/womensprevention.html

Parts of prenatal care are covered. Most is not. Delivery is certainly not.

 

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11-09-2012 at 3:47 PM
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The good thing about this post is that it gives everyone an opportunity to look over their insurance coverage. The links from GM are very helpful too.

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11-09-2012 at 3:49 PM
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GM, you might have someone that will biitch about you now in the "biitch about a bumpie" thread. Wink

 

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11-09-2012 at 3:51 PM
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PrimRoseMama:
The good thing about this post is that it gives everyone an opportunity to look over their insurance coverage. The links from GM are very helpful too.

Yes

Also, please note that if your company is self-insured, they do NOT have to follow any of the state mandates (goes by the state the company's HQ is in). Not many people know that their company IS self-insured because, well, most companies do not actually say a detail like that on their communication (it's not that they are purposely hiding it). Any large company I have worked for actually was self-insured and most are. It really is cheaper for a large company to pay for all of the claim out-of-pocket versus paying the high employer portion of the premium costs.

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