Help regarding Maternity Expenses

[agrocks]

Hi,

I will be visiting US on L1 visa in February and my wife will accompany me as well. My wife will be completing 5 months of pregnancy in February. My company is having insurance with BCBS in US. Can you please confirm if my wife's pregnancy expenses will be covered when I will travel to US on L1 in february as my wife is already pregnant and we are planning for delivery in US? Also, please let me know what could be the maternity expenses if my insurance company pays for pregnancy (90:10 ratio) and if they doesn't pay for the pregnancy.

Thanks in Advance!!

AG

[C4us]

You need to confirm with your company's HR department AND BCBS that she will be covered. It all depends on your company's policy since you do not have US insurance at this time. Be sure you confirm with BCBS - and get it in writing - once you have the group identifying number. BCBS is generally very good insurance but the rules vary by company and become quite confusing.

Normal delivery costs between $10,000-$20,000. Extreme problems with the baby can run the costs over a million dollars. You will not qualify for government paid services due to your income and visa status (in many states).

Depending on the policy, you may have a higher copay if you do not choose an "in network" doctor and hospital. Some copays on our BCBS plan can be as high as 50% if we do not follow the rules exactly.

Another problem you will face in many locations is finding an OBGYN with an opening for a new patient since may doctors no longer perform deliveries. In my location, first visits may take 3-6 months to obtain even just transfering doctors within the clinic. Especially if it is a high risk pregnancy, you need to check with others in your company to get a better idea of times and conditions at that location.

Happy baby!

[agrocks]

Thanks C4us!!

I am kinda scared now as how the things will be when I will be here. So what's the suggestion, should I get the delivery done in my home country and then visit US? My company won't allow me to do that and company is saying that everything will be covered. Do I need to confirm with BCBS about the Copay and Coverages?

I know I might sound nonsense but request you to please help me to take good decision.

AG

[txh1b]

Many group policies (those provided by employers) do cover existing pregnancies. So, your HR and BCBS should be able to give you the correct details if you get the policy number of your employer.

Copay and coverage will be the same for everyone in a group that has the same policy. Doesn't differ. You also should plan on using the Health Care reimbursement account if your company has one.

[C4us]

You are right to be concerned and are doing exactly the correct thing to investigate. Since you are not moving until February, you have time to get everything setup for an easy transfer of your wife's care to the US.

If your company is a reputable one that is relatively large, the HR department should be knowledgeable about the plan, but still confirm with BCBS. Verify with HR that your coverage begins when you land in the US and that there is not any delay in starting coverage.

Some companies have their insurance documents online so that you can find out the plan name and see the coverages - if not ask for the plan name and group number. Once you have the plan name (in my state they look like "Blue Choice", "Blue Links", ...) you can generally go to the BCBS site for your state and enter the plan name and get a list of acceptable hospitals and doctors. You need to decide whether you will pick your doctor or your hospital since they generally practice in only one or two in a community.

It is possible to find doctors who speak other than English if your wife is not fluent in English. That may be the determining factor for you. See if your employer can put you in touch with other ex-pats in the company for assistance in sorting out the hospitals by location, etc.

Most hospitals have websites sell their services. You will be able to find out a lot from this. Most doctors will have their basic credentials - education, graduation date, etc. posted online at the hospital, BCBS, or clinic website.

Once you have selected a doctor, call to see if they are taking new patients and make an appointment for 2 to 3 weeks after you arrive assuming that she is seen by her current doctor right before you travel. Ask to have their new patient paperwork faxed or emailed to you and return it to them so it is in their hands when you arrive in the country. At that point she is in their records and can be seen on an emergency basis more easily. Make arrangements to have your wife's medical files sent or hand carried to them; if they need to be translated, make arrangements to have that done.

If it is a high risk pregnancy - which it very likely is not, evaluate your options and discuss with your current doctor whether she should move at this time. Otherwise, if you plan ahead, everything should be fine.

[C4us]

txh1b and OP,

Failure to use an "in network" doctor under some plans results in a much higher co-pay. My plan can have a penalty of as much as 30% difference in copay for "out of network" services - including such things as lab services, durable medical equipment, etc.

OP,

It is essential to understand the terms of your plan. BCBS customer service is generally very helpful in answering questions.

Be sure to see if you have an annual deductible that needs to be met by you before payments begin. This frequently is not for hospitalizations but will apply to doctors visits, etc.

[txh1b]

I assumed everyone uses or tries to use in-network whenever possible. Heathcare plans and in depth details of a third party cannot be talked about on a forum as we ourselves would not know many hidden details of our own health plans.

[C4us]

txh1b,

My comparison is as a word of warning to OP as many coming into the US health care system so not understand the importance of "in" verses "out of network" so that he does not unnecessarily create additional costs due to the crazy rules of the system.

After dealing with as many as 6 people over 40 years, it still surprises me what gets added into the rules to make it difficult to minimize out-of-pocket costs.

I'll leave it to you to explain health care reimbursement accounts as I need to do the paperwork for this year on ours - bah,humbug.

[txh1b]

I concur. Hope the presidential election does not add a third degree of complexity to the already complex healthcare equation by including an IRS element of taxation of benefits :-)

[C4us]

I cannot even think about that!!!!!!!!!!!

If OP follows even some of the advice in this thread, he and his wife should have few problems in their move. If only more people would plan ahead so they do not have the surprises - and headaches - dealing with the US health care system. I hope he posts back if he has more questions.

[agrocks]

C4us, txh1b
I am highly thankful to you for providing such a detailed and beneficial information. Just an update, I had a talk with BCBS and they said that they do cover existing pregnancies on insurance provided to our company's employee. So I am relaxed a bit, but I know I have to do a lot of things before landing in US with my wife. Can you please do me a favor again, if you can provide me with website where I can see all maternity expenses in US?
Assuming, the ratio as 90:10 (insurance company will pay 90% and I will pay 10%), what shall be the expense from my pocket if delivery is ceserian and without complications (touch wood)? (just an approximate figure will do) Copayment is $25 per visit other than 100$ for Maternity Services.

Thanks A Lot,
AG

IMMIHELP ROCKS

[txh1b]

There is always a out of pocket max in all plans after which they cover it at 100% in the network. It could be any amount. most of the times less than $5000 depending on your plan. Check with the plan provider. That is the max that can go out of your pocket in any case.

One good thing about maternity is 1 co-pay of $25 covers all routine visits to the doctor for normal cases.

[C4us]

Your wife will pre-register at the hospital and you will be offered childbirth and infant care classes. These will be very helpful as they will take you both through the areas of the hospital where you will be and give very specific instructions about check-in, what to bring, what to expect, etc. You will meet with a financial person who will give you that information and make any payment arrangements that might be necessary.

Babies in the US are not cheap. They need so many things. One of the first things you will need to be sure to purchase an infant carseat as it is required by law that a child ride in one. Tell your wife that she can start to plan to shop for infant necessities by looking at the .com sites for Target, Kohls, and BabiesRUs. These are nationwide chains of stores. The brands thay carry are of reasonable/typical price and good quality. I will warn you about purchasing or borrowing old baby beds as the safety standards have changed and there are recalls on entire models when children have been injured by defective designs.

There is one thing that I do suggest you bring from your current home. If your wife plans to use an infant carrier/sling that is traditional to her, she should bring at least one. It is difficult to easily find ethnic "baby wearing" items. Google "baby wearing" to see what I am talking about. (How do I know, my daughter wants me to make her a mai tai for my soon to be grandchild.)