Can someone break down insurance for me?

Question

I'm a FTM and have an struggling to understand the ins and outs of insurance, and what I'll be responsible for! 
I'm due in March. I have insurance through United HealthCare with my job. I have a $500 deductible, and my insurance covers 90% once that is met... My out of pocket maximum is $3,000.

Can someone explain what happens if my deductible has not been met by the time I deliver? I pay my deductible by having it taken out of my check every 2 weeks, and when I did the math, by the end of March, my deductible will not have been met. Could I pay a little extra each month towards that? Like just call and say I want to pay towards my deductible? 
If my deductible has not been met, does insurance cover any of it?

I'm just confused on everything! Thanks.

Answer

The money you get taken out of your check is your premium to even have insurance. Depending on exactly how your plan is laid out you may have to pay the $500 out of your own pocket, outside of your premiums(taken from your check) and then 10% of the remaining expenses until you reach the out of pocket.. If you call customer service, they can explain it.. Just ask how your maternity benefits lay out this year.. Also ask them to walk you try myuhc.com very useful website!! I used to work there ;)

Answer

The money that comes out of your paycheck is your premium - what you pay to have insurance, not your deductible. I have a higher deductible (thanks crap school employee insurance) BUT my insurance covers 100% of prenatal care so I haven't had to pay much. I pay my co-pays and that's it. My uktrasounds are 50% covered so the half I pay (usually about $120) goes towards my deductible. Call your insurance and have them break it down for you.

Answer

You're going to have to verify coverage of benefits with your provider. Every plan is different not to mention the affordable healthcare act changed so many policy's. Also more changes are being applied to insurance policies this year a lot of HMO's are being done away with and PPO's are going to EPO's it's quite complicated. Your obgyn should be able to give you a run down of anticipated costs as should the hospital, then speak with provider to see what is or isn't covered.

Answer

For example with my insurance....

$400 deductible that is paid out of pocket before insurance covers anything (not to be confused with your premium taken out of your paycheck, that's a different thing)...

My insurance covers 75% (once I pay the $400 out of pocket) and maxes at out $2000. After $2000 they cover 100%.

So in my case my max is going to be $2400.

From what you described it sounds like your cost is going to be $3500...$500 deductible plus $3000 out of pocket expenses.

I would call your insurance company, tell them you are pregnant, and ask what you need to know about what your insurance pays for, etc. and what amount you can expect to pay out of pocket. I highly recommend you talking to them. For example, my insurance told me I have a $1000 hospital copay for delivery to expect to pay upfront when I check in to have baby. It's best you find out what you will need to do by talking directly to your insurance company.

Answer

Do you not have maternity coverage? I have humana thru work and maternity is covered at 100%! I haven't had to pay for anything as of now and I have had 3 scans! You may want to check on that.

Answer

What is being taken from your check is the premium not the deductible.  You will be responsible for the first 500 plus 10% of the cost up to 3000 total including your deductible.  If the baby will also be covered under the same insurance it could mean that additional amount for the baby, depending on what the family deductible and out of pocket max are for your insurance plan

Can someone break down insurance for me?

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