NICU cost?

Discussion in 'General' started by pnl4evr, Jul 18, 2008.

  1. pnl4evr

    pnl4evr Active Member

    Hi everyone. I hope I don't offend anyone by asking this. I'm almost 22 weeks and paranoid about the twins maybe having to spend time in the NICU. How does everyone pay for that. I know I probably won't be thinking about that if and when it actually happens, but that's all I can think about right now. Any input would be greatly appreciated. :)
     
  2. Kyrstyn

    Kyrstyn Well-Known Member

    Thankfully we had insurance!! The insurance company did tell me that it was around $110,000 per week per baby (and my girls were in their for 10 weeks)!! I still got some bills from the hospital and had to dispute a few of them, but its all taken care of now. I hope you have an uneventful remainder of your pregnancy and they don't have to go to the NICU. GL!
     
  3. bebedoc

    bebedoc Well-Known Member

    Good question. I just found out today that the neonatalogists in NICU are not "participating providers" for my husband's insurance. I'm guessing that means we'll be responsible for the remaining 30% of an out-of-network provider. I need to find out if I add them to my insurance will it pick up the difference. It's hard to worry about things like that when they're in NICU when all you want is your babies to grow, be healthy, and come home. Just one more thing to worry about.....like we need the extra stress, huh? :)
     
  4. Flutterbymama

    Flutterbymama Well-Known Member

    QUOTE(Kyrstyn @ Jul 18 2008, 10:11 PM) [snapback]884286[/snapback]
    Thankfully we had insurance!! The insurance company did tell me that it was around $110,000 per week per baby (and my girls were in their for 10 weeks)!! I still got some bills from the hospital and had to dispute a few of them, but its all taken care of now. I hope you have an uneventful remainder of your pregnancy and they don't have to go to the NICU. GL!


    Our insurance covered the majority of it. We had to pay an inpatient co-pay to the hospital for each of the babies since they were admitted as patients. Our ins. co. ended up paying around $62k for Nathan and around $80k for Makenna.

    One thing to be aware of is that the hospital can be in network with your ins. co. but some of the doctors' groups that work there may not be. Usually if that happens, it's certain specialties: emergency room, anesthesiology, radiology, pathology and neonatalogy. We received bills from the neonatology group at our hospital. I didn't call to question them but maybe I should. (I do the ins. contracting for an anesthesiology practice so I know it's common for patients to have legit bills. Maybe I ought to call and complain anyway.) The hospital groups' participation is something you can look into while you're still pg. It may not help much as far as hard numbers go but at least you'll know if you should expect any bills. Whether your have prior knowledge or not, the patient is ultimately responsible for the bill. I think that's bs but it's not within my power to change that. Hopefully you'll have 37 week + full term babies and all of this won't matter. PM me if you want more specific info.
     
  5. jakeandpeytonsmommy

    jakeandpeytonsmommy Well-Known Member

    A LOT! :rolleyes: We have somewhere in this house the cost breakdown and for a simple diaper change it was like $12. So...if a diaper was that, you can only imagine.

    Thankfully I don't think we paid any of it b/c of insurance. They were there 7 and 9 weeks.
     
  6. raptwins

    raptwins Well-Known Member

    Luckily our insurance paid it all but I know (at least in Michigan) that once the boys were there for 30 days, they automatically qualified for Medicaid so it would've been covered by them anyway after that point. It was a very VERY good thing we had insurance though as Joe was in the hospital (3 actually) for 4 months and Jake in 2 different hospitals for 3.5 mths. Once the bills exceeded $2MM I stopped counting as insurance covered it anyway. It's nuts! Take care of those babies and I'll pray for a happy, full pregnancy for you :)
     
  7. reeba1976

    reeba1976 Well-Known Member

    Our insurance covered it. Our total bills were around 300K for both. Just remember if you do not have insurance, they cannot make you pay it in full. You can set up a payment plan. If that payment plan is only 5 bucks a month, so be it.....that is all you can afford.
     
  8. laura305

    laura305 Well-Known Member

    my babies are covered by a state plan, we qualfied for incomewise, otherwise we have hubbys insurance but i chose not to enroll them in that because the co insurance is astronomical could you imagine 10% of 300k for one, my babies have already been there for 2 weeks and we dont know how much longer it could be 2? 4 weeks? for 1? that alone would put us in the poor house. So i applied for the state plan while i was pregnant and we qualified. So my bills are being paid that way there are alot of programs in so cal for it. Good luck dont worry about it, just make sure you have insurance lined up or check out plans for children withoutout health insurance you might be able to get them enrolled if you and your husband qualify financially. its better to check it out now and at least plan around it. But most people have health insurance.
     
  9. FirstTimeMom814

    FirstTimeMom814 Well-Known Member

    I wanted to add that I used to work on the insurance side of things. If you are at an in-network facility and they have an out-of-network dr attend to you or your children usually the insurance company will cover it as in-network. You may have to call them and explain the situation, but since there is no option for you but to have those drs they usually have a clause that protects you. HTH.
     
  10. Cynthia3200

    Cynthia3200 Well-Known Member

    Our insurance paid for most of it. We just had our deductible. Both of my girls were in for 12 days. Addison's bill was 46,000 and Samantha's bill was 53,000. In our NICU, if they were just in an open crib and not on any IV's or breathing treatments..the cost per day was $880.
     
  11. summerfun

    summerfun Well-Known Member TS Moderator

    We are very fortunate to have great insurance. Emilie and Trevor were in the NICU for 8 weeks and they each had a $100 copay, that is all we paid. :) Our bill for both was around $500,000+. Thank goodness for insurance.
     
  12. DATJMom

    DATJMom Well-Known Member

    We too had insurance cover a large part of it. But then the nickel and dime bills started coming in once we brought them home. You know the $30 here for labs and the $15 here for ultrasounds. Then we got a large one for each of them at about $500 for their Dr. costs. But other than that most of it was taken care of by our insurance.
     
  13. angie7

    angie7 Well-Known Member

    Our insurance covered 100% of the babies NICU cost and mine after a $200 hospital fee per baby and myself. My c-section was over $14,000 and the babies bill was over $300,000. So only paying $600 bucks was no problem ;)
     
  14. alankford

    alankford Well-Known Member

    After everything was said and done our NICU bill was 1,692,786.52. Our insurance paid all but 10,000. We are still paying on that. The twins were both there for 78 days. Saw a million Drs. had tons of medicine. and I agree about the 12$ diapers.

    GERRRR
     
  15. Babies4Susan

    Babies4Susan Well-Known Member

    Our insurance covered everything 100%, Lily's bill was around $110K for 34 days, Grace's around $140K for 41 days, and mine, in total across multiple hospital stays (one of them 4 weeks long) was around $40K. We have BCBS and don't normally run into out of network docs with that.
     
  16. bridgeport

    bridgeport Well-Known Member

    Ours were both in for 45 days, and the total bill for both of them was over $500,000. That included their 'room and board' in the NICU, all of the labs, specialists, etc., and the neonatologists. Every time a doctor did rounds it was another grand at least (and they did rounds every day). If they had to actually do something, it was more.

    Our insurance had a deductible and co-insurance amount that we were responsible for, but only up to a $3,000 annual out of pocket max for each insured. So we had to pay $6,000 total for the boys. And since we hit our max for the year on the NICU bill, we didn't have to pay any out of pocket for any care (including the outrageously expensive Synagis shots) for the rest of the year.

    Our NICU had a social worker that would help parents who didn't have insurance, or who were not able to pay their portion after insurance. It was the social worker's job to figure all of this out, so the parents could focus on their babies. They'll get you the gov't assistance, and work with you on payment plans, to get your babies the care they will need. The last thing you'll need is to stress over money - so let the social worker do that for you!
     
  17. Tripsmommy

    Tripsmommy Well-Known Member

    I call my guys million dollar babies, b/c by the time it was all said and done, it was over that... both boys had their fair share of issues, but dd had multiple surgeries, and life saving attempts several times, so I'm sure that added to the cost...
    My Dh has ins., I did until July 31st of that year(teacher contracts end in July, and I did not renew to stay home w/ babies), and in the state of TX if babies are born under 1500 grams (I think) then medicaid will automatically pick up the rest of what ins doesn't cover regardless of income level. all 3 of my babies were under the weight guidelines. I don't reccommend having babies that small, but my two survivors are going strong now!

    PS I'm in Houston, but if I ever had to live anywhere else in TX I'd pick the SA area! We'll be there in a week at the Hyatt Hill country resort... love it there!
     
  18. pnl4evr

    pnl4evr Active Member

    QUOTE(Kyrstyn @ Jul 18 2008, 10:11 PM) [snapback]884286[/snapback]
    Thankfully we had insurance!! The insurance company did tell me that it was around $110,000 per week per baby (and my girls were in their for 10 weeks)!! I still got some bills from the hospital and had to dispute a few of them, but its all taken care of now. I hope you have an uneventful remainder of your pregnancy and they don't have to go to the NICU. GL!



    Wow! Thank you. :) We do have insurance that covers 90% after the deductible but the deductible is $1500/family. I totally forgot I posted this. I wish there was an option to receive an email notification when someone replies to my post. Thanks!
     
  19. pnl4evr

    pnl4evr Active Member

    QUOTE(Flutterbymama @ Jul 18 2008, 10:45 PM) [snapback]884333[/snapback]
    Our insurance covered the majority of it. We had to pay an inpatient co-pay to the hospital for each of the babies since they were admitted as patients. Our ins. co. ended up paying around $62k for Nathan and around $80k for Makenna.

    One thing to be aware of is that the hospital can be in network with your ins. co. but some of the doctors' groups that work there may not be. Usually if that happens, it's certain specialties: emergency room, anesthesiology, radiology, pathology and neonatalogy. We received bills from the neonatology group at our hospital. I didn't call to question them but maybe I should. (I do the ins. contracting for an anesthesiology practice so I know it's common for patients to have legit bills. Maybe I ought to call and complain anyway.) The hospital groups' participation is something you can look into while you're still pg. It may not help much as far as hard numbers go but at least you'll know if you should expect any bills. Whether your have prior knowledge or not, the patient is ultimately responsible for the bill. I think that's bs but it's not within my power to change that. Hopefully you'll have 37 week + full term babies and all of this won't matter. PM me if you want more specific info.



    Thank you so much.
     
  20. pnl4evr

    pnl4evr Active Member

    QUOTE(Tripsmommy @ Jul 23 2008, 06:01 PM) [snapback]892320[/snapback]
    I call my guys million dollar babies, b/c by the time it was all said and done, it was over that... both boys had their fair share of issues, but dd had multiple surgeries, and life saving attempts several times, so I'm sure that added to the cost...
    My Dh has ins., I did until July 31st of that year(teacher contracts end in July, and I did not renew to stay home w/ babies), and in the state of TX if babies are born under 1500 grams (I think) then medicaid will automatically pick up the rest of what ins doesn't cover regardless of income level. all 3 of my babies were under the weight guidelines. I don't reccommend having babies that small, but my two survivors are going strong now!

    PS I'm in Houston, but if I ever had to live anywhere else in TX I'd pick the SA area! We'll be there in a week at the Hyatt Hill country resort... love it there!



    Have fun here in SA. :) We actually live in Universal City which is just north of San Antonio. :) DH and I didn't qualify for medicaid, so everything's been kind of a big headache. :)

    Thanks everyone for all of your replies. :)
     
  21. Tripsmommy

    Tripsmommy Well-Known Member

    That's the thing, we would never qualify for medicaid, (my dh is a lawyer /now Judge and I'm a teacher) but once the babies are born if they are born under a certain weight, they are an automatic coverage. Trust me, I was stunned. I kept asking the girl if she was sure, and if she knew how much we were making...she said it does not matter in tx. But you won't know until they are actually born, but it is only for the micro preemies born under 1500 grams. (3 1/2 lbs. very low birthweight) all 3 of mine were 2 lbs or under. The lady came in the day after they were born and signed them up. Nothing prior, b/c no one knows until they are born.
    Hopefully you won't have any babies under that weight, but its good info to have...
     
  22. stumpstress

    stumpstress Well-Known Member

    From what we were told, Social Security (SSI) kicks in for all babies below a certain birthweight--nationwide. Then, certain states will pick up costs after children are discharged, which is when the SSI ends. The hospital should have a patient advocate you can discuss this with. In our case, we were informed of it by our insurance company--when you have a nicu child w/ Cigna, they automatically assign a caseworker to help you out. As for our bill...it was nothing. I had an HMO with no copay for nicu stays as long as all the paperwork was done right. Each child's hospital bill was just over $300k. That was the hospital bill only...that didn't include many of the specialists that came in (such as the eye dr), and it certainly didn't include all the after discharge treatment. By the time you add in RSV shots, specialist appointments, etc, I'm guessing we hit the $1 million per kid mark in the first year or 18 months. Now that the kids are in early intervention, I'm guessing we are well past that.

    If you are very concerned, I would call your states welfare department. In Pennsylvania, certain disabled people receive Medicaid no matter what their income. Preemies are included in the list of disablities, and I think it's for their first 3 years. If you have an insurance that has percentage copays (like a PPO, etc), this is really helpful. We used it, mainly because we had to switch out of the HMO to a PPO, and the RSV shots required a copay of about $700 per month total for both kids. Unless your Bill Gates, that hurts no matter how much you make.

    HTH!
    penny
     
  23. Tripsmommy

    Tripsmommy Well-Known Member

    Oh, yes, i forgot the ssi. and I forgot to mention that the medicaid at least here in TX was only to cover while in the nicu. Once discharged, they are your kids, your issue. unless of course they have an actual disablility, but then that is a different thing you would apply for.
    Our boys were both discharged on Aug. 14, and it ended that day. they also only got the ssi checks while in the nicu. 30.00 each kid.
     
  24. clb8899

    clb8899 Well-Known Member

    We had insurance as well. We also got approved for Medicaid since I was off work for several weeks before the babies were born. I had just dropped the paperwork off at HHS in the morning. The babies were born that afternoon. We were there 6 weeks & it cost a little over $60,000 per baby. I was actually surprised it wasn't more. Of course, that doesn't include the room we stayed in at the hospital or the food we at while we were there. Either way, it was well worth it!!
     
  25. SilvrHeart

    SilvrHeart Well-Known Member

    Just fyi, b/c I don't think anyone's mentioned it - your babies are covered automatically under BOTH your ins and your husband's (if you have 2 sep policies, which we did b/c we were each separately insured thru our employers) for the first 30 days, whether you add them to the policy or not.

    6 days in the NICU each (no real probs) = $15k per baby ($2,500 per day per baby). That does not include the neonatologist's bills, of course. We will be covered 100% by the 2 policies once the hospital and the ins co's get their acts together. Yes, it's been over a year and we are STILL trying to work that out. For us, that's been the biggest problem - not the cost, but the unbelievable hassle of dealing with the bills and the 2 ins co's.
     
  26. debbie_long83

    debbie_long83 Well-Known Member

    Our insurance paid some, but because the girls were so early they automatically qualified for medicaid and ssi, after leaving the hospital our income was evaluated to decide on ssi checks. They will get to keep medicaid for a year. In other words, no money out of our pockets. We are still getting some bills where they messed up... this has been a huge pain. At one point, the hospital had filed them as well babies and the insurance did not want to pay for "unnecessary wellness procedures". ugh. Anywho, in all between 2 hospitals our bills totaled around 450,000. Our girls were born at 29 weeks and stayed in the NICU right at 2 months. Insurance companies can be an absolute nightmare so I hope you have better luck with yours!
     
  27. eehrlich

    eehrlich Well-Known Member

    it was about 30k for 9days for my girls, insurance covered everything after we met our 1000 deductible.
     
  28. april mcdaniel

    april mcdaniel Well-Known Member

    luckily our 'ins. payed a big chunk, but we still ended up owing around 1000 dollars per child just to the hosp. That isnt counting DR bill, , etc. They stayed for 11 days. The cost per day in the NICU was $900. That is alot when you have to double it!!

    START SAVING NOW!!!!!
    GOD BLESS
    April :a_smil09:
     
  29. skovarik

    skovarik Active Member

    Our insurance covered everything from me going on hospital bed rest for a week to the boys 5 weeks in the NICU. I believe the total for the boys (not for me) was 260,000! It still boggles my mind.
     
  30. pnl4evr

    pnl4evr Active Member

    QUOTE(Tripsmommy @ Jul 25 2008, 05:31 PM) [snapback]896680[/snapback]
    That's the thing, we would never qualify for medicaid, (my dh is a lawyer /now Judge and I'm a teacher) but once the babies are born if they are born under a certain weight, they are an automatic coverage. Trust me, I was stunned. I kept asking the girl if she was sure, and if she knew how much we were making...she said it does not matter in tx. But you won't know until they are actually born, but it is only for the micro preemies born under 1500 grams. (3 1/2 lbs. very low birthweight) all 3 of mine were 2 lbs or under. The lady came in the day after they were born and signed them up. Nothing prior, b/c no one knows until they are born.
    Hopefully you won't have any babies under that weight, but its good info to have...



    Wow, thank you. Hopefully I don't have to go through that, but it's comforting to know. :)
     
  31. pnl4evr

    pnl4evr Active Member

    Wow, thanks a lot ladies. I have pretty good insurance I guess. You're set my mind at ease for the most part. :)
     
  32. twinzmom2b

    twinzmom2b Well-Known Member

    Mine were in the NICU for 17 days each. Neither had any medical problems, neither required any form of oxygen. They were ONLY there as growers/feeders and I did 10 hours of their care each day myself! That being said, I should've been put on the payroll register...lol!!!

    Anyway, their bill (total for both) was $250,000. That's a TON considering there was nothing wrong with them. They were just there to gain some weight and learn to eat.

    We paid $1500 out of pocket (deductible and co-insurance) total. The insurance picked up 100% of the rest of the bills.

    However, all of the neonatologists they saw WERE on our insurance, so we didn't have any issues like some pp mentioned in regards to that.

    My SIL had a baby that was in the NICU for a few days and needed some chest xrays...the radiologist was NOT on their insurance plan, so they had to pay out of network costs for that.
     
  33. pnl4evr

    pnl4evr Active Member

    QUOTE(twinzmom2b @ Jul 31 2008, 09:07 PM) [snapback]907532[/snapback]
    Mine were in the NICU for 17 days each. Neither had any medical problems, neither required any form of oxygen. They were ONLY there as growers/feeders and I did 10 hours of their care each day myself! That being said, I should've been put on the payroll register...lol!!!

    Anyway, their bill (total for both) was $250,000. That's a TON considering there was nothing wrong with them. They were just there to gain some weight and learn to eat.

    We paid $1500 out of pocket (deductible and co-insurance) total. The insurance picked up 100% of the rest of the bills.

    However, all of the neonatologists they saw WERE on our insurance, so we didn't have any issues like some pp mentioned in regards to that.

    My SIL had a baby that was in the NICU for a few days and needed some chest xrays...the radiologist was NOT on their insurance plan, so they had to pay out of network costs for that.


    Once my $1500 deductible (for family) is met, they'll cover 90% of everything. $500 will be met by October just because my son is going to have a tonsilectomy and his deductible has to be met before that. So that leaves us $1000. DH doesn't work. He goes to school full time and receives monthly disability checks from the Army and his GI bill. So no insurance there. :) The faster he gets done with school, the faster I can get done. :) He feels really guilty but I told him that it's ok. He has less time than me until he graduates and then he can start working full time and I can go to school full time instead of working full time and going to school part time like I am now. :)

    Sorry for the rambling. :)
     
  34. pnl4evr

    pnl4evr Active Member

    I also wanted to say that everything looks good so far. My cervix was measuring 4.8 cm at my last appt and absolutely no signs of PTL. :) We should be ok I hope. :) Thank you very much everyone for sharing your stories.
     
  35. summerfun

    summerfun Well-Known Member TS Moderator

    QUOTE(c_chavira @ Aug 1 2008, 10:20 AM) [snapback]908265[/snapback]
    I also wanted to say that everything looks good so far. My cervix was measuring 4.8 cm at my last appt and absolutely no signs of PTL. :) We should be ok I hope. :) Thank you very much everyone for sharing your stories.

    Glad to hear it. :)
     
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