Tuesday, November 29, 2011

Guide To Free: Don't forget to be nice :)

Tip: how to get free stuff
1. Smile
2. Say Please
3. Say thank you
4. Let everyone know you are paying cash and get them on your team (how? see above), you will be surprised at the results.

Monday, November 28, 2011

SHOW ME THE MONEY! Part One - If Maternity Coverage was an umbrella, I would be soaked!

Ok Cash Baby, enough with the prize winning writing, lets see some numbers

Some Latin "Res Ipsa Loquitor" - a term in learned in legal studies which means "the think speaks for itself"


Here is the math based on numbers quote for a 32 year old male and 35 year old female with maternity for HSA*

With Maternity Insurance
Premium: 937
Minimum Required Term Prior to Benefits: 22 months **
Total Insurance Premiums: $20,614
Hospital CoPay: $3,000
Anesthesia: 1000 Estimated (unclear if it is included above)
OB PrePay: $2200 plus labs
Guaranteed Out Of Pocket: $26,184

Without Maternity Insurance
Premium: 300
Minimum Required Term Prior to Benefits: 10**
Total Insurance Premiums: $3000
Hospital Payment: $6,000
Anesthesia: $1000 estimated
OB PrePay: $2200 plus labs
Guaranteed Out Of Pocket: $12,200

which would you rather spend?

*HSA (Health Savings Account) is a term for High Deductible Qualified Plan that allows the insured to manage thier own savings account and the contribution to the account is deposited post tax but the total contribution comess off of end of year personal taxes. For more info see http://www.treasury.gov/resource-center/faqs/Taxes/Pages/Health-Savings-Accounts.aspx
** 22 months assumes 12 months of coverage prior to becoming pregnant plus 9 months of pregnancy, which is actually 10 months since pregnancy is 40 weeks. assuming you are pregnant on the anniversary of the policy inception (which is highly unlikely)
Disclaimer: this is a HSA to HSA comparisson. there are other plans PPO, etc that can be enrolled in with different premiums and coverages. We choose to use the HSA for the tax benefits and the control it gives us over our own money.

Thursday, November 24, 2011

Swing and a miss!

Quick stats:
Cost: unknown
Location: Hospital

4 cm and dialating...Dr. recommends non-synthetic Prostaglandin and walking to induce labor. Gives dad a wink, gives mom a check and out the door we go. Followed Dr.s orders, sent the kids to the grandparents, contractions spaced 4 minutes apart for over an hour so its off to the hospital. At 9:30 we arrived and by 9:50 we were in our room. by 10 we had our nurse and were hooked up to the monitors.


by 11:00 contractions had stopped. when this happened with our other child, we were given Pitossin to get the contractions started. Oh, did I forget to mention it was the Tuesday before Thanksgiving, and the end of the on call Dr.'s shift? Apparently the world does not revolve around us! Our patient and pleasant young nurse, who had for the last hour walked us through the standard stack of paperwork (we agree to try really hard not to screw up and you promise not to sue us) was concerened with our progress as the labor had stopped. we too were concerned. but like last time we assumed that we would "get the drugs, man". bring on the pitossin an let us get this party cranked back up!

but the word from the on call dr. was that we could stay until morning and maybe they would start pitossin. Our nurse, bless her heart, was not aware that this was a cash based transaction and that we had not budgeted for a "paid for trial run" at childbirth. Nor was she blessed with the "cujones" required to tell the dr. that we were here, it was our 3rd kid, and we needed to start Pitossin.

so here is where we deviate from those with and without insurance. if we had insurance, then its a nite on the provider. free ice chips and crappy fruit cocktails, yahoo! but this is not how we are rolling, we are cash baby! so for us, its "how much is this going to cost us and how quickly can we get the timer to turn off. "

lets equate this to ordering a hamburger.

If a standard hamburger costs $5 and on average it takes 1 minute to make the burger, we are running at at $5 per minute to make the burger. sounds fair. now what happens when they run out of meat and have to wait on the truck. If you already paid for the burger, then you would just wait and when the truck came, you would get your burger. No problem here.

but what if you were paying for your burger by the minute. and that truck takes 1 hour to get to the store. So that would be 60 times $5 and (stay with me here) our by the minute burger now costs $300. same burger, two different costs.

Now what if when you orderd the burger the chef looked at you and said, "you don't look like you are quite ready for a burger, wait until I feel like it." You would certainly tell the chef to stick the patty where the sun don't shine. after all, the other people in line are getting their burgers.

so now that you are hungry (or disgusted/asleep), what does this have to do with being in labor and then not.


so when you look at your beloved, and then your wallet, and then your beloved says what the hell, look at me, i am wearing sheet with snaps. lets get the *** out of here because if we don't pop out a kid by the morning we will have paid for someone at this hosptial's new car for a marginal night in a bed you can crap in. You find the nearest nurse and get your discharge papers.

Those with maternity coverage would handle this differently, but thats not us. Our screaming neighnbors for the 2 hours we were at the hospital were getting they rightfully deserved. we nevery saw our nurse again.

In hindsight, we should have spoken to the doctor and nurse and explained the situation and maybe it would have gone differently. If there is anyone to blame it is ourselves and not "the system".

At this time, we don't know what the cost is because, unlike the burger, there is no posted menu with prices. we will have the pleasure of getting a bill in a few weeks and will find out what the damage is.

So in closing, here are the key items you should be prepared for if this happens to you.

1. forget about burgers
2. speak with your doctor and nurse upon arrival and explain the situation so they have all the facts and can be your advocate

Part 2: The cost of a swing and a miss...

what is a "cash baby"?

What is this, a joke? No, its real. Due to the insanity that is the insurance industry, more couples are finding out the hard way that having a baby with private maternity insurance is too expensive, so why not pay cash! this blog will document the ins and outs of paying cash for the delivery of a baby.

we were unable to find a good resource online that had everything laid out so that we would not have to learn the hardd way how to work the system. Now others will be able to benefit from our experiences with the doctors and hosptials that are supposedly there to help you.

It used to be all you needed was "two to tango" and 9 months later you get a baby. The new reality is that you need to have a third person to help you, and that is your insurance broker. No worries, the intimacy remains intact, but the dollars and cents of this baby will be different than any baby you had under your "traditional insurance"

We will cover the following:
- How to negotiate with the hospital
- Questions to ask your insurance agent
- Training your OB/GYN to bill correctly
- Setting up payment plans
- Budgeting Properly
- What to do if you go into labor and are sent home because contractions stopped
- What Prostaglandin can and cannot do for you
- How much is an ultrasound, really?