million dollar babies - page 2

I have a question...when parents have a baby in NICU, and they end up with a preemie that has a long/expensive hospital stay does this financially devestate them? If they have health insurance, and... Read More

  1. by   RNin2007
    I've learned a lot about how this works by reading this thread. Now I wonder if an insurance company can deny you coverage d/t pre-existing condition?

    ~J
  2. by   mom23RN
    Quote from RNin2007
    I've learned a lot about how this works by reading this thread. Now I wonder if an insurance company can deny you coverage d/t pre-existing condition?

    ~J
    We often hear about that with Blue Cross/Blue Shield. They are "non profit" in the state of Michigan. They say that they don't deny anyone. They don't... they just charge so much if you have a preexisting condition that you can't afford to get it.

    Do you mean preexisting as in trying to deny because of a baby's preexisting condition before birth? If you're covered during maternity I believe that the baby is automatically covered as there can be no "preexisting condition". If you're trying to switch coverage after baby is born then some can deny or just charge you accordingly.
  3. by   BSNtobe2009
    I do know there is a federal law that prohibits a health insurance company from denying insurance, even at a jacked-up rate, to a newborn if the mother is already covered. She has 30 days to add the infant after birth as a dependent, and the benefits must be retroactive to the date of the birth. I learned that from my Human Resource Generalist when I called to add my daughter because I was afraid they would refuse to cover her.

    I have no idea of how it would work if the mother didn't have insurance at all.
  4. by   Zippedodah
    i have a friend whose baby was in my unit. this baby was 26 weeks, had mulitiple problems, readmissions, vsd repair, caths, etc. total hospitalization almost one year. she also works at the same hospital i do. they met their million dollar lifetime cap with her. they had to apply to medicaid to cover her expenses. now, this child is no longer eligible for health care insurance for her life. if they had been on welfare, this wouldn't even be an issue. and yes, there have been families that have lost their homes, etc due to hospital bills. most places are ruthless when collecting their money and the old adage, well, if you pay $5 a month, they can't do anything is a thing of the past.

    our unit is close to $1800 per day, just for the bed. that doesn't include meds, o2, etc.

    it is so unfortunate that the working class seem to get the short end of the stick.
    Last edit by Zippedodah on Nov 28, '06 : Reason: adding
  5. by   BSNtobe2009
    I have a question, I hear all the time about people losing their homes due to medical bills, but in 10 years of working with housing loans I have NEVER seen a medical lien on a piece of property.
  6. by   Zippedodah
    it is probably because they have to sell their house to make the payments, so yes, they are losing their home. they have to rent usually after that or move in with family. this has happened to a few families that have long term kids. fair? no not at all. also, miss a payment, ruin your credit.

  7. by   BSNtobe2009
    Quote from zippedodah
    it is probably because they have to sell their house to make the payments, so yes, they are losing their home. they have to rent usually after that or move in with family. this has happened to a few families that have long term kids. fair? no not at all. also, miss a payment, ruin your credit.
    depending on how bad the debts are, as a rule of thumb, besides your mortgage, if you are in debt double your salary, you need to file for chapter 7. that is what it's designed for. selling a house or not, you still have to have a place to live and save for retirement, or else you'll be 70 and eating dog food.

    filing for bankruptcy doesn't ruin your credit like it used to. in fact, you usually get tons of credit cards to start rebuilding your credit because they know the courts won't allow you to file it again. that 's a heck of alot better than selling your home, cashing out the equity, losing all of your savings for many, many years, and then having to start all over again.

    with excellent re-established credit, 3 years out of chapter 7, they treat it like any other borrower who never filed bankruptcy, and after 4, you are usually back up to 700 score status.

    lenders also disregard medical debts when deciding to lend. we don't even take them into consideration if they are over $1500.
  8. by   Nyoro
    In Japan, national government grants cover the medical care for any child born under 2500g, which ends up covering almost all the preemies. The only thing parents have to pay for is "nutritional needs" and "room"... Non-vitamin nutritional supplements aren`t covered - thickeners, milk, etc. I guess that the room charge is some micro percentage of the NICU space. On average, it`s around $200 to $300 a month.

    I`ve never heard of any big problems with parents paying for NICU stays, even long term ones. The grant only applies for a year, but usually any care after that is covered until 2 by the city. (Depending on the city though, that can range anywhere from 18 months to 12 years.) If the child is in hospital care for over 2 years then they usually have some sort of condition that would make them eligible for some other grant.

    When my son was in the NICU (25 weeker, 437g, in for 5 months), we would get monthly statements from our insurance telling us how much was actually spent on his care, along with a tiny bill for what wasn`t covered. The first couple months ran about $200,000 a month if you don`t count the first week... The first 3 days were $50,000 a day! I can see where this would really ruin your finances - even if you were only paying 20%.

    I always did wonder how that worked in the US though - especially with drug related preemies, etc. The parents definitely wouldn`t have any way to pay... We`re lucky in that I`ve never even heard of a drug related preemie in our NICU - Japan just doesn`t have that problem. (Thank God!)

    -Nyoro
    (Volunteer at an NICU in Japan)
  9. by   gauge14iv
    In Texas they cant touch your house unless you don't make your house payments.
  10. by   Sweden
    In sweden parents dont pay for anything during the childs hospital time! Our taxes are high (about 35% on a normal nurse income) but we also get a lot back.......

    Im coming to california to work (hopefully next year) and cant even understand how your system works? Do you keep track of everything used on the baby (supplies, medicines, equipment) and then bill the parents/insurance company? :uhoh21:

    Anna
  11. by   Zippedodah
    Sweden, that about sums it up. They area charged certain things by the day, and then there are items we use that are charged to the patient. Everything we use has stickers so we just put the stickers on a piece of paper at the baby's bedside and the secretaries bill from that.

    I wish we had better coverage for all things long term.
  12. by   mauigal
    I have seen this go alot of ways. Where I work we have a one million$ cap per family on our health insurance. I have seen a parent of a micropremie get fired from her job after the baby had been in level3 NICU x8 months and the bill was well over 1million$ and still climbing, they told her to her face insurance was the reason but on paper sited poor sales. I know of many parents how have gone bankrupted trying to pay 20% of the i million$ plus hospital bill. Public assistance works for some parents.
  13. by   flowers4me
    Hi! As a mom of twins that were preemies and spent almost four weeks in the NICU I know that medical expenses can be overwhelming to say the least. That being said, what the stay costs is the VERY LAST thing on your mind when you are in that situation. I think it really depends on your insurance coverage and if you have a PPO or an HMO. My Husband carries insurance on us through his job and it is a PPO. Although we still ended up with approximately $38,000 in medical expenses to pay, many of the providers wrote off the portion of the expense that our insurance didn't cover and others obviously are accepting payments. I don't know about other states but in my state, healthcare providers can not turn you into collections or credit bureau if you make a payment every month. Believe me, especially in the beginning there were several months I sent them $5 checks. What are they going to do, repo your babies????

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