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Community Corner

Bracing for Newborn Medical Bills in Hoboken

Kathy Zucker got an expensive surprise with the hospital deliver bill for her first child. See how she is planning ahead for baby #3.

Bringing home a newborn is like Christmas morning. Between the newness of being a parent and the intense wristband security at the hospital, you get the distinct impression that your baby is a precious commodity. One of my cousins once said to me, "I can't believe we get to keep him!" in reference to her newborn son.

The first month is a euphoric time of getting to know the new family member, before the effects of long-term sleep deprivation really set in. And then the medical bills arrive.

We have health insurance through my husband's employer. We had quite good health insurance when my daughter was born; United Healthcare. That's why it was such a shock to receive medical bils for several thousand dollars. I had a fairly routine vaginal delivery, was this normal?

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It appears it is.

The total bill for our two days at NYU Hospital came to a little over $12,000. The biggest charges were for basic hospitalization ($6,020), operating/delivery ($2,940) and anaesthesia ($2,075).

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I was fortunate enough to deliver at an in-network hospital so the facility charges exactly matched the insurance reimbursement rate, and insurance covered 80% of the charges after the deductible. But over the five years since I gave birth, I have noticed a distinct imbalance between the amount medical providers have been charging and the reimbursement rate from insurance. My kids' pediatrician typically receives about two-thirds of his billed rates.

What happens to the remainder? Either the medical provider has to take a write-off on the difference or we, the consumers, are responsible for paying it. Yikes.

And what happens if you go to an out-of-network physician? My husband's employer switched last year from United Healthcare to Anthem Blue Cross, and suddenly my obstetrician was no longer in network. Pre-natal care was fully covered under United so I never received a bill, but I remembered seeing paperwork when I first became a patient regarding the office financial policy, and it wasn't pretty. I asked my physician about it during my last annual exam, and I would be on the hook for about $5,000 in fees that I would then need to submit to insurance for reimbursement. The same would go for the radiologist during the frequent pregnancy ultrasounds that are intrinsic to any high-risk pregnancy. Ouch.

We have a healthcare flexible spending account through my husband's employer that enables us to pay medical bills with before-tax dollars; with four family members, odds are good we will spend that much each year. However, in 2013 that amount will be much lower since the government has enacted legislation limiting contributions.

With insurance premiums skyrocketing and coverage decreasing each year, I am budgeting about $7,500 to cover the costs of delivering our next child. At least this time around the bills won't be a surprise.

To read more about what makes Kathy Zucker tick, check out her blog at http://momcondoliving.com/ and follow her at http://twitter.com/kathyzucker

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