Pregnant with a different insurance plan and office from previous child, I’m so confused with how this is being billed.

Hopefully Reddit can help, if not, tell me who I should talk to (doctor’s office, or insurance company?) I worked in healthcare and am familiar with billing but still can’t figure this out!

I had Priority Health through my employer my first pregnancy, I didn’t pay a dime the whole pregnancy, including all ultrasounds and visits, and it was wrapped up into the global period and got one big bill at the end for $2,500 for everything.

This time I have Anthem BCBS through my husband’s employer. I’m 12 weeks along and due in March. I’ve already gotten a $120 bill for bloodwork to confirm the pregnancy, charged a $60 copay for my first visit, and I see another $195 charge coming from that initial visit (ultrasound and standard 99213 visit)

I looked at our plan and it says:

Pregnancy office visits $30 for first visit then 20% coinsurance (my typical specialist copay is $60, which is what they charged me at the start of the visit…was that maybe an overcharge since they didn’t have access to my benefits and I didn’t know better?)

Childbirth/delivery services 20% coinsurance

our deductible is $3500 and out of pocket max is $8500

the office I’m using this time is affiliated with the hospital I’ll be delivering at and is all billed to the same place.

I looked at the plan’s cost estimator for Routine Obstetric Care, which says includes pregnancy care, standard vaginal delivery, and postnatal care, and my estimated total was about $2,000.

Should I anticipate this pregnancy and delivery will cost about $2,000 total, but this time I will receive bills throughout? Does my deductible and the fact that I will deliver after January 1 factor in at all? Meaning, could I end up paying some mystery number more than $3,500 even if my pregnancy remains normal and boring?

See also  Selecting insurance options!

Forever grateful if someone can make this make sense, or tell me who I should talk to! I didn’t anticipate getting billed like this and was hoping to just pay at the end with our tax return like with our first child.