r/HealthInsurance Dec 20 '24

Plan Choice Suggestions Girlfriend is pregnant with $3500 deductible and 20% copay

My girlfriend has Aetna insurance through her job with a $3500 deductible and $7000 OOP max. Her OBGYN gave us a paper today to sign stating that we will have to pay them $3803 for the delivery because of the $3500 deductible plus $303 for a 20% copay. It also said that this does NOT include the hospital stay fees, which I guess could be another couple thousand or maybe even another $3500 and eat up her entire $7000 OOP max.
She makes $65k a year so she won't qualify for most programs and we could pay it if we have to but I am wondering if anyone has any advice/ideas for us to help lower this massive amount? Some sort of supplemental insurance or a government program that anyone knows of? My insurance deductible is only $500 but we are not married so I don't think that my insurance can be used in any way. Even if we had a shotgun wedding could my insurance somehow be used to help?

edit: she is only 11 weeks pregnant

Thanks In Advance

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u/jumpythecat Dec 20 '24

You should have your 2025 open enrollment docs for your own plan. That would have outlined cost of emp+spouse and emp+spouse+child in terms of cost of increased premiums, deductibles and OOP. They are often significantly higher because employers don't usually supplement them at as a high a rate as an individual employee. There is sometimes a "penalty" to add a spouse that employers view as someone that could have their own insurance. So you would have to consider if the increased premiums and family OOP are even better and if your HR considers a marriage a qualifying event. Joint taxes with a new dependent in 2025 will be great when you file in 2026. You should try all options others mentioned, but her putting money into her FSA/HSA will lower her taxes. Her company may allow the HSA option at any time, if she qualifies. She might be able to get more help from the hospital if she's a single mom at $65k. You have to work the numbers to see if your family plan makes more sense.