r/HealthInsurance • u/milwaukee4 • 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
5
u/scontoFumare Dec 20 '24
Have you confirmed that you cannot get coverage for her under your policy as a Domestic Partner? A lot of comments on this thread so apologies if this has already been brought up.
I was together with a girlfriend for years without getting married and she was under my insurance through my employer as a Domestic Partner. Typically qualifications are something like living together, sharing bills, and being committed to staying together for the foreseeable future. You might sign a form from your employer stating those things.
Even if it's not the open enrollment period for your benefits, you can often change your coverage through your employer with a Qualifying Change of Life Event. This includes events like having a baby, although I think (not sure) that would add the baby at birth but would not add her beforehand for prenatal care.
In my case my girlfriend becoming my Domestic Partner counted as a qualifying change of life event. I would check on this with your employer before any other options.
And then move forward with other pieces of advice like seeing if the hospital will cut her cost share if she has to stick with her carrier and then go to payment plan. Typically you get two year payment plan for the facility bill and one year for the physician bill.
Will reiterate someone else's comment - do not get married for the sake of saving money on the hospital bill.