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

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u/linzkisloski Dec 20 '24

I mean if marriage is in the table why not have a courthouse wedding and add her assuming that counts as a qualifying life event under your plan. First, I would check out the coverage for you to add a spouse. It’s typically the most expensive to add a spouse vs. add dependents and the deductible/monthly costs etc will likely increase.

44

u/some_random_tech_guy Dec 20 '24

This is right. Marriage is a QLE. https://www.healthcare.gov/glossary/qualifying-life-event/

7

u/scontoFumare Dec 20 '24

Domestic Partnership can be a QLE so marriage is not required vs living together and signing something saying you're a couple and you intend to live together. Other requirements may vary depending on employer. I've had a partner covered under my plan using this.

20

u/BaltimoreBee Moderator Dec 20 '24

The majority of employers don’t cover domestic partnerships to begin with… and it’s a much more expensive way to get coverage than marriage because of the federal tax implications.

7

u/scontoFumare Dec 20 '24

Even if the majority don't, some still do. I'd say it's worth a glance over the company benefits policy just in case. May be more expensive due to tax implications but if it's an option it's absolutely worth considering. If OP and girlfriend get married that's great, but I wouldn't encourage a hospital bill and tax rates to be the deciding factors.

1

u/xxxiii Dec 20 '24

It might be more expensive than if married but sounds like anything might be better than her current coverage