Expenses for baby in first year of life

[latin2112]

Hey guys. I’m an financial advisor but I’m no expert on healthcare and could use some assistance.

My partner and I are having a baby and trying to decide between two health care plans. On the cheaper of the two plans (plan A) it will likely costs us about 8k to have the baby at the hospital. On the more expensive plan (plan B) it will cost about 4K . However plan A costs about 4.5k year in premiums and plan B costs just over 10k. So all in all well save about ~1600 having the child on plan A.

Max out of pocket for plan A is 11k deductibles are 5k each for mother and child. Plan B is 2.5k deductibles, max out of pocket 5 k.

With that being said here is my question. I’m wondering if all the doctors visit/vaccines/etc the baby will make up for the 1.6 k in savings from the child birth. From what i am reading a baby needs to see a pediatrician about 8 times by the time they are a year old (our due date is the 8th of January). Do you think our costs for the baby will mitigate the 1.6k in savings?

Any help on this matter or advice in general would be greatly appreciated as I am not very experienced in this field.

Thanks!

 

[munyaku]

@latin2112 The federal individual OOP max is $8550 for an individual. You can't spend more than that on one person on Plan A, the OOP must be embedded at that point.

Pick whichever plan minimizes your total cost. You'll have to run two calculations on Plan A since you have embedded individual deductibles and OOPs.

Pick whichever minimizes total cost, or has the network of physicians you prefer.

Without seeing the rest of the plan structures it's hard to say.

 

[latin2112]

@munyaku The 11k OOP is the family OOP. So my question is more about the expenses for the baby in her first year of life.

 

[munyaku]

@latin2112 I understand, my point is no single individual can spend more than $8550, even if the family OOP is $11k. At that point, you must have individual embedded OOP max values.

None of us here your doctor and can't predict what care your kid needs, if you're looking for that kind of advice, try /r/parenting. But you have your estimate, 8 doctor visits, so using the information in the SBC, you should be able to calculate a total cost for yourself.

 

[resjudicata]

@latin2112 Assuming a happy healthy baby (congratulations!) many of the check ups in the first year are (generally) billed as preventative- vaccines etc, so while other things may come up and it’s good to plan, it’s very likely you’ll see 0 copay and not have to hit a deductible on many of those visits.

 

[cssparks]

@latin2112

I’m wondering if all the doctors visit/vaccines/etc the baby will make up for the 1.6 k in savings from the child birth.

Most plans cover preventive services at 100%. This will be true of plans that you buy on healthcare.gov. you can see a list of all of the child services that are classified as preventive here https://www.healthcare.gov/preventive-care-children/

Also, depending on your income you may qualify for CHIP for the child.