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Teena & Joe

Questions About Medical Bills?

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I don't know if this question has been asked, but I noticed that on our application there was an asterik saying that prenatal/birthing/medical expenses weren't covered by the adoption cost estimate. I understand that these are case specific, but is there typically a huge amount that we need to save in order to cover these costs? Or are these costs sometimes covered by Medicare or insurance?

I was hoping to get some sort of idea of the cost so that we can start saving (aka, me not spending money unnecessarily when I should be saving!!!)

Thanks!

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It really is a case by case estimate. You might want to ask Angela or one of the Abrazo girls. They can be a little more specific.

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. . .there was an asterik saying that prenatal/birthing/medical expenses weren't covered by the adoption cost estimate. I understand that these are case specific, but is there typically a huge amount that we need to save in order to cover these costs? Or are these costs sometimes covered by Medicare or insurance?

Mona provided me with a rough estimate of the hospital costs based on no insurance.

Cathy

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In answer to your question: each adopting family deposits an initial amount of $3k into the agency escrow account, to be used for case-specific expenses, the sum total of which depend upon the maternity needs related to any case to which you commit, in addition to other applicable costs, such as overnight deliveries, color copying, staff travel on your behalf, legal fees and court costs, foster care if needed, medical bills, etc.

Every month each adopting family receives a copy of their ledger, showing what has been spent; every month prior to placement, the family submits funds to maintain the balance at the same level. At placement, the balance of the agency fee and the remainder of all anticipated costs are due in full; after finalization, any funds remaining in escrow are refunded to the adoptive family within 30-60 days after a copy of the adoption decree has been provided to the agency.

Many of Abrazo's birthparent clients do qualify for Medicaid or insurance coverage; however, if such resources are unavailable, cancelled or coverage is denied, adopting families are liable for all pregnancy-related medical bills (which average $7-10K in a "normal" normal delivery.)

Total case costs, assuming Medicaid or insurance coverage is applicable, typically run $13-19K, including the agency fee; however, please note that costs may run higher or lower, depending on the needs of the case with which you choose to match. (Written estimates are routinely provided in advance of every match, and adopting families have the right to match or not as they see fit.)

Should either party in a match opt to withdraw from the plan, actual funds already expended are lost (and Texas law does not permit agencies to seek repayment from birthparents on behalf of adopting families.) Birthparents are not "entitled" to financial support; any such assistance must be given only by the agency in accordance with a social services needs assessment completed by degreed agency staff. Direct payments by adopting families or gifts of value are never allowed.

Hope this helps give you an idea of how this works. If you have more specific financial questions, please feel free to contact our family services coordinator at 210/342-5683.

I found this on one of the threads. I thought it might help with your questions.

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Thank you very much for this information. It definately helps understand the anticipated costs.

Cathy

Edited by Brian and Cathy

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Thanks so much for that info. I really appreciate it! I'm guessing I'll find out lots more at orientation. I can't wait!

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I received this press release by e-mail today:

The cost of having a baby, from the first prenatal visit to the baby’s delivery, averaged roughly $7,600 for an uncomplicated birth, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The total, in 2004 dollars, includes payments for hospital childbirth, prenatal office visits, prescription medicines, and other services.

AHRQ also found that:

• Average spending for prenatal care for women with private insurance and women with Medicaid was about the same—approximately $2,000. However, their inpatient delivery costs differed: $6,520 for the former and $4,577 average for the latter.

• On average, privately insured women paid about 8 percent of their total expenses for pregnancy out of pocket, or about $660 for a privately insured woman with an average level of expenses. In contrast, women on Medicaid paid only about 1 percent out of pocket.

• Only 23 percent of women had some prescription drug expenses associated with their pregnancy and the median amount of these expenses was $640. About three-quarters of all prescription drug expenses during pregnancy were for nutritional products such as prenatal vitamins.

AHRQ, which is part of the U.S. Department of Health and Human Services, works to enhance the quality, safety, efficiency, and effectiveness of health care in the United States. The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey (MEPS), a highly detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid.

Abrazo's cost estimate for child birth is obviously very much in line with the results of this study.

Here is a link to the study.

Edited by John&Nina

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We're not sure whether it's blowback from the healthcare reform act or what, but recently, we are seeing a huge (and horrifying!) jump in medical bills in healthy newborn cases.

One family's insurance got a nearly $9k bill-- for the pediatrician's care, alone! We've gotten several hospital bills lately topping $13k for single babies discharged in the routine 2-3 day's time, which is more than four times what Abrazo typically collects from adoptive families for baby's hospital care at placement.

(We're also finding, suddenly, that fewer local pediatricians are willing to see babies being adopted for single visits outside the hospital, for some reason? We've found one or two who will do us a favor and get our clients in, but only on a private pay basis, because they don't want to have to mess with insurance.)

And keep in mind that a mother's Medicaid coverage does not apply to her baby if relinquishment is being done before she leaves the hospital, unless the hospital bills baby's costs to Medicaid in error? And such coverage can be reversed and charged back should Medicaid learn the child is not in her care.

Rest assured, we're fighting outrageous medical billings as best we can, but we don't yet know whether this is a fluke or a trend, so just be forewarned...

http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html?pagewanted=all&_r=0

http://www.nerdwallet.com/blog/health/2014/03/27/having-a-baby/

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Wow this is scary...

Elizabeth, I'm wandering if this cost is discounted at all? I work in 4 hospitals in Pennsylvania, all of which offer discounted rates to cash paying patients (after all participating insurances don't reimburse the hospital the full cost of the hospital charges, but rather the reimbursement rate they have contractually worked out). You may know this already (and probably do!) but thought I would ask anyway.

Thanks!

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Sometimes, if we age the bill out, they'll offer up to a 40% discount (depending on how desperate the provider is?) This does necessarily delay finalization sometimes, however.

The only other discount sometimes offered is a pre-payment plan, which we do not do, since the agency does not accept responsibility for hospital bills in advance of relinquishment (which happens no sooner than 48 hours after birth.)

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I can attest to higher medical cost. Chris' recent appendectomy was sky high. We owe the hospital and various doctors a lot after our really good insurance covered most of the bill. The insurance person at the hospital told me gone are the days of 100% coverage on anything.

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We just went through this and it was very Scary at first! It was a normal delivery and the hospital was asking for WAY more than the $13k as Elizabeth stated above. We had to wait it out for a while and still had issues along the way. We are happy to say that that chapter is wrapped up. Thank you Abrazo Chicks! We know our case was a ton of work!!!!

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Judy-

I'm so glad it all got sorted!

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So glad that's done Judy!!

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