I was wondering if someone could explain how your medical system works in the US in relation to pregnancy, birth etc...
If you do have health insurance do you still pay some money and how much??? And do you get your own doc etc...
And if you don't have private health insurance what do you do??
What system is better?
Everybody in AUS is entitiled to free health care no matter what but I've heard its a lot more complicated in the states.
Can someone help satisfy my curiousity?
Thanks
2007-08-23 20:58:03 · 5 answers · asked by Cindy; mum to 3 monkeys! 7 in Pregnancy & Parenting ➔ Pregnancy
I'll try to tell you what I know.
If you have health insurance, you usually have to pay some. How much depends on your individual (or group) plan. I would say average would be something like this: $500 deductible + 20% of the bill thereafter, up to $250,000. Anything after $250,000 would be up to you to pay. This is just an example, it does vary. You employer (or you) can choose from different plans. If your automobile insurance is anything like ours, you get the idea. As far as your own doctor...well, the doctor has to be in the "network" in order for the insurance to cover it. So, no you basically go to whichever doctor your insurance wants you to. If your employer should switch insurance companies on you, the doctor you've always seen might not be in the new company's "network" so you would have to switch. Don't get me started on how the insurance companies dictate prescriptions. (lol)
If you don't have private health insurance, you may be ellegible for Medicaid (Government medical insurance assistance). From what I understand, it is easier to get on Medicaid as a pregnant woman. I qualified for it when I became pregnant and never have before or since. It also may vary from state to state. Medicaid pays everything. 100% as far as I know or have ever heard. Odd, huh?
If you are not ellegible for Medicaid, you pay the bill yourself or die trying.
Which system is better? Yours by far--from my point of view. I might have to ask everyone about that.
(edit) I totally forgot about copays!
2007-08-23 21:15:38 · answer #1 · answered by blooming chamomile 6 · 0⤊ 0⤋
okay so if you dont have private insurance but dont make much money you may qualify for public assistance for the pregnancy and birth and maybe even after that....
if you dont have private insurance but make plenty of money you are on your own...you pay cash....LOTS OF IT!
if you have insurance it depends on your insurance...my insurance pays 80% of all pregnancy costs and delivery costs EXCEPT for the first 1000.00 dollars(deductable), which is a fairly high deductable compared to the rest of the states. After I have paid out 2,500.00 in copayments and deductables they will pay 100% but only on "covered" costs. So an example maybe an ultrasound...I paid my 20% today and it was $69.00(co payment) so that goes toward my 2500.00 I am at 2000.00 so far so in 500 I willnot pay anymore... that is a basic run down sorry it is sooo confusing and hard to write with out drawing a map lol. I do want to make sure you realize that my numbers are high due to medical costs in the state I live in being high....other states cost far less and have far lower copays and deductables.
Hope that calms the curiosity...
2007-08-24 04:12:42 · answer #2 · answered by akhoney 3 · 0⤊ 0⤋
There are 357 answers to your question, since that is how many different private and public insurance plans there are here.
2007-08-24 04:04:47 · answer #3 · answered by Steve C 5 · 0⤊ 0⤋
does not quite work that way here in AUS...yeah we get free medical but anything goes wrong and get ready to wait like two years if your not in a private health fund. get stabbed and your right as rain though....sigh.
2007-08-24 04:03:02 · answer #4 · answered by Anonymous · 0⤊ 0⤋
too confusing to explain here.
2007-08-24 04:00:44 · answer #5 · answered by KitKat 7 · 0⤊ 0⤋