Cost of Giving Labor and Prenatal Care at Kaiser

I’m a PPO girl — and as of Jan 1, I’ve dived headfirst into the wonderful(?) world of HMOs. Kaiser HMO to be exact. Why? Because, although with health insurance one cannot be 100% clear what anything will cost, it appears had I stayed on Anthem PPO my pregnancy would cost somewhere between $6000 and $1M (exaggeration at the high end, slightly), whereas Kaiser, outside of premiums, would be free – or almost free?

It really is ridiculous how much childbirth costs in the US vs the rest of the world. Kaiser offers refuge to those of us who would prefer not to spend what’s equal to one year of daycare to help our child escape our uterus and enter the world.

My experience at Kaiser so far – as limited as it’s been – is mixed. My first appointment (a phone screen) was botched because apparently Kaiser didn’t have my phone number in their system. I’m not sure how that happened – they should have had it from when I registered through my work – but, they didn’t, so I sat and stared at my phone until it occurred to me that maybe they didn’t have my number. I checked my online profile and saw it was blank — but updating it just gave me a message that it will “take up to two days to update in the system.” Great…

Had I not been 9 weeks pregnant at the time, I’d be a little less stressed about the situation — but my insurance didn’t start until Jan 1 and Kaiser conveniently wouldn’t let me book any appointments until this date for any future date. I was stressed about getting the first appointment to begin with and then missing it was a trigger and set me off in a bit of a panic.

I called the number that the website said to call if I was having problems and was on hold for 15 minutes. When I did talk to someone, he was able to update my number in the system, but then he called the office where I was supposed to be having an appointment and got their voicemail. He said the next appointment he could schedule me for was next week. I agreed to take that appointment, hung up, and went back on the website out of curiosity to see if I could find an earlier appointment…

Based on my location, another Kaiser clinic came up and that clinic had in-person appointments available same day (go figure), so I scheduled myself for an appointment that afternoon. The appointment was fine – I’m not sure what to look for exactly in a good OB, but other than having me wait about 40 minutes after the nurse did a preliminary Q&A screen (which, btw, included the question that stumped me “are you sexually active?”), she was fine. One thing she said kind of rubbed me the wrong way… she recommended that I do a pap at that appointment and earlier I had told her I planned to fly across the country to deliver the news to my parents that I’m pregnant in person. I mentioned that I read online that a pap during pregnancy could cause miscarriage and she kind of rolled her eyes at me and said “flying across the country is more likely to cause miscarriage.” Maybe that was a fair remark(?) but the delivery just felt off. Plus, flying isn’t supposed to increase risk of miscarriage, esp in second trimester. I don’t even know if she was trying to say flying is a bad idea or what, it was very confusing.

After that appointment I decided I didn’t want to keep seeing her as my OB, and I’d rather go to the other clinic anyway where I had booked my original appointment… so I held on to the phone call scheduled (for today) and waited to see if they’d yell at me for making too many first appointments. I have no idea how this will be billed, but they seemed fine with starting over on the call.

The OB I want to see at other clinic isn’t available for my first appointment so I’ll be meeting with a nurse. I’m fine with that at this point… I feel like due to my infertility treatments and multiple early ultrasounds before starting at Kaiser, I’m in a good place and don’t need a massive amount of medical intervention. I need to get the ultrasound in a week weeks to see if my baby has down syndrome, and the standard blood work, but other than that until I’m later on in the pregnancy I think I’m good. I just need to focus on eating healthy since I’ve gained 10+ lbs already which is too much for the first trimester.

So, now I have an appointment with the nurse scheduled next Friday with a ton of blood work and then the NT test the following Friday. It’s a bit annoying that their ultrasound technology isn’t available at the big hospital/clinic where i’ll be going and we have to go 30 minutes south for that appointment – but luckily there are only two appointments that need to be done there (I think) and so far I’ve been able to schedule them on Fridays when I work remote. It will all be a lot easier when I tell my boss I’m pregnant so he doesn’t wonder where I’m going all the time in the middle of the day for my other appointments.

I’m curious if this Kaiser birth will actually be free or almost free. It’s possible based on my understanding of my health insurance plan. It’s just more important than ever to keep myself gainfully employed for the next six months prior to maternity leave. Which I plan to do anyway, but the additional pressure of knowing I can’t lose my insurance is an added anxiety I don’t need right now. Yes, I could get COBRA but that’s super expensive and it would be MUCH better if I can be employed through this entire first pregnancy. Once I tell my boss, I think he’ll be more understanding — I still need to do my work and do it well – but if I disappear for half the day because I need a break, he’ll hopefully see that I’m staying up late at night to make up for my mid-day exhaustion and it won’t be an issue.

Well, here’s to new experiences in 2018.

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3 comments

  1. SP says:

    For the very basic care my spouse and I have needed, Kaiser has been good. I can see why people complain, but I haven’t experienced anything. I love that they offer a choice of phone/video/in-person and make mail order pharmacy easy.

    I also have Kaiser HMO and we just started trying to conceive. It sounds like you went through someone else for fertility treatments? I don’t know if we’ll have to go that route, but I’m curious how Kaiser will be if we try to go through them. (My plan covers 50% of infertility treatment and diagnosis, but excludes IVF.) I was also surprised, it seems like a birth will cost about $500.

    Good luck with your appointments!

    1. Joy ( User Karma: 0 ) says:

      There seem to be some good things about Kaiser so far — I’ll see what I think after a year. We did not use Kaiser for infertility because I didn’t have them at the time. My current plan also has the 50% (but not IVF) coverage so if I still have them in the future I’ll prob go that route for child #2.

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