Has anyone used United Refuah for pregnancy and bi...
# general
p
Has anyone used United Refuah for pregnancy and birth related costs? What was the process? Would you recommend?
m
Very curious as well!
p
When my wife was pregnant, her OBGYN was very expensive (temporarily) as they just started with the new 3rd party billing company and weren't giving discounts to cash patients. (that's not so common, and apparently a few months later their billing practices were back to normal) United Refuah has limits how much they're willing to get "ripped off" (generally up to 150% of what Medicare pays for the same service codes, but for childbirth they have specific maximums, I'll post soon). So they advised us to either explore using a different provider, or see how much it'd cost to get a proper insurance plan on the NYS marketplace and they'd pay the premium meanwhile - saving us all that extra money. Hashgach Protis - when I put our info into the NYS application - they put my wife on Medicaid for free - because she was pregnant - even though we were higher than the limit for pregnant women, so I cancelled United Refuah for her,,,
The maximum amount eligible for sharing for global maternity physician services and routine fetal ultrasounds is $7,000. This includes all antepartum, delivery, and postpartum physician services, as well as one ultrasound per trimester. In addition, the 20-week anatomy scan ultrasound will be eligible for an additional $500 sharing allowance. Lab fees for a routine pregnancy without complications are limited to $1,000. Hospital charges for routine labor and delivery without complications are limited to $25,000. Anesthesiologist charges for an epidural are limited to $3,500 for routine labor and delivery without complications. Expenses related to the use of a certified doula or labor coach are eligible for sharing up to a limit of $300.
They claim these numbers are generally sufficient to cover normal hospitals, as long as they bill reasonable. If there's complications during birth - these limits don't necessarily apply. Seems like it falls back to their default rule of 150% of what Medicare would pay for that exact CPT code. They claim they put that there as a "safeguard" top all sharing members in the community, as if not the same exact care can cost 20x the amount without negotiating the bill down to what insurance typically pays - and that wouldn't let them keep charging these crazy cheap monthly "premiums". And I see that making sense. I once had to get an H. Pylori stool test and I was out of town - the lab wanted to charge me $226, when the same exact lab test costed me $22 (at the same lab - Quest diagnostics) after United Refuah negotiated them down / repriced the bill for me
Thanks for sharing the experience! Women get Medicaid for more easily, very important to be aware of. Recently, my family was not able to qualify for Obamacare in a way that would be reasonable, but my wife was able to get on Medicaid while pregnant, and children at a mid level chip program (there is a 75 premium) and I am using united refuah as a sort of “catastrophic” plan. It seems like up to a certain threshold, united refuah is far more expensive per incident, but for many people, the savings in monthly premiums make it worthwhile vs some higher premium lower deductible plans. Medicaid is always the best option especially for childbirth as it is totally free
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Can you please elaborate what you mean "It seems like up to a certain threshold, united refuah is far more expensive per incident" As far as I've seen, the "deductible" ($500 for single plan) and total copay's of 20% (max an additional $1,000) is much lower than almost all insurance plans. (Obviously besides for Medicaid and CHIP and even Essential plan)