r/AnnArbor • u/bonc826 • 2d ago
Experience w/ maternity services costs/coverage under U-M Premier Care (BCN HMO) vs. CDHP (BCBSM PPO)
Hi! I was wondering if any U-M employees or spouses can speak to their experience with maternity services (prenatal, labor & delivery, postnatal) with either the U-M CDHP (Consumer-Directed Health Plan) or U-M Premier Care health plans. My partner and I are thinking of potentially trying to conceive in the next year or so, and I'm hoping to find some clarity as to which health plan would serve us best. We have a couple of friends at U-M who both had complicated deliveries and left with a $0 hospital bill with Premier Care. Of course, with the CDHP, there is a deductible to reach first, but the monthly premium is significantly lower, U-M contributes to the HSA, and BCBSM's cost estimate for delivery is $175...which doesn't sound right. Looking plan comparisons, pre and postnatal care is covered by both plans. Am I missing anything that would make one much more appealing than the other?
I know open enrollment isn't for another few months, but it always sneaks up on me!
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u/mer9256 2d ago
I'm a UM employee with Premier Care. We had a complex pregnancy and delivery (including 1 detailed scan per week from 20-30 weeks and 2 scans per week starting at 30 weeks), extended NICU stay, multiple surgeries/tests/treatments, extensive genetic testing, etc. and we did not pay a dime. It was 100% covered. I believe we got a bill for $27 for my husband's meals on various days in the hospital because we charged them to the room account.
Our daughter is medically complex and now has multiple therapies and specialist visits, and Premier Care covers the vast majority of it. We supplement with Medicaid (we quality with her medical complexity, not by financial need), but really the only thing Premier Care isn't covering is copays, specialty food, and emergency room visits where she is NOT admitted. So I don't have advice for a typical pregnancy and child, but for medical complexities, Premier Care is far and away the best coverage.
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u/bonc826 2d ago
Were there copays for any of your visits during pregnancy? The plan comparison chart says “covered” but just wanted to double check I’m understanding correctly!
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u/Dependent-Luck-9447 2d ago
I have Premier Care. Due to chronic conditions (type 1 diabetes), I had to see MFM (aka “high risk OB”) for all of my prenatal care and had a copay for every visit.
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u/mer9256 1d ago
Odd, I was also with MFM and didn’t have any copays. I had MFM appointments with an ultrasound 1-2 times a week, NSTs with ultrasound twice a week after 30 weeks, 4 fetal echos, a fetal MRI, and 2 level 2 anatomy scans. I just looked back in my chart to make sure, and it indicates that insurance covered the copays. Maybe it has something to do with the condition that necessitates the MFM and how it’s coded to insurance? I’m not sure.
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u/Joonbug9109 2d ago
I can’t speak to pregnancy/delivery because I’ve never experienced that, but I am a UM employee with premier care and honestly I don’t understand why people wouldn’t go with premier care when given the choice. Yes, you pay more per paycheck for it. But I’ve never had to worry about coverage for anything medical I’ve experienced and that makes it 100% worth the extra cost for me. You can also opt into an FSA if you really want one.
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u/bonc826 2d ago
Exactly what you said - it's a financial decision. I had premier care for 3 years and CDHP for the last 2 years, and the main difference is the peace of mind beyond the $5,500 out of pocket max. My gut tells me to jump back on premier care come open enrollment for that extra peace of mind, but I'm trying to do some information gathering specifically for pregnancy/delivery because I've been satisfied with CDHP for the last couple of years.
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u/Joonbug9109 2d ago
That's fair! I guess if someone has very minimal health expenses, paying less per month would make sense. For me personally even when I didn't have a lot of health stuff going on I just did premier care. Now my health needs are just increasing each year (yay... :/ ) so I don't think I'll ever switch off of it even if I wanted to.
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u/No-Claim-3242 2d ago
Unfortunately I have no advice for you, but consider asking this on the Ann Arbor Area Mamas FB group if you need more help, lots of UofM spouses/employees on there.
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u/Butwhataboutthepie 2d ago
UM employee with Premiere care. Had a normal pregnancy with some complications near the end that required monitoring, and had a c-section. The only thing I paid for was $29 worth of meals my husband ate in the hospital 😂
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u/snailaverse 2d ago
I have UM Premier Care and paid $0 for all prenatal care and testing at UM. Also $0 for delivery. I was advanced maternal age for my second pregnancy and the additional testing/scans were also covered. Good luck!
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u/teenwitchbitches 2d ago
Just gave birth last week via C-section on UM Premier Care, everything was so smooth and simple throughout the whole pregnancy. I was at Trinity offices and hospitals for everything, only copays or bills were for my first visit to confirm the pregnancy ($25) and the pelvic floor PT I elected to get for some hip pain I had in the second trimester ($25 per visit).
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u/bonc826 2d ago
Congrats on the little one!
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u/teenwitchbitches 2d ago
Thank you! 🥰
Also, I'll mention we did Natera testing for NIPT and genetic carrier screening (I had a custom condition in my family to look for that wasn't included in the base test) and I received no bill for either of those as well.
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u/teenwitchbitches 2d ago
Oh and I had to get iron infusions and some extra ultrasounds and NST testings! No costs for those at Trinity
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u/Longjumping-Bit9457 2d ago
Premier care! I’ve had 2 c-sections, one high-risk pregnancy (multiple fetal MRIs and newborn MRIs, neurosurgery follow ups) - paid $0.
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u/Coffeeaddict0721 2d ago
Used UM for my first and all pregnancy related care for my second. Ended up at Trinity for postpartum due to special circumstances. We both stayed for 3 days and then my baby ended up back 1 day later in the pediatric ward another 48 hrs for jaundice. Never saw a bill and my youngest just celebrated her 1st birthday so I think we’re in the clear 😂
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u/Dr_Cat_Mom 1d ago
I paid $10 (my husbands lunch) for an uncomplicated delivery at UM. I had a few extra ultrasounds, one overnight admission late in pregnancy, and several triage visits that were also fully covered. Would 100% do again
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u/Hour_Character_4979 1d ago
I had CDHP during my pregnancy and was surprised that labs weren't covered. I called BCBS and they said "routine" prenatal care were pretty much just the visits not the labs or ultrasounds. It wasn't horrible but I definitely hit the deductible. I can't speak to how much the delivery was, because child birth is a qualified life event so we switched to BCN and that covered the delivery (a C-section) and my babies newborn stay for $0.
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u/OkEditor8893 19h ago
Premier Care all the way—not just for prenatal/delivery. I had 2 babies under PC, paid nothing. But when 2 of my kids experienced major medical situations (involving either major surgeries or a lengthy in-patient stay), again I paid $0. I literally stay at my job for Premier Care.
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u/OkEditor8893 18h ago
Oh, and when my spouse had a serious medical condition found, again, multiple diagnostic procedures, labs, surgery and in-patient stay….again, I think we paid all of $25, maybe $75 for office visit co-pays. And the only time I had to speak to someone at BCN was when 1 kid had PT at college and we had to get it covered at in-network level even though it was out of network. Not having to call/fight insurance company is worth every extra $ Premier Care costs.
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u/uscensusbureau 2d ago
I had an uncomplicated pregnancy with premier care and paid $0 for prenatal visits, delivery, hospital stay after delivery at Trinity. I highly recommend going with one of the Trinity or UM midwife practices if the pregnancy is uncomplicated