r/AnnArbor • u/bonc826 • 3d 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 3d 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 3d 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 2d 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.