Insurance question - NYC Teachers??

My husband is a NYC teacher and I am under his insurance. I was wondering if you can give me any information regarding the hospital stay and what they cover and don't - in terms of co-pays, etc. Also, anything we have to do before or after??

Re: Insurance question - NYC Teachers??

Im a city teacher also and all of my doctors appointments have ben $15 co pays (I have ghi) but i have no idea what it covers regarding the hospital yet...good question though

Re: Insurance question - NYC Teachers??

Well, it depends on what insurance you have. If your provider is GHI like mine then the following info will be of help. So far all of my pre-natal care and screenings have been covered with a $15 co-pay. The hospital co-pay is $350. Your child will be covered for the first 30 days. Your husband should add your DC as a dependent ASAP thought, I was told that submitting hand and foot prints will suffice until the birth certificate arrives. Also, be sure that he adds DC to UFT Welfare as a dependent for prescription coverage. Have DH call his UFT Borough Office and speak to a special rep. for further assistance or more specific responses. Every UFT office has a special rep that handles maternity questions.

ETA: GHI covers at the hospital including a room with only 1 other patient (single rooms aren't covered).

Message edited 8/10/2009 6:21:48 PM.

Re: Insurance question - NYC Teachers??

I am GHI as well (husband's plan). EVERYTHING was covered. i paid a co-pay at my very first pre-natal visit and NOTHING since to see my OB. (and you go once a month and then 2-3x times a month at the end and I never had a co-pay). Sonograms were $15.00 co-pay each and bloodwork was $15.00 co-pay (I think that was about 3x).

In terms of the delivery and recovery: Everything was covered except the $300.00 deductible. (So your hospital room, OB, nurses, anethiesologist, recovery, etc. is all covered). Also, any neonatologist or pediatrician looking at the baby while they are in the hospital is covered. Baby is covered for the first 30 days under DH and then once you have his/her birth cert. you add them to the plan. (There is a form to fill out). Also, call the Welfare Fund (to be added to his Rx coverage).

Well visits (expected visits for check-ups) for the baby with the ped. have no co-pay.

DH has the optional rider, so I don't know if that makes too much of a difference; I don't think it does in this case.

Also, non-health insurance related, but he should also call the NYC-TRS and add the child as a beneficiary to what's in his pension plan God forbid anything happened to him, you and the baby would be the beneficiaries.

Re: Insurance question - NYC Teachers??

Thank you very much for the info. I'm actually 35 weeks now and haven't had to pay anything at the doctors for quite some time. Before that it was teh 15 copay and that also was the case for all ultrasounds, special bloodwork and my high risk doctor. I was unsure about the co-pay for the hospital, but now I'll be ready. My hospital only has double or single rooms. During my tour, they said the single rooms aren't extra charge - just a first come first serve basis. That should be covered - right?

I'll make sure to tell DH to put the baby on when he is born and call the Welfare Fund, as well as deal with the TRS people.

THanks again!

Re: Insurance question - NYC Teachers??

Posted by Jenise

Im a city teacher also and all of my doctors appointments have ben $15 co pays (I have ghi) but i have no idea what it covers regarding the hospital yet...good question though

Re: Insurance question - NYC Teachers??

Posted by JennB

Posted by Jenise

Im a city teacher also and all of my doctors appointments have ben $15 co pays (I have ghi) but i have no idea what it covers regarding the hospital yet...good question though

same here, but when I have a sono the copya is $30 for some reason....i have to double check that tho bc i just got a statement and it shows my co-pay as being $15 for sonos

Re: Insurance question - NYC Teachers??

Re: Insurance question - NYC Teachers??

Posted by MrsAT

Posted by JennB

Posted by Jenise

Im a city teacher also and all of my doctors appointments have ben $15 co pays (I have ghi) but i have no idea what it covers regarding the hospital yet...good question though

same here, but when I have a sono the copya is $30 for some reason....i have to double check that tho bc i just got a statement and it shows my co-pay as being $15 for sonos

If you have GHI your co-pay shouldn't be $30...it's clearly stated on your GHI card that the co-pay is $15