by Nate Dallas
For all three of the situations above, there are additional options, but we must first consider traditional insurance.
This information gathering stage can be a time-consuming task. You must call these companies and find out what is covered by the plans, how much it costs, and what the limitations are. Ask questions until you understand. You cannot determine what the most cost-effective option is until you get all of the information in front of you. If you live in the U.S. and the Affordable Care Act still exists at the time you are reading this, the government healthcare marketplace website is probably a good place to start. Search there to see some options, then dig further into each option by calling the companies that offer the plans. If you are a high-income earner, you will find that you don’t get any help and you are expected to pay exorbitant premiums. The current system punishes you. Sorry. The hard truth is that you aren’t just paying for your family. You will, in essence, be paying for six or eight people who pay nothing. Again, no such thing as a free lunch. Once you have a clear understanding of deductibles, maximums, coverage amounts, and waiting periods, then you must determine if your providers accept these insurance plans, and if they are in-network for them. Call the obstetrician’s (OB) office that you plan to use and ask them what plans have the best coverage and which ones they accept.
An additional option to consider is funding an HSA (Health Savings Account). This is a tax-advantaged savings account that you build up over time and use only for medical expenses. The same account can be used for medical, dental, vision, and pharmacy expenses. You just have to report how much money was deposited into it and how much was removed for medical expenses at tax time each year. The benefit is that you get tax deductions for using this type of account. The only way to participate in the HSA with the tax benefits is to be enrolled in an approved, high-deductible medical insurance plan. Personally, I like this route and use it myself. Since it’s a high-deductible plan, that means that insurance coverage will only start once your total bill exceeds the deductible amount. This also means that you will need at least that amount saved in an account. Hopefully, you have an emergency fund stashed away somewhere. If not, start putting money into a savings account every month. Like, go do it right now. I encourage you to make these deposits an automated monthly event so that it happens without you needing to physically do anything. Your bank can set this up with no cost to you. If you bank online, there is probably a simple form on the bank website to do these sorts of transfers. This automated saving system is a life hack, not just a childbirth hack. Everyone needs to put away cash for a rainy day or an emergency. Having a decent amount stashed away creates security and peace of mind.
Back to the HSA plans. Some of these plans do not have maternity coverage, so look closely and be sure to get the right one. These plans are helpful when you have some money in savings and you just want to prevent BIG bills or a catastrophic hospital visit. The hard reality is that you will pay for the delivery one way or another. You will pay it in premiums for an insurance plan that covers it, or you will pay for the portion that the cheaper plan doesn’t cover. It’s expensive, unless you qualify for some assistance from the state, from a federal plan, from an employer, or from the hospital itself. The key is having protection from unforeseen events that you could not afford to pay if something goes badly wrong. Staying in the hospital for extended periods, having surgery, or receiving prolonged treatments can quickly get ridiculously expensive.
So, what’s the right option? If you can get on an existing plan with a spouse or join a policy at work, that’s likely the best option, as the employer pays part of the premiums. If you are on your own, it’s different. On your own, if you have a routine pregnancy and delivery with zero complications, you are much better off just paying for the services outright (with the negotiated discount techniques that I will show you later in the book) and not using any insurance. In other words, by the time you pay premiums for 12 months (waiting period) + another 9 months (pregnancy and delivery), you would likely have been able to afford to pay cash for the whole thing anyway and come out better on the total. You just need to do the math. However, if you go with the uninsured route to save money, it’s risky. If you don’t have coverage, and something non-routine happens, the prenatal hospital bills can skyrocket. These events are exactly what insurance is for. If your spouse becomes high-risk during pregnancy because of placenta previa, preeclampsia, twins, low birth weight baby, or any other issues, you will need to see a specialist, which will certainly cost more. If you need a C-section instead of a vaginal birth, the bills just went way up again. A single extra night in the hospital can add thousands to your bill. An extra few days can get ugly real quickly. Obviously, the problem is that there is no way to predict these things. That is why you should be prepared and have some coverage in place for the worst case scenarios.
There is one other item that is imperative for you to understand. Once the baby is born, he will be on his own plan. If there is a problem, and the new addition has to spend eight days in the NICU (Neonatal Intensive Care Unit) at the hospital, that stay is not typically classified as a maternity service. Once the little one enters the world, he will have his own patient record and his own set of bills. If you have an active insurance plan in place, you just call the insurance company (usually within 30 days) and add the new addition to the plan as soon as you have a Social Security number for him. The services provided to him would be retroactively covered as long as you get the policy soon enough. In the case of a high-deductible HSA plan, the deductible is usually a family combined deductible. Again, make sure that you understand your deductible, her deductible, and if they will be combined under a family deductible.
I know this topic stinks and is starting to irritate you and cause anxiety, but stick with me for a few more minutes. We’re almost done. This final part is a downer too, but again, very valuable to understand. If you presently have or later obtain coverage, don’t assume that the policy is what it says that it is. The website will say that it pays 80% of labor and delivery, but that doesn’t mean that it will pay 80% of what the hospital charges. Most people don’t realize this deceptive truth. The insurance company pays 80% of a preset amount that the insurance company thinks is a fair price based on their pre-set fee schedule, not what the hospital charges. So if a procedure is $1,000 at the hospital or OB office, and the insurance company thinks the procedure limit should be $750, they pay $600 (80% of $750), not $800 (80% of $1,000). Oh, and don’t forget, that’s after the deductible has been met. Guess who is expected to make up the difference? YOU! So it’s imperative that you ask questions when shopping for plans. Get as much information as possible from the doctors, hospitals, and pharmacies about what the bottom line looks like. Don’t just read a form or browse a chart online. Call the company and speak with a knowledgeable person. That in itself can be difficult. If you find a helpful, knowledgeable, polite employee, ask for her name and a direct number. Heck, send some chocolates if you can. You will need a go-to person like that on your team in the future. One of the most important details of the insurance plan is the out-of-pocket maximum. Regardless of how much the insurance plan pays or refuses to cover, you need to know what the maximum amount that you could possibly owe. Keep in mind that there is usually a separate entity that will bill for services by each office or department, like the hospital, doctor, anesthesia, radiology, labs, etc. You need to make sure that all of them accept your plan so that they all combine and contribute to the deductible and the out-of-pocket maximum.
The bottom line is that having good insurance is expensive, and not having insurance is also expensive. I think it’s illegal not to have any coverage nowadays, but I’m not sure if Washington D.C. has figured out a way to monitor, enforce, or punish the crime. If you don’t have cash stockpiled somewhere, start now and keep adding to it, even if you have great insurance. If you have plenty of cash saved, you still need a plan to help protect the family in case of complications and unexpected ser
vices that may skyrocket the numbers by tens or hundreds of thousands of dollars. Even IF you don’t read this entire book, please listen to me right here. There is a major money hack and something that few people ever know or practice later in this book. DO NOT make any payments for medical services for mother or baby until you read the chapter on negotiating and paying bills. In that chapter, I will teach you how to negotiate and reduce every bill. Fifteen minutes on those tactics will save thousands of hard-earned dollars.
Whew, that’s enough for now. I’ll talk to you about how to negotiate fees and the right way to go about paying for all this in a later chapter. For now, start determining what option is best for your family as it relates to monthly budget and risk tolerance. Preparation is key. Knowledge is power. Surprises stink.
15 MONTHS BC
How to Build a Superhuman
Sometimes we like to poison our kids, just a tiny bit at a time. You know, to make ourselves feel better. Discipline is such an inconvenience to our busy lives.
Disclaimer: I know that this chapter may offend some, but I am confident that most people who would fit into the offended category probably don’t read books like this one, so we will trudge forward and hope for the best. I am not trying to be unsympathetic or overly-aggressive, just honest. I’m confident that even if it makes you irritated, you will agree with me, and maybe even find it in your heart to thank me one day.
We want the best for our children, right? Parents will unconsciously say things like, “I’ll do anything for my kids,” or “My kids are my number one priority.” It’s much easier to say these things than to practice them. I guess it makes people feel better if they say it out loud. If we look at their schedule and their bank statement, we may see a different priority than what is readily spoken. No one wants to admit their own selfish desires taking precedence over that of a child’s needs. It’s unlikely that you have ever heard someone say, “I’ll do anything for my children… except change my diet, wear cheaper shoes, drive a beater car, and stop smoking.” The truth is that some will do anything as long as it doesn’t require working harder on a marriage, forfeiting favorite purchases, or adding more effort or expense. We don’t hear anyone admit it, but this attitude is, all too often, true. We could go into a hundred different required sacrifices that are necessary for a family to thrive, but this chapter is focused on the physical health of the entire household. Hacking physical health, like all other success, requires some preparation. Hacking a new child’s health starts with you.
Two of the most important elements to total health, in any stage of life, are rest and nutrition. These only come with deliberate and disciplined systems. When a baby arrives, every area of your life is shaken. An entire new way of life is demanded when a totally dependent newborn shows up on the scene. If you want to really be good at handling these life changes, it’s necessary to work out the bugs many months in advance. Rigid schedules and fortified boundaries must be constructed early if we are to prevent the chaos that ransacks so many homes.
The only way to provide optimal nutrition for the bun in the oven is for the new mama to eat an ideal balance of real food. When I say real food, I mean something natural that came out of the ground or had a mother. Furthermore, these food items have not been reconstructed, modified, or fortified in an effort to make them an attractive neon color, kill pests, make them super sweet, super cheap, or prevent them from ever decomposing in a box the way that real food should. The only way for Mom, the developing baby, and the later newborn baby to get optimal nutrition is for the entire household to subscribe to a better way of living. More specifically, the family needs an optimal method of eating well and staying fit, and that certainly includes you. When I said in the beginning pages of this book that this wasn’t for everyone and that it would be a life change, I was serious. If you aren’t there already, now is the time in your life when you get serious about nutrition. Diets and fads don’t ever work because they are temporary. Wellness is a lifestyle, and it must be non-negotiable if you are serious about your role as a family leader. It’s time to take the plunge and do it the right way, for the whole family. You are the one to lead the revolution in your house. Without you participating, and preferably leading, it cannot be sustained. Your family needs you for this. Do it for the baby, do it for your wife, and do it for yourself. Everyone wins when you execute the plan well. It’s time to start moving more, eating better, and dropping the bad habits. If either of you almost-parents smoke, you gotta kick it. If you eat poorly, now is the time to change that. If the most exercise you get is walking to the refrigerator, you need to start an intentional workout program. I’m not saying that you go all the way from couch zero to CrossFit Games hero today, but it needs to at least start today. Add a healthy practice that is attainable, like working out one more day a week. Once that is routine, add another step. It takes time.
This discussion is about more than just eating well so that the developing baby has all the vitamins and minerals he needs. That alone should be enough to make you want to change your life. We know that Mom is eating for two, and that the growing child can only have access to what she eats. Mom needs to be healthy so the baby can be healthy. We get it. But there’s more to it than just child development! Here is where the hacking comes into play.
There are some groundbreaking food studies on babies’ nutrition and habits during childhood that are directly linked to the mother’s food choices while pregnant. Yes, what she eats while pregnant affects the baby’s eating habits after delivery. We know the immune system develops better with better nutrition, and so do the other systems and internal organs that are being formed. What is fascinating and extremely useful for developing the baby’s eating habits is that the same foods that mothers consume end up being the ones more preferred by the baby as he grows. What an amazing parenting hack! We can teach a child how to eat before we ever pick up a spoon or a sippy cup. What a gift for your baby. We can actually pre-program them to like good food instead of bad food. If Mom eats a lot of spinach while pregnant and/or breastfeeding, the baby will likely have more of an affinity for spinach in the early years and beyond. If she gorges on doughnuts with icing and sprinkles every morning, she just set up your child for some future struggles with the very same sugary vises. One hard truth that no one wants to admit is that childhood (type 2) diabetes, which was once called adult-onset diabetes, is an illness almost exclusively caused by poor choices. Some parents are actually giving their children diabetes by pre-conditioning them to love sugar, and constantly giving it to them as they grow. In my mind, this is a form of unconscious child abuse. This is too much guilt to ever bear, so let’s just avoid it. Also, life is hard enough without unwanted addictions. Don’t force your child into a compromised disadvantage by gifting them a sugar addiction. It has been proven that in young infants and toddlers, greens and other healthy vegetables are turned away more by babies who did not receive them in breast milk. But now we know that it’s not just breast milk. Further studies have shown the same results for babies in utero, based on Mom’s diet, even before breast milk, and even in kids that are exclusively formula fed. So even if you bottle feed your newborn, if Mom ate well while pregnant, the child will prefer better food and be less likely to dislike them later. This hack only works if we commit to doing it early enough. This is like retirement planning in that it’s pretty easy to come out ahead if you start correctly and put in work early enough, but it’s a mountain to climb and tons of work if you miss the early steps.
My kids are living proof of this. They eat raw veggies like they’re going out of style. They also think a six-ounce, non-colored, organic juice box is an amazing luxury. Other parents say things like, “Man, I wish mine would eat a salad like yours do.” They assume that we are just lucky, that we won the genetic lottery, and they were unfairly punished. They have no idea that is was an early and deliberate conditioning hack. There is a major soapbox speech that I could give about who buys the groceries and who runs the
house, but no one wants to hear that. For the sake of brevity, I will remind you of something embarrassingly obvious. Your two-year-old can’t eat Skittles or drink Mountain Dew unless you purchase them and then hand it over. He cannot be approved for a debit card and go shopping. People will make passive aggressive comments about your child’s eating habits, but no one will ever commend you on being smart and disciplined, unless they are gloating with you in the same success. My kids each have their favorites and all have different tastes, but they eat what their parents eat at every meal. We all eat real, healthy food. Avocados, broccoli, brussels sprouts, tomatoes, cucumbers, peppers, asparagus, and every fruit you can think of, are all on the weekly menu for all of us. (A lot of this is grown in our own garden… #GroceryHack #FinanceHack). Sure, we have our moments of defiance and coercion when introducing new foods. But you can bet your wallet that my wife has never said, “Lil’ Dallas is such a picky eater. He will only eat fried chicken strips, gummy bears, and cheesy fries.” I’m sure they would like these things, but they are not available, and therefore, are not missed. Their systems learned early what real foods they will eat. They also indirectly learned what not to eat. For the first few years before we got the grandparents fully on board with the no-junk, all-natural foodie thing, they gave lots of treats and sweets to the boys. That’s what grandparents do, right? The ones in our family did too, for a little while anyway. Before we got a handle on the junk food and treats, our kids would come home from an overnight visit with grandparents and actually be sick. They would be lethargic all day once they returned home, probably from the sugar crash. Their little engines were wrecked from the malnutrition. Many times they would actually vomit. Their bodies were rejecting the junk food that was invading their healthy, well-trained systems. It reminded me of the scene in the Supersize Me documentary when Morgan Spurlock eats his first value meal from McDonalds and pukes before he finished the fries. Prior to the binge, he was a vegan and a real food consumer. Even if you are late to the game, you can still train them to eat the right things, but it’s a whole lot easier if you start pre-pregnancy and if the whole family is on board. Work smarter, not harder. The smart approach on the front end is way easier to pull off than trying to fix these same problems with a defiant two-year-old in the high chair at your favorite restaurant. Everyone benefits with healthier bodies, better rest, more energy, and a sense of well-being.
