Wednesday, 28 March 2012

Comparing health costs

Counting down seven weeks to my flight home! Seriously starting to take stock of our belongings...

Was clearing out documents when I came across health bills from Singapore (don't ask me why they're here!) and here. Can't help but compare... All in local currency.

Sg - two visits in mid 2010
It was supposed to be a preconception check but we found a polyp so that was removed.

First consultation: $128
Ultrasound: $155
D&C: $2000
Histology of polyp: $140

I think I had another ultrasound follow-up so that was probably another $155.

Evanston - preconception visit in late 2010
Actually I wanted to ask about getting flu shot before pregnancy. Look at what I paid for that!

Consultation: $152 (negotiated charge, i.e. after insurance discount; originally $275!)
Flu shot: $72 (I later found out that the drugstore offered the same at $25!)

Sg - hormone blood test
TCM told me to go check out my fertility hormones...

Draw blood: $5
Blood test: $80

Evanston - first pregnancy in early 2011

Confirmation of pregnancy
Consultation: $98 (originally $189)
Doc's service (ultrasound, PAP, draw blood): $202 (originally $529)
OB panel blood test: $57 (originally $302)
HIV blood test: $18 (originally $152)
PAP diagnostic: $111
HPV test: $147

Draw blood: $31 (insurance did not cover!!)
Hormone blood test: $20 (originally $183)
Hemogram, whatever that is: $10 (originally $91)
Sonographer's fees for ultrasound: $109 (originally $206)
Hospital incidentals for ultrasound: $212 (originally $283)
Consultation before ultrasound: $65 (originally $126)
Consultation after ultrasound: $40 (originally $100)
Doc's fees for examining foetus in her clinic: $103 (originally $340)
Tissue exam in lab: $245 (originally $437)

Evanston - the whole LEEP affair

Doc's fees for colposcopy: $152 (originally $530)
Tissue exam of colposcopy: $245 (originally $437)
Doc's fees for LEEP: $254 (originally $911)
Hospital incidentals for LEEP: $5247
LEEP diagnostic: $185 (original $260)
LEEP diagnostic: $87 (originally $170; don't know the difference from above!)
F/u PAP: $100
PAP diagnostic: $35 (originally $90)
HPV test: $46 (originally $147)

Evanston - hormone test in mid 2011
Period went crazy. Doc suggested testing for ovulation.

Draw blood: $3 (original $15)
Blood test: $27 (originally $185)

She had, before the first pregnancy, suggested testing the whole suite of fertility hormones. I called the hospital for the cost and found that everything before insurance would cost just over $1,000! And my insurance would not cover that. I didn't do it of course.

Evanston - skin rash in mid 2011

Consultation with GP: $134 (originally $156; all I got was a referral to a dermatologist!)
Consultation with dermatologist: $152 (originally $200; I got expired sample rash cream!)

For the above done in Evanston, I had to pay a $250 deductible before insurance kicked in when it paid 70% or 80% or the negotiated charge depending on procedure until I had paid another $1,000 out-of-pocket! And have I mentioned the $20 co-pay every time I went to the doctor?

I felt so stupid for not doing enough research before getting the insurance! Also didn't have the time to do that back then. So of course I didn't insure myself the second year. But I managed to get state insurance when I got pregnant because of a provision for pregnant women and children, especially in zero-/no-income families. The catch? You don't get to choose your doctor and you see her interns most of the time - it was four out of five times for me.

Evanston - two visits at the end of 2011
I shouldn't have received the bill as the state insurance covered 100% from the first dollar but the insurance info hadn't got through in time so, I had a rude shock!

Sonographer's fees
First ultrasound: $206
Nuchal translucency: $185

Urine culture: $16
OB panel blood test: $77
HIV blood test: $25

Hospital incidentals
Lab: $62
Lab chemistry: $564
Lab immunology: $152
Lab bact-micro: $118 (why so many labs?!)
Ultrasound: $1044
Other RX services: $116

I think if the insurance got through, negotiated charges would apply so the costs would be lower but still!

A friend was telling me that she somehow received the bills for her delivery too. She was induced, had epidural for natural delivery and stayed in the hospital for two days. It was last year so I don't remember exactly how much but the total was in the range of $15,000!

All things considered, even though we have to pay to deliver in Sg, it's better that way. I get a doctor I trust. I have family and friends. I'm surrounded by familiar things, especially food! So yes, definitely counting down excitedly! :)


  1. Well, there is always pros and cons. For instance, your breast pump will cost less in USA than Sgp. Baby clothes are cheaper too! And baby toys are cheap too! Otherwise, why would you consider buying them in USA and shipping them back? Moreover, if you are gainfully employed with a reputable company, you get rather decent insurance too! It is almost free for the entire pregnancy!

    To be fair, USA health care is not as scary as it seems. And Sgp's is not entirely perfect either. Why can't I use all my medisave for childbirth? Why only limit to a certain $ value? Medisave is also my money right?

    There is always 2 sides to a coin. It is a matter of choice.


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