Among the many surprises waiting for you when your baby arrives: How much will the whole experience cost? The tricky part is that there isn’t a magical number that everyone pays to bring a child into this world. Thanks to the intricacies of privatized health care and insurance, pretty much every new family in America will have a different out-of-pocket expense for pregnancy and delivery.
However, you can go into the whole process knowing what to expect if you open the lines of communication with your doctor and hospital billing departments, as well as your insurance company. As Samantha Albergo of patient accounting at Northwestern Memorial HealthCare in Chicago says, “Keeping yourself well informed will lead to a less stressful pregnancy and more time with your child once they arrive.”
Here are some questions and answers to help you get started.
How many doctor’s appointments will I need when I’m pregnant?
According to Northwestern, the “global package” for prenatal care is 14 visits, plus two to four ultrasounds — one for early viability and the anatomical survey at 20 weeks. If a pregnancy is more complex, more visits will be required. Throughout the process there are also various labs, including blood draws and urine samples.
Is there an ‘average’ cost of a hospital birth?
Unfortunately, there isn’t even a ballpark, Albergo says. “It really depends on your HR policy based on your employer’s insurance, or your private insurance plan.”
There is a laundry list of what you’ll be billed for, though. “For a typical delivery (which means a healthy mom and baby with no Neonatal Intensive Care Unit stay) you’ll be billed for room and board, sterile instruments used during the delivery, labs, pharmacy if you get an epidural or any drugs [including post-birth painkillers or anti-nausea meds], the actual labor — meaning the physician delivering the child and nurses assisting — plus other types of diagnostic services, perhaps an ultrasound in the room or any other imaging needed,” Albergo says.
Does a C-section cost more than a vaginal delivery?
With insurance, a C-section actually won’t cost more than a vaginal delivery.
“Because healthcare around pregnancy is so robust, you’ll probably hit your deductible, so both types of deliveries will be around the same, unless you have an extremely high deductible,” she says.
Do birth complications or NICU stays make delivery cost more?
Yes, but again, it varies by case and by insurance. “Sometimes this is a surprise to parents, but you will get a bill for your child after birth, in addition to one for yourself,” Albergo adds. “The big charges are for specialists and ancillary care.”
Do I need to add my newborn baby to my insurance?
“You need to do it ASAP,” Albergo says. “That’s where the high dollar confusion comes in, when people realize they don’t need to take that step. Sometimes you need to notify your company’s HR, too.”
Many insurance companies give a grace period after birth — “It’s such a backwards thing; you shouldn’t be worried about calling your insurance company while you’re trying to bond with your child,” Albergo says — but with many, once your child turns 1 month old you might be out of luck.
“If you forget to add your child you will see that full out of pocket charge,” she says. “At Northwestern we try to be an advocate for the patients, and do what we can prior to billing to collect that insurance information.”
Should I notify my insurance company once I’m pregnant?
Yes — and keep talking to them throughout your pregnancy.
“It’s always good to continue to question,” Albergo says. “It could save you money — it’s always good to double check what you are being charged for, and if you’re unsure, call and ask.”
“We hear from a lot of parents having their second, third, fourth child asking why they got a bill for X amount when their bill was so much lower for their previous child,” she continues. “It’s very important you discuss with your company what physicians are in and out of network. Just because a physician is on the unit at a hospital doesn’t mean they’re in network for you. Being aware that you might accrue a higher cost because a physician rounding to see you or your child is outside your network is good knowledge to have. And it does often happen with specialists, like in the NICU.”
What do I do if I’m pregnant and don’t have insurance?
“I don’t think people realize how much labor and delivery costs when you don’t have insurance,” Albergo says. And the answer is: a lot. A 2018 Guardian article estimated the average cost at about $32,000 for a typical delivery.
“If you don’t have insurance, I would find out what your state can do for you. I’d utilize resources via the web, just walk into a hospital and ask for help,” she recommends. “I know in Illinois we try to give as much help as we can, and the best thing to do is to be transparent, get all the care that you need and worry about your finances on the back end. Make the choice for you and your child with your health in mind; as long as you are open with the healthcare system, they are always willing to help.”
Some hospitals and doctor’s offices will offer payment plans, though again, it’s something you need to discuss with your provider from the get-go.
“If we know prior to delivery that the mom and child need financial assistance, we can make arrangements,” Albergo says. “However, if they didn’t inquire about help before, and now feel they can’t pay their max out of pocket, we can negotiate a payment plan after services rendered.”
At the end of the day, “healthcare and finances are ever changing,” Albergo says. “Stay informed and hopefully everyone will have a great experience.”
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