Miscarriage Is Devastating — and Then the Bill Comes
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Updated on April 20, 2023 with the most recent information and statistics.
It takes an emotional and physical toll when you experience pregnancy loss — and it can also bring an unexpected financial burden.
Even with insurance, surgical treatment for a miscarriage can cost more than $4,300, according to FAIR Health, a national health care nonprofit. How much of that you pay depends on your insurance plan.
What is a miscarriage?
Miscarriage is the most common form of pregnancy loss, according to the American College of Obstetricians and Gynecologists. A miscarriage occurs when there is a spontaneous loss of the embryo or fetus during the first 20 weeks of pregnancy. Studies indicate roughly 1 in 4 pregnancies end in miscarriage, with the majority occurring during the first trimester.
After a miscarriage, the body needs to shed the contents of the uterus. This may happen naturally and last a few weeks. But it could require taking medication or undergoing a minor surgical procedure called dilation and curettage, or D&C, to ensure all the remaining tissue is removed.
The Cleveland Clinic provides more detail on the signs and types of miscarriage. If you're pregnant and experience any of the symptoms described, contact your physician.
How much does a D&C cost?
The average cost of a D&C during the first trimester is $4,307 with insurance or $8,445 without insurance, according to FAIR Health data. In the second trimester, the cost of a D&C rises to $5,301 with insurance and $9,742 without insurance.
These costs include outpatient facility and physician fees, which may be higher or lower depending on where you’re treated.
If you have insurance, your share of the bill would be determined by your plan’s coinsurance or copayment policies, as well as your deductible and out-of-pocket maximums.
State Medicaid programs also cover treatment for miscarriage. Pregnancy-related care provided under Medicaid includes medical services, such as a D&C, that can become necessary when a person is pregnant. Medicaid pays for roughly 40% of births in the U.S., according to KFF, a health research group.
A person who qualifies for Medicaid because they are pregnant remains eligible for at least 60 days after the pregnancy ends, allowing for continued care during the postpartum period that could include pregnancy loss. And under the American Rescue Plan Act of 2021, state Medicaid programs can extend the postpartum coverage period to 12 months. As of April 2023, 38 states had implemented or planned to implement that extension.
Contact your state Medicaid office to determine what is covered where you live.
Miscarriage and the cost of medication
A surgical procedure may not be necessary after a miscarriage, as medication abortion being a less invasive and cheaper option. The most likely drug to be prescribed is misoprostol. Studies show adding a second medication — mifepristone, taken before misoprostol — can be more effective than taking misoprostol alone. Taking both medications also reduces the likelihood of somebody requiring additional medical intervention, like a D&C.
Since pregnancy care is an essential health benefit under the Affordable Care Act, most insurance plans and Medicaid are required to cover medication used to treat a miscarriage. However, because mifepristone and misoprostol are also used in medication abortions of viable pregnancies — the procedures are identical — their availability in some states was impacted by the overturning of Roe v. Wade..
On average, treating a miscarriage with medication costs just under $700, whether you take one or both drugs, according to a 2018 study published by the American Medical Association.
How the recent Roe v. Wade decision impacts miscarriage
The overturning of Roe v. Wade by the U.S. Supreme Court allowed states to ban or severely restrict abortion. These state laws can also impact people experiencing pregnancy loss, since treatment for miscarriage often depends on the same medications and the same surgical procedures that are used to induce an abortion and clear tissue from the uterus.
The impact could be felt through insurance coverage as well as access to care.
A Texas abortion law enacted in 2021 allows civil actions to be brought against anyone who assists with ending a pregnancy after six weeks, resulting in at least a $10,000 fine. As a result, there have been reports of patients struggling to get care after a miscarriage because their doctors or pharmacists want to avoid any appearance of assisting an abortion.
Access challenges could impact cost if patients are forced to pay for services themselves, either because coverage is denied or they’re forced to seek care at facilities outside their insurance plan’s network. Delays in administering medication after a miscarriage could also result in the need for additional medical care.
In July 2022, the Biden administration warned pharmacists that they can’t refuse to fill prescriptions for medications used in abortions because those drugs have other approved uses.