If you’re pregnant or planning a family, figuring out how much it costs to have a baby can be tricky in the wake of landmark health care reform. Maternity and newborn care are required to be covered by insurance under Obamacare, which is great news, as families in the U.S. face the highest birthing costs in the first world. Obamacare or not, there are ways to keep costs at a minimum while still receiving the care you and your infant need.
How much does it really cost to have a baby?
It may surprise you how much the bill can vary. A recent University of California, San Francisco study found that the cost of uncomplicated vaginal births in California varied between hospitals by as much as $34,000, ranging from $3,296 to $37,227 for on-site hospital costs.
A larger study by Truven Health Analytics looked at five different states and found the average charges among women and newborns with employer-provided Commercial health insurance in 2010 to be approximately $30,000 for vaginal births and $50,000 for cesarean births. Even with insurance, the Truven study found, out-of-pocket costs still ran about $2,200 for vaginal births and $2,700 for cesareans.
Why does it cost so much to have a baby?
There are a number of factors that contribute to the overall high cost of pregnancy. Many pre-Obamacare plans provided inadequate maternity care or none at all, according to Childbirth Connection, an organization that helps women make informed health care decisions. Going forward, more maternity and newborn care will be covered as required by the law, and out-of-pocket costs are predicted to decrease.
Health care in the U.S. is billed per service, and each hospital gets to set its own prices, according to a Centers of Medicare and Medicaid Services report from 2011. For complicated admissions such as for childbirth, a lot of small charges can add up quickly. Furthermore, nonprofit hospitals are increasingly converting to for-profit entities, which charge more for services across the board, according to the group Physicians for a National Health Program.
According to the New York Times, obstetricians face the highest malpractice risks among physicians, so your doctor may recommend unnecessary tests and scans under a “more is safer” mindset, according to Catalyst for Payment Reform (CPR), a nonprofit organization that helped fund the Truven study. Consequently, the U.S. standard of care for childbirth has grown to include a number of blood tests and ultrasounds that are both costly and avoidable. When combined with the fee-for-service payment system, there are too many opportunities for hospitals to overcharge, CPR says.
What can I do to lower the cost of having my baby ahead of time?
You should start by researching and choosing a high-value pregnancy provider. Then, get to know your insurance coverage. If your plan is Obamacare-compliant you’ll have access to many maternity benefits. If you have a grandfathered plan, find out what, exactly, your insurance covers. There’s a chance that pregnancy coverage is not one of your benefits.
Next, check out your delivery options. If you have a choice between hospitals, find out what each one charges and whether they are nonprofit or for-profit. Hospitals are not required to publish their fees unless mandated by your state or county, so it may be up to you to investigate. You should keep in mind that what a hospital charges won’t necessarily be what you pay, since insurance companies have contracted rates set up with hospitals. Even if you’re uninsured, you may be able to negotiate your bill to be much lower than what was originally charged.
Some hospitals are starting to offer comprehensive maternity packages—the type of bundling available in most other developed countries. These packages charge a set rate for the entire delivery, as opposed to billing separately for each item. You’ll definitely want to know whether such a package is available to you and what it includes. If so, check out the package options before you buy because you’ll have to agree to it up front.
If you do not have a choice of hospital, make sure you know what tests you’ll face and the reasons for each. Check with your obstetrician to make sure all procedures are absolutely necessary, especially if you and your baby are healthy—it’s always ok to get a second opinion.
Pregnancy photo courtesy of Shutterstock.