Getting pregnant can be one of the most life-changing and exciting developments of a woman’s life. While the news should give you every reason to celebrate, finding out that you are pregnant also means that it’s time to start thinking about the cost of having a baby—and doing what you can to get the best value.
1. Understand your insurance
It all starts with your health insurance. Finding out which provider networks your plan uses will enable you to start compiling a list of doctors, hospitals, and pediatricians that are fully covered by your plan. Knowing exactly what your insurance benefits, deductibles, and copays are early on in your prenatal care will also help you to better understand what your insurer will cover and what you will be responsible for paying.
Getting this out of the way early on in your pregnancy will let you focus on the health of your baby as your due date approaches and delivery is the only thing on your mind. Although the complicated health insurance terms pop up time and time again, it’s important to have a firm understanding of what they actually mean.
A deductible is the amount you pay for health care services before your health insurance begins to pay. For example, if your deductible is $1,000, you will pay 100% of your health care charges until the amount you owe reaches $1,000 (except for preventive care, which is free even before meeting your deductible). A copay, on the other hand, is a fixed dollar amount you pay for a health care service at the time of receiving that service.
Copay fees for visits to the doctor are often somewhere around $30, whereas emergency room copays are generally more expensive. While it will be your doctor’s responsibility to ensure the well-being of you and your baby, you should take responsibility for knowing the ins and outs of your insurance plan so as to avoid paying for procedures and tests not covered by your insurer.
2. Know what’s covered
As one of the ten “essential health benefits” (EHBs) under the Affordable Care Act, covering maternity and newborn care has become mandatory for most insurance plans. However, the Department of Health and Human Services did not specify what is covered for many categories, which gives states the option to select an EHB package based on certain pre-set options. Knowing your home state’s policies—and what is and isn’t covered—is therefore that much more important as you budget for your expenses.
3. Ask which tests are necessary
Throughout your prenatal period, you should look into coverage and costs for visits with your primary care doctor or OB/GYN, ultrasounds, lab work, vitamins, prescription medications, hospital stay, cost of labor and delivery, midwife or nursing services, and newborn care after delivery.
Once you know the costs, be prepared to question whether you really need an expensive test or procedure, as doctors may make choices without first checking whether or not you can afford it. You have every right to ask your doctor if these tests are absolutely necessary. If you think a certain test may be superfluous, seeking a second opinion is often a good idea.
4. Research your birthing options
Even before you get close to your delivery date, you should start researching your childbirth options. Though hospital births make up the overwhelming majority of births in the United States, home births and birthing centers are gaining in popularity.
Home births are sometimes offered in packaged deals, contributing to an overall cost that is 60% less than hospital births, which contain fragmented costs that tend to pile up as more procedures and tests are added. Hospital birth costs can vary greatly depending on how much your insurance covers, as well as price variations between hospitals.
Check to see if any hospitals covered by your health insurance offers these cost-effective packaged deals—and ask your potential OB/GYN the right questions to determine if he or she is a good fit for your needs. It’s also worth keeping in mind that if there are risks or complications during your pregnancy–at any time during your prenatal period–it is recommended that you give birth in a hospital.
5. Know what to do if you’re uninsured
Lastly, don’t fret if you don’t have health insurance. While insurance will often help to lower your costs, you can still negotiate with hospitals to lower your bills. If you are considering a home birth, which may or may not be fully covered, going without health insurance may not cost you much more—and many midwives will likely be willing to settle on a price you can afford.
Piggy bank photo courtesy of Shutterstock.