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June 18, 2014
By Jennifer Jordan
Expecting a baby is one of the most special and exciting times of one’s life. Sometimes the excitement may overshadow the need to have a sound financial plan in preparation of baby’s arrival. We do so much research on what to expect when baby arrives but what about the financial plan for paying for prenatal care and delivery. With just some basic research and asking the right questions of your insurance carrier and doctor, you may be able so save as you prepare for your new arrival.
The Affordable Care Act requires insurance carriers to cover maternity care; however, this mandate of coverage does not mean maternity care is free. Most insurance plans have some amount of co-pays whether it be a percentage or certain amount per visit. A recent study suggests the prenatal visits and tests run approximately $616 in out-of-pocket expense for an insured member and an estimated $6257 for the uninsured. These charges usually include ultrasound exams; most healthy women receive 2 ultrasounds per pregnancy and if you fall into a higher risk category, there may be more. Other common tests are to check for gestational diabetes and Rh incompatibility. Under the Affordable Care Act (ACA), these tests are considered preventative so if your insurance follows the ACA the test should be free. There are other tests that may be recommended by your healthcare provider and your provider will help you determine which are necessary. Before moving forward with any test it is best to check with your insurance to determine coverage and your out-of-pocket expense for additional tests.
A recent study by Truven Health Analytics determined the average charge for care during delivery is approximately $16,165 for a vaginal delivery and $24,572 for a cesarean birth. The out-of-pocket for the patient is around $1,038 for a vaginal birth and $1,246 for cesarean birth. The numbers do indicate insurance covers a large portion of delivery. I have noticed the my health insurance provider has a tier system of coverage based on the hospital chosen and a member can save over $1000 by choosing a hospital that is preferred by the insurance carrier.
With the anticipation of your delivery approaching, trying to figure out how much having a baby will really cost you can seem like a daunting task, but don’t let it overwhelm you. Start with your health insurance provider. Most providers have customer advocates and on-line resources to help you compare costs and determine out-of-pocket expense. Next work with your OBGYN to ensure they work with hospital in which you plan to deliver. Your OBGYN may also work out a payment plan so by the time delivery day arrives, you have met most if not all of the charges associated with your OBGYN. Don’t be surprised after delivery that there will still be hospital bills as well as bills from the anesthesiologist and other parties involved with the actual delivery.
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