What to Expect When You’re Expecting

January 09, 2017

When I found out I was pregnant with my daughter, I thought a lot about what I needed to do to have a healthy pregnancy and birth. I didn’t consider how much it was going to cost. I had a healthy pregnancy, but during the last few days before labor, I developed high blood pressure, so I had to have extra monitoring for both me and the baby. My daughter was a breech baby, which we knew, and I ended up with an emergency C-section after nearly two days of unsuccessful labor in the hospital birthing room. My daughter was born healthy and I recovered quickly.

Luckily for us, I had excellent coverage from my HMO, so our out-of-pocket costs were minimal. However, for most families with low risk pregnancies, their costs could be in the thousands, especially if they have a high deductible health care plan. If a woman were uninsured and had a situation similar to mine, the cost could be $10,000 to $70,000, depending on where she lived and where she gave birth.

If you are thinking about getting pregnant or are already expecting, you’ll need to take care of your financial business in addition to your health. Even if you are insured, you are likely to have significant out-of-pocket costs for pre-natal care, labor and birth, and care for your new baby.  Step one is to contact your health insurance provider to see what’s covered:

Am I covered and how?

• Will my insurance cover my pregnancy?
• What kind of care does my insurance cover? What coverage is fully paid, and what costs should I expect?
• What is the most I could pay out-of-pocket?
• Does my health care provider offer a healthy pregnancy program and birthing classes? How can I participate?

What if I need more than the basics?

• What happens if there are problems during the pregnancy which require special care?
• Do I need preauthorization for any prenatal care procedures? What is the process for getting authorization?
• How will I know in advance how much I will pay for a specific medical test or procedure?
• What is the coverage if there are complications during birth?

What to expect for my hospital stay?

• Do I need preauthorization for my hospital stay during birth? What is the process for getting authorization?
• What if the hospital bills for a provider who does not participate in my health insurance without my knowledge (e.g., physician, lab, etc.)?
• Do I have choices of where/how I can deliver my baby?
• How many days can I stay in the hospital following the birth? What if I need a cesarean birth?

Is my baby covered?

• Will my baby be covered right away under my health insurance? Are my baby’s costs covered if he/she has to stay in the hospital longer than me?
• How can I add my child to my policy when he/she is born? Is there a time window (e.g. 30 or 60 days)?
• Does my insurance cover any breastfeeding coaching and supplies?

While not everyone can plan in advance for the costs of pregnancy and birth, if you have the opportunity, estimate your out-of-pocket costs up front and build cash reserves to meet them. Even if your pregnancy is a surprise, you still have nine months to get prepared financially. That way, you will be able to focus on the joys of parenting and not the stress of unexpected medical bills when your baby arrives.

 

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