Budgeting for Baby

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Before you have your baby, it’s smart to sit down and look at your finances and the cost of having a baby. Unfortunately, it’s not simple to find out that amount. It varies depending upon whether you have insurance, and if you do, what portion your insurance will cover. Labor and delivery costs are among the most expensive health care expenses in the United States. Make a plan before your baby is born so that the unknowns of financial stress won’t be part of your early days with your baby.

What Should I Do If I Don’t Have Insurance?

If insurance isn’t provided through work, you can enroll through marketplace coverage, or find out if you qualify for Medicaid.

  • Marketplace Insurance: Open enrollment in the marketplace usually is available in November and early December each year. If you’re pregnant or thinking about getting pregnant, it’s a good idea to enroll during this period. (However, if you miss it, you can still qualify for a special enrollment period.) You can opt for five different levels of insurance, from catastrophic to premium. Health care officials recommend the Silver level to pregnant women as generally the best option.
  • Medicaid: If your income is below a certain amount, you may be eligible for Medicaid. In Ohio, for example, for a family of four, you would need to make less than $32,319. If you fit the requirements, you can know that Medicaid will cover most of your labor and delivery costs (99 percent of vaginal births; 98 percent of C-section births). However, while your hospital costs may be taken care of, you may still have to pay your prenatal care provider. 

What Should I Find Out About My Insurance?

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Whether you’re trying to figure out what kind of marketplace insurance you want to enroll in, or you’re just trying to learn the details of your current insurance, here’s what you should find out:

  • Your deductible: This is the amount that you will pay out of pocket before your insurance starts to pay your costs. For example, if your deductible is $3,000, you know you will pay $3,000 of your labor and delivery costs before your insurance kicks in.
  • Your co-pays and premiums: Your co-pay is the amount that you will pay whenever you have a health care appointment. Your premium is the monthly amount that you pay in order to have insurance coverage. 
  • Your in-network co-insurance: This is the amount you will pay when you have a bigger procedure (like a C-section, or even just normal labor and delivery) up to your out-of-pocket max.
  • Your out-of-pocket max: After your deductible is met, you may still have to pay for your co-pays and your co-insurance. For example, a higher deductible plan may pay 80 percent of your costs after your deductible is met, to a max of $12,000. 

Does My Choice of Hospital Make a Difference?

Hospital costs for birth can range widely, generally from $2,000 to $12,000, according to a study published in Health Affairs. And, the hospital where you choose to deliver makes a big difference. Before you decide on a hospital, call their financial aid department. Learn more about the costs associated with labor and delivery. Many hospitals offer financial aid to those who need assistance (and this includes those whose income is too high to be eligible for Medicaid). 

Make a plan before your baby is born so that the unknowns of financial stress won’t be part of your early days with your baby.

What Can I Do To Reduce Costs?

  • Doing your research beforehand is a great way to be prepared. Call your insurance company right away when you know you are pregnant to learn the details of your coverage.
  • Stay with in-network doctors. Make sure that the health care providers you choose are in your insurance network, otherwise you will be paying a lot more. 
  • Ask questions when your health care provider wants to order a test or other procedure. Explain that you are trying to be as careful as possible with the cost of this pregnancy and ask to only do what is essential.
  • Don’t stay in the hospital longer than necessary. If you’re feeling up to it, leave the hospital as soon as your doctor says it is appropriate and safe to be discharged.
  • If it’s possible, time your pregnancy so that that your pregnancy care and delivery happen within the same year, so that you don’t have to pay the deductible twice. 
  • After the birth, find out what is available to you free and take advantage. For example, under the Affordable Care Act, you can get a free breast pump for nursing and lactation counseling without any cost to you. 

It's easy to get the care you need.

See a Premier Physician Network provider near you.

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