More “how much does birth cost?” numbers

In the June 2009 Parents magazine, there was an article titled “Budgeting for Baby,” and it included “Medical Bills” as its #1 Budget Shock. It mentioned a study by the Kaiser Family Foundation, and said that with typical insurance coverage, out-of-pocket expenses for an uncomplicated vaginal birth ranged from $1455-$7884; for an uncomplicated C-section, the range was $2244-$9818; and a C-section with complications could set you back as much as $21, 194. This is with insurance.

I’m assuming that all of these scenarios include prenatal care, including things from ultrasounds to prenatal vitamins, and not just birth expenses. One variable it raised that I hadn’t thought of before was if you have to meet an annual deductible twice, if your pregnancy covers two calendar years. So, unless you get pregnant in January, February, or March (or have a preterm birth, which will also raise your out-of-pocket costs, because NICU tends to be quite expensive), you very well may have to pay your deductible twice. I think that may have happened to my sister-in-law.

She had some complications in her last pregnancy — some heart palpitations, blood pressure problems, dizziness, weakness, or something along those lines, and needed to be seen not just by her OB but by a cardiologist as well, and to take medication, and all that jazz. She had a typical hospital birth, but lost a lot of blood (nearly had to get a transfusion) and had a long recovery. So it ended up being a “complicated” vaginal birth, plus her cardiologist’s fees were not covered as part of her pregnancy costs, because although her problem was caused by her pregnancy, the fees to go see the doctor were extra. Plus, her pregnancy (like most) covered two calendar years, so she likely had to meet two deductibles, with the bulk of the cardiologist’s fees and other pregnancy costs happening in the first year, with a few doctor visits plus the birth happening in the second year; and the baby may have met her own deductible as well. All in all, there was plenty of room to have lots of hidden fees and extra costs that were most unexpected, unpleasant, and unwelcome. I don’t remember the exact figure she said (and she wasn’t totally sure, herself, since the bills were all so scattered around, with the prenatal visits, the ultrasounds, the cardiologist, the hospital charges, the epidural, the anesthesiologist, the IFM, the postpartum — you get the picture), but I think it was over the “vaginal birth” range quoted above.

One solution it suggested was to have a medical flexible spending account through your employer — but be careful, because some accounts like this are set up in such a way that if you have money left over at the end of the year, you lose it. I know Dave Ramsey recommends Health Savings Accounts, but beyond that don’t know much in this area.

There are areas where you can cut costs — and you may be able to prepay some costs and get a deal as well.

2 Responses

  1. Health Savings Accts are not necessarily the way to go. All options that I have seen in Az, MA, ME, CA and OR require that you have a $3K deductible before you can use the account, so that would be over most of the fees listed above.

    The cheapest thing I can see would be to have PPO insurance, and ensure up front what will be covered, then plan a home birth. Many insurers will pay at least the out of network rate. Then if you get transferred its to an emergency room, and there is only the emergency room co pay if you use in-network (most local is $240 co pay for emergency room with 24 hour hospital stay). In which case, for most home birth midwives I am aware of, you would come out considerably ahead.

    If on an HMO it would behoove everyone to read the fine print. While some on the higher end plans only pay $25 co pay, plus the hospital co pay, in other cases the amount can be considerably higher, as they may charge for each prenatal visit. My HMO 2 years ago with the birth of my son, had a $50 co pay for the ultrasound, and $5 for prenatal vitamins, $5 for most lab work (pregnancy test, gbs, strep, etc) and there were additional fees for in hospital.

  2. Having a baby can be very expensive – so you may have to watch what you spend on the baby so you can cover all the medical expenses. Consider waiting until you know more about your baby’s interests and personality and what your lifestyle will be like with baby. What you think you want pre-baby may change after you actually have your baby and see what the reality is. If you absolutely must have the $2,000 crib, consider getting a less expensive stroller. Most importantly, if you want the top of the line crib, plan for it and give yourself permission to spend the money and enjoy it. Know where the money is coming from to do all of the start-up stuff: is it from your income, on a credit card, or from your savings? I your situation, you could draw from your savings (emergency fund and./or extra cash in the checking) and just plan to replenish that account over the next 4-6 months.

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