How to Save on Maternity Medical Expenses
Having a baby costs a lot of money. I know plenty of parents who joked about how they were still “paying off” their kid, i.e. maternity hospital bills, well into the child’s toddlerhood.
For my first pregnancy, we had a hospital co-pay which made the whole endeavor less expensive. But when our second child arrived, we had a completely different plan: a high-deductible HSA. We chose the plan hoping to have another child that year and had crunched the numbers to determine it was a prudent choice. It was, in part because the company was offering a $2000 HSA stipend. But we still became much more cost-conscious since we were essentially paying for more of our medical expenses directly from our own pockets. The great side-effect was that I become more proactive and informed about my care.
The first thing I did was start questioning some of the procedures at my first prenatal visit. Were the many blood tests (that I’d just had two years ago) covered fully by insurance? They were, so test away.
But my practice had also added an early ultrasound “for dating” as a routine procedure. This was not the case when I had my first, and since I knew when I got pregnant, I didn’t feel I needed it. With the second baby I also felt comfortable waiting to schedule my first appointment until I was far enough along to hear the heartbeat. This made the ultrasound less necessary, as well. In the end it saved me at least $250.
I know others who received the ultrasound (some practices require it), but were strategic about timing it in the same calendar year as their due date so it would count towards the deductible.
Of course, if your pregnancy is high risk, you might need to see your practitioner sooner. There are some problems, such as low progesterone, for which early interventions exist. But in a textbook pregnancy they don’t even test hormone level changes (at least at my practice).
Near the end of both my pregnancies, I was told I needed an ultrasound because I was “measuring small.” In both cases it was user error, because in fact I measured perfectly. The first time, it was a simple matter of the intern writing down the wrong number. In the second, I saw a different practitioner and he just didn’t seem to take the same careful measurements as the person who had been measuring me for months.
In both cases, an ultrasound was ordered. Intrauterine growth restriction is a real, serious problem that can be minimized with early delivery, so I didn’t want to write it off, but I also felt that careful re-measurement by a nurse-midwife was probably all I needed. In both instances, I checked out perfectly and saved another $250 on ultrasounds. Why make use of expensive equipment and procedures when a simple tape measure will do the trick?
I also turned down early screenings for genetic disorders. While these decisions are very personal, I think helps to understand that screenings do not provide a yes or no answer to whether your child has the disorder (though some tests do); there is nothing that can be done medically to fix the problem; and if you’re not willing to terminate the pregnancy, it might make sense to save yourself the worry and expense.
It’s often confusing to figure out whether a procedure is covered by your insurance. If you’re not sure, ask for the diagnosis and procedure codes and call your insurance before accepting it. Since some tests in pregnancy are time-sensitive, you may want to ask at your first appointment which procedures will be offered throughout the pregnancy, or at your next visit. I’ve found that using these codes has helped me get much more concrete answers from the insurance company than even inquiring with the procedure’s name.
I also researched hospital charges and discounts, since my practice and insurance were compatible with two area hospitals. I’d heard from a friend that one hospital offered a 30% discount if you requested to pay your bill upon leaving the hospital. In my case, the maternity bill was prepared, but the newborn’s bill wasn’t ready yet. So they said to call and inquire about the prepay discount which had been noted on my account. In the end I saved around $1000 by asking for this discount (and having the money in the HSA ready to go).
So having a baby is going to be expensive, no doubt, but you can minimize the cost by becoming informed about what your insurance covers, why a procedure is being offered, and what discounts are available through your local hospitals. This, paired with saving in advance, can make bringing home that bundle of joy a little more joyful.
Have you found ways to reduced maternity costs? What are some ways to save up ahead of time?
I wish I had known to ask for a discount with my first two births! My third, I was at a different hospital and they offered a discount for paying within 24 hours of discharge. Practicing strategies to manage my pain helped me save a lot of money. I know everyone’s pain tolerance is different, and medical circumstances vary, but if you can forgo an epidural, that’s big savings. Also, really paying attention to my body and seeing if I really did need that Percocet or ibuprofen after delivery. Just because a nurse offers you meds, you don’t have to take it. And my hospital charged $9 for a single ibuprofen! Also, I liked to labor as long as possible at home. It’s more comfortable at home, and you’re paying by the hour for your room and nursing in the hospital.
Yes, I was also able to save by foregoing pain medication, though I find it hard to recommend! I think if you’re doing it for other reasons, the savings are a nice bonus.
This is valuable information that more people need to know. Careful shopping is the best way average people can reduce medical expenses. Even though I will never need to worry about maturnity medical expenses a lot of this applies to any medical procedure. Before now I didn’t know about diagnosis and procedure codes. Hopefully, my health will stay strong and I won’t need to I won’t need to apply this new knowledge but if the need arises I will be asking the right questions.
Great point, David, this does generalize beyond maternity costs. My mother negotiated a cash-pay discount for a surgery when she was uninsured (pre-ACA). And I’ve used the codes trick in a number of settings.
I remember watching a 30 Rock episode in which Alec Baldwin’s character and his wife (played by Elizabeth Banks) go to Canada for a visit, and his wife ends up going into labour and delivering her baby in a Canadian hospital. “Why can’t we find a Canadian to pay!!” Baldwin yells after nurses and doctors told him there was no fee. I found it funny, but now I have more insight into it. Ay caramba! The idea of paying to have your baby delivered is very foreign to me. I’m glad there are ways to minimize the expense though.
I’ve heard these things work quite differently elsewhere. American health insurance is amazingly complicated!
We participate in a cost sharing ministry. It paid for the midwife, plus hospital costs when we ended up in the hospital because of prolonged labor. The ministry paid for all but a few things (like the epidural).
In general, going with a midwife is usually going to cost less than hospital birth if you don’t have insurance or have a really high deductible (our midwife was $3000.00 for prenatal care and delivery). My pregnancy went very well, so we didn’t have any ultrasounds or other extra procedures done. The cost sharing ministry was a nice back-up plan for us since I didn’t end up giving birth at home after all.
All said and done, having our baby was quite affordable. 🙂
I was a bit too nervous to attempt home birth, though I think in my deliveries it actually could have been fine. But I was able to deliver with a CNP midwife both times at the hospital, which was great. I’m sure it is less expensive to deliver at home with a midwife, unless you have unusually amazing insurance. The cost-sharing ministries are definitely intriguing as well.
The important thing to focus on is your out of pocket maximum. No matter where the
charges originate they go to your insurance as first-come first-serve. Obstetrical charges ‘pile’ up for different services. Each patient is different and may need additional testing, but they all go towards your deductible and out of pocket. Once that ded/OOP is met you can expect 100% coverage.
Yes, pregnancy and delivery have many, many variables that can change the cost dramatically. While out-of-pocket maximum is important to consider, I’ve never met it for a having a baby. So it is not the only factor to consider, as we were paying 20% of hospital charges after meeting the deductible.
Forgoing pain medication to save money – ouch. Respect to anyone who can do that without harming themselves because I most certainly couldn’t.
We’d stick with our current HMO if we were to have another baby. We don’t get to choose the doctor who delivers but we do get everything but the $150 admittance fee and any prescriptions to go home free. They usually give you some formula to start if you needed it, diapers, wipes, and other stuff like that.
Yes, I wouldn’t recommend skipping the meds just to save money! But if you’re doing it for other reasons, it’s a nice perk. Needles really bother me, and though I’m sure I would have been fine, I just didn’t like the idea of the epidural because of that. The savings really depend entirely on your health insurance plan. If you had a hospital co-pay I don’t think it’d matter.
Another option is to somehow get a Canadian citizenship. Cross the border where all this stuff is free