When you’re pregnant, one of the first things you have to think about is how you’re going to pay for your baby’s care. Unless you have insurance, it can be expensive to give birth in the United States. The cost of having a baby can depend on many factors. The type of health insurance plans you have, for example, will determine the amount you end up paying.
If you do not have any insurance at all, then there might be some hospital or clinic that will provide pre-natal care and birthing services without charging you anything out-of-pocket. These free clinics and hospitals do exist. The affordable care act requires all insurance plans to include maternity coverage, including those sold through the Health Insurance Marketplace Plans. In this blog post, we will break down the average cost of having a baby without insurance in order to help you plan for your little one’s arrival.
In This Article
How much does pregnancy cost without insurance?
The average cost of pregnancy without insurance is around $5000 to $11,000. In the United States, having a baby is extremely expensive, with parents spending an average of $32,093 for their upcoming bundle of joy. The final price tag mostly depends on how much you spend on pregnant women care, your delivery method and whether or not you stay in the hospital overnight.
When you have health insurance, it pays for a large chunk of your pregnancy costs. The Affordable Care Act requires all new private plans to include maternity and newborn care as part of their Essential Health Benefits package. This means that most plans purchased through the Health Insurance Marketplace will cover prenatal doctor appointments, ultrasounds, blood work and other services that you will need before your child is born.
HMOs, PPOs and POS plans typically cover around 90 per cent of delivery costs, according to the Health Insurance Marketplace Coverage. In some cases, they may also cover lab fees and prescription medications associated with pregnancy care. Health coverage and maternity care costs vary, however, and depend on where you live and which plan you choose. For example, if you live in a state that has not expanded Medicaid (it covers pregnancy care for women who make up to 133 per cent of the federal poverty level), then your minimum cost in the absence of insurance could increase by thousands of dollars.
Therefore, including hospital bills, prenatal visits and other pregnancy-related services, health affairs state that the total cost of having a baby without health insurance comes out to around $5,000. However, this amount is the average price tag for women who have low-cost or free medical care.
Pregnancy costs can be much higher if parents are forced to use an HMO plan with limited coverage. You can see how much free hospital maternity coverage will cost in your area by using the KStar calculator. The actual figure might vary depending on variables. As well as the hospital birth, you will also have to pay for other expenses. For example, if the doctor transfers your baby to another medical facility due to complications during pregnancy, then you’ll have to cover both travel and medical expenses.
How much does pregnancy cost out of pocket?
As we said above the average cost of pregnancy without insurance is anywhere between $5,000 and $11,000. Vaginal birth out of pocket maximums is nearly $8,000 and a C-section run about $11,000. According to the most recent study done by kaiser family foundation, which analyzes insurance claims data to give consumers an inside look into their medical costs, the average cost of giving birth in the United States is over $10,000. This price can vary based on how much is covered by your health insurance.
For all health services, if your partner is a businessman or your partner’s employer, the out of pocket costs of medical bills are paid by the company. This includes postpartum care, labor and delivery, postnatal bills, etc. Healthcare costs for a newborn baby are also included in the deductible of your health insurance. The remaining medical bills are paid by the insurer. Most insurers cover a large percentage of pregnancy costs, but what they don’t cover is often higher than you might expect.
If you’re covered through your employer’s plan, then the maximum out-of-pocket costs will be lower than they would be if you were not covered. If you choose private insurance plans then out of pocket max costs for pregnancy can be up to $12,000. Federal law requires all insurance plans (except for those offered by the government like Medicare and Medicaid) to cover maternity expenses as well as preventative services such as postpartum care, screening tests and counselling.
Though for pregnant women healthcare research state that they also have to be covered for postnatal care. However, hospital birth is still more expensive than other options. It’s important to know what you are covered for, as each insurance plan has different variations of coverage for birth costs. C-section is almost twice as expensive as vaginal birth. If you are considering an elective cesarean delivery, be prepared to pay between $20,000 and $30,000. You may be able to negotiate with your doctor for a lower fee, but there are no guarantees since this is usually how much they charge insurance companies.
If you have an uncomplicated vaginal birth, it may cost you anything from $8,000 to $10,000. The average amount paid for vaginal birth is nearly $11,000. You can expect to pay around $13,500 if you have a C-section. Even though this is the national average, where you live makes a big difference in how much your pregnancy will cost. For example, in New York City you can expect to pay $13,600+ for a vaginal birth and over $17,000 for a C-section. By comparison, the national average is about half of that cost at $6,600 and $8,600 respectively. Manhattan has some of the highest prices compared to other U.S. cities.
How to reduce maternity care costs?
Though to reduce maternity costs one should leave the hospital as soon as possible. Maternity costs can be really high and it is not an exception when you are uninsured, because the charges for maternity care at hospital laboratories, imaging centres and medical clinics are crazy. Many expectant mothers say that they don’t understand the cost to have the baby without insurances. The costs of prenatal care vary substantially depending on the kind of provider, location and individual health plan. Below we have discussed points to reduce health care costs and they are:
1. Call your insurance company
Health insurance must cover the costs of prenatal care. It is advisable to check with your insurance company if pregnancy is included in your plan and what does it cover. Also, you can find out the amount that will be covered by regular and specialist visits and ultrasound scans. You can even get in touch with a representative at your local health insurance provider’s office for more information.
2. Choose generic drugs
There are certain prescription drugs that can increase your expense when you are pregnant, but the majority of them should be covered under your health plan. Many health insurance companies might require prior approval before they agree to cover their cost. You must take drugs that are covered under your insurance. Otherwise, if you buy brand-name medications, they might be expensive for you. Also, look out for generic options or ask your doctor about them.
3. Opt for an HMO
This is a health insurance plan that requires the patient to obtain most of their routine medical care from doctors who work with the HMO. They are sometimes known as an exclusive provider organization (EPO) or network. These plans have lower premiums but they have additional costs in case you need to visit a specialist for some reason.
4. Find a provider in-network
Nowadays many physicians are open to negotiating their fees with health insurance coverage companies, so it is better to look for doctors who have contracts with your insurer. Or else if you have to go out of network then the costs will be higher compared to what you would pay if you were in-network. The charges for routine prenatal care will be less if it is provided by independent midwives.
5. Open a flexible spending account (FSA)
This is a type of account that allows you to pay your medical expenses with pre-tax dollars. If you are not covered under insurance, then the money deposited into this savings account can be used to pay for any pregnancy-related costs. This will reduce your taxable income and hence lower all the maternity care costs that include hormone therapy, acupuncture or other treatments.
6. Look for a cheap place to have your baby
The costs of having a healthy birth can be substantial if you choose a hospital that is out-of-network. In this situation, the insured should ask about their prenatal care or health insurance provider and the cost to have a baby without or with insurance before considering the delivery service one will need. According to the children’s health insurance program, the insurance coverage for vaginal delivery will be around $18,329 and if it is a cesarean section then the costs can increase to $27,866. You must choose a hospital that provides prenatal care in-network because they usually have lower charges for out-of-network benefits.
7. Use generic prescription contraceptives
The hormones used for contraception are similar to those used in oral contraceptive pills, injections, implants and vaginal rings. They are available at a much lower cost than the other forms of hormonal contraceptives. You will be able to find these contraceptives online or at low-cost health clinics that are funded by state programs for women’s health care.
The Conclusion
Therefore, the average cost of pregnancy without insurance is anywhere between $5000 and $11,000. This number can vary greatly depending on the location, hospital, and other factors. However, this should give you a general idea of how much having a baby costs without insurance coverage. If you are pregnant and do not have health insurance, be sure to reach out to your local community health centre or Medicaid office for more information on available assistance programs. You might be wondering how much it costs to have a baby without insurance.
In general, the cost for an uncomplicated vaginal delivery is about $5,000-$11,000 and cesarean deliveries can run as high as $30,000. The average out-of-pocket expense ranges from around $2,500-$5,500 depending on your health coverage. We hope that this information will provide clarity on any questions you may have had about pregnancy and childbirth in general as well as those related to cost. If you have any queries regarding the above context then feel free to reach us through a comment section below.
