Having a Baby > Insurance Baby Medical Bills, Bills, Bills

Team PV

“I haven’t entirely paid off my student loans, but it looks like my baby will help my doctor pay off hers!”

You and your doctor will be besties after all those visits. But there’s a crucial checkup you won’t schedule with your doc- an insurance checkup. It won’t hurt, we promise.

What does hurt: that the average American hospital birth, without complications, costs an average of $32,000 without insurance. Too bad there’s no epidural equivalent for your hospital bill.

Just as you’d schedule a preconception visit with your doctor, start investigating your insurance options before you become pregnant. Review your current plan to figure out which medical expenses will and won’t be covered as well as what your co-pays and out-of-pocket maximums will be. If you’re concerned you won’t have adequate coverage, you may have to wait until your company’s open enrollment period to change your plan. Though most plans should cover doctor appointments, prenatal tests, ultrasounds, and medical supplies, don’t wait until the last minute to find out!

If you and your partner have different health care plans, consider which will provide the best comprehensive care for your baby, and don’t be afraid to shop around. If you have a high deductible plan, start putting money aside at least six months ahead of conception; if you have a flexible spending account or health savings account through your insurance provider, you can put pre-tax dollars aside for prenatal vitamins, doctor co-pays, Lamaze classes, even breast pumps- use this account to your advantage!

Ask your insurance company about other potential costs like:

  • In-network versus out-of-network coverage for obstetricians, hospitals, and pediatricians
  • Any common prenatal procedures or tests not covered by your plan
  • If your plan will cover an extended stay at the hospital (if medically necessary) for you or your spouse or a NICU stay for your baby
  • If coverage includes a certified nurse midwife
  • When you need to enroll your baby for dependent care benefits
  • Baby well-visits and vaccinations

If you don’t have insurance, you’re not completely screwed. If you aren’t pregnant yet, wait until November for open insurance enrollment under the Affordable Care Act and shop for a plan that accommodates your growing family. Unfortunately, pregnancy is not a qualifying event- your child’s birth is- so prepare ahead of time if you can.

If you recently lost your job, investigate Medicaid- in some states, Medicaid income thresholds increase for pregnant women and you may qualify for benefits. Though it’s notoriously expensive, COBRA insurance is an option that continues prior group plan coverage after a job loss. 

You can also ask your doctor if he/she will offer a discount if you pay for your visits in cash, or if a hospital you’re considering offers an interest-free payment plan.


It’s not a fun topic to discuss with your partner, but since about 6.7 million American women experience infertility issues, it’s better to have that “What if?” conversation early on. Check which options your insurance company will cover or see if you can apply funds from your flex spending or health savings account. Deciding what you’re willing to spend on infertility tests and treatments ahead of time can save you from a potential financial headache down the line.


Photo: r0kk

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