Know What Your Insurance Covers
You will want to find out, preferably before you are pregnant, what you will be expected to pay. Don’t assume that everything maternity-related is covered without getting the details from your insurance provider first. Ask specific questions. Will you have a co-pay or deductible? Will your baby have a separate co-pay or deductible? What procedures and tests are covered during pregnancy? At birth? For newborns? Depending on your insurance provider and the type of coverage you’re enrolled in, you can potentially save money on your hospital bill—it just might mean your monthly premium is higher. Be sure to inquire about all of your options.
Check Bills for Errors
There’s a chance that you’ll find a few errors on your hospital bill. When you go over the detailed bill—even if you’re covered by insurance and don’t have to pay out of pocket—you can dispute any errors and have them fixed. Examples of hospital bill errors include being charged twice for procedures or being charged for medications or procedures you didn’t have. For example, you might accidentally be charged for a circumcision kit. When my daughter was born, she certainly didn’t have a circumcision. Or, you might find you were charged for a cesarean section when you had a vaginal birth. You will also hear stories of being charged for multiple epidurals or other medications.
Negotiate a Better Price
If you are paying out of pocket for your prenatal care, labor, and delivery, see if you can get a deal. Will you save money if you completely prepay all the fees that can be determined ahead of time, for example? Will a certain hospital or birth center offer you a discount? Do not hesitate to shop around for prices for both your practitioner and your place of birth. After all, you are essentially the consumer of their products and services.
Ask If You Really Need Every Procedure
When you are getting your prenatal care, you might simply take every test that is offered to you. Before you agree to have a medical test or procedure, whether it is an amniocentesis, blood work, or an ultrasound, be sure to find out why it is being offered or ordered. Get informed consent. Is this test really necessary? What do you hope or expect to find out from the test? How much does the test cost? Do you really need the test or procedure? For example, an expectant mother asked her doctor about a test they had ordered. The doctor ordered it for every patient because it was readily available. The doctor didn’t know how much the test cost offhand, but when the woman checked into it, the test was nearly $900, was not covered by her insurance, and was not a necessary procedure for the health of her baby. She declined the test rather than find a surprise $900 medical bill. Find out which tests are routine during pregnancy versus which are additional and not required.
Save on Prescription Prenatal Vitamins
Your practitioner may write a prescription for prenatal vitamins. But you don’t necessarily need a prescribed prenatal. Most people are fine with the generic, over-the-counter variety, of which there are many great brands to choose from. These may be cheaper than the co-pay on a prescription.
Plan Ahead If You’re Having Twins
As soon as you know that you are having twins or other multiples, call your insurance company. Ask if they can assign you to a case manager. This allows you the ability to call one person to handle each of your questions as they arise. Since being pregnant with multiples increases the risks of complications (though it does not mean that everyone will have complications), you could be looking at a higher costs. Even if you only pay 10% of your bill, the difference between 10% of $7,000 for a vaginal birth at term and 10% of $200,000 (or more) for an extended NICU stay for premature babies is very big. Your case manager can direct you toward special programs and resources to help you stay healthy and increase the odds that your babies will go to full term. This person can be your go-to if you are charged incorrectly or if payments are denied. Think of this scenario: two babies, same health issue, both get the same treatment the same day. Your insurance thinks that the hospital is double-billing and denies the second charge.
Consider Birth Attendant Options
Did you know that using a midwife may be less expensive? This is true regardless of your insurance status. The cost of midwifery care is a fraction of the cost of the care of other practitioners, mostly because they see only low-risk women and they do not do high-risk procedures like cesarean sections, forceps deliveries, etc. You may also find that your insurance covers some types of midwives. It may cover a certified nurse midwife in a physician’s practice. Or it may cover all midwives in all practices. Talk to the midwives you are interviewing about insurance costs and billing practices as well as asking your insurance company about coverage.
Consider Where You Give Birth
Birth center births and home births are typically less expensive than hospital births, because there are no high-risk procedures done; only low-risk parents are eligible. So you save money by not having to pay for those procedures outright, or for any fees involved in the event you’d need them. Another big way that costs are kept down in these settings is the length of stay. With a home birth, you don’t go into any facility for your birth or postpartum care unless there are complications requiring a hospital. The typical stay at a birth center for postpartum care is usually between 6 and 8 hours. Some people have to pay out of pocket for this birth option. You can use flexible spending money to cover it with many insurance plans. You can also set up a payment plan. Some facilities and practitioners may even work out a barter. Even if your insurance says that they will not pay for a birthing center, some parents have been successful in submitting the bill to their provider. It can take time and energy on your part, but even a partial reimbursement is a good thing. Some states have mandated coverage for these options; your insurance company may not tell you this. Be sure to ask the home birth practitioner or the people at the birth center.
Ask About Procedures at Birth
One way to cut costs is to avoid costly procedures unless they are necessary. This can include epidural anesthesia and cesarean sections. You may also ask about early discharge from the hospital, say 24 hours rather than 48 for a vaginal birth. Some people will choose to do this while others will not. The good news is that you can try to avoid these and change your mind as needed. So let’s say you decide to go without pain medications and halfway through your labor change your mind, you still have the option to do that.
Use a Doula
Using a doula can help you lower the need for pain medications as well as help you reduce the need for some costly procedures. While the majority of doula fees are not covered by insurance, the small out-of-pocket price is worth it for many families. You can also ask a doula for a sliding scale and about bartering, as you could with all of your practitioners.
