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We get this question from expecting parents all the time: What’s the average cost of having a baby and how much can I expect to pay?
The answer: It depends.
Factors include where you live, whether or not you have insurance and the details of your plan and what type of birth you have. Let’s break it down.
What do hospitals charge?
According to the most recent data from the U.S. Department of Health and Human Services*, the national median charges for childbirth hospital stays in the United States include $13,524 for delivery and care for the mother and $3,660 for newborn care. That adds up to $16,884.
What are these charges for?
Your doctor’s services
Lab tests for you or your baby
Your room (costs vary depending on whether you choose a shared or private suite)
An anesthesiologist, if needed
Medications administered, such as an epidural
The type of birth you have plays a big role in your bill, since more complicated births require more care and often come with longer hospital stays. Here are the median costs by birth type:
Vaginal with no complications: $10,958
Vaginal with complications: $13,010
Cesarean with no complications: $18,570
Cesarean with complications: $21,704
Do I really have to pay that much?
Short answer: If you have insurance, no.
Maternity coverage is considered an essential health benefit. Under the ACA, pregnancy, labor, delivery, and newborn baby care must be covered by all health insurance plans offered to individuals, families, and small groups.
If you don’t have insurance, there might be state or local programs that could help with costs. In Illinois, the Moms & Babies program covers healthcare for eligible women while they are pregnant and for 60 days after the birth.
So, what can I expect to pay?
If you have insurance, ask your plan administrator these questions:
What is my deductible? This is the amount you have to pay out of pocket before your benefits kick in.
What is my copay? This is the amount you pay for your appointments or hospital visits.
What is my coinsurance? This is the percentage of costs you cover once you’ve met your deductible, until you reach your out-of-pocket maximum.
What is my out-of-pocket maximum? This the highest amount you can expect to pay in a plan year — once you’ve hit this amount, your insurance will cover the rest.
Pay special attention to your out-of-pocket maximum. If your plan covers more than one person, you might have an individual out-of-pocket maximum and a family out-of-pocket maximum. In that case, when what you’ve paid toward individual maximums adds up to your family out-of-pocket maximum, your plan will pay 100 percent of the allowed amount for healthcare services for everyone on the plan for the rest of the year.
Any other costs I should consider?
Ask your doctor about the cost of your prenatal visits, tests, and ultrasounds. Any copays or coinsurance fees you pay along the way should be counted toward your deductible. Outside of doctor’s visits and your hospital stay, you’ll also want to think about:
Prenatal vitamins: These can get pricey, but your insurance may cover all or part of the cost
Childbirth classes: Your hospital might provide a free or low-cost option
Baby gear: You’ll want to purchase these things like clothes, a car seat, crib and diapers ahead of time.
How can I save money during my pregnancy and delivery?
Stay in-network. Out-of-network doctors or hospitals will be pricier and might not be covered at all.
Plan ahead by working with your doctor to create a birth plan. Your birth plan will document which tests you want or don’t want during labor, and doing the research now will help you make informed decisions ahead of time.
Shop around for prenatal vitamins. If your insurance doesn’t cover prenatal vitamins, compare prices on over-the-counter options. If you have an FSA or HSA, use that to make these purchases tax-free.
* Source: 2014 data from the U.S. Department of Health and Human Services