Pregnancy and childbirth can be expensive, so there are a lot of things to consider. One important aspect is your insurance coverage. It is important that you have a plan that will provide the necessary coverage for your needs.
As a licensed insurance agent, I occasionally have pregnant clients. Pregnancy and childbirth can be an expensive experience, so it is important that you have coverage that will take care of you.
Having a baby can cost a lot, sometimes even up to $200,000, but with insurance, it can be much cheaper. Some insurance plans are more affordable, but they don’t cover as many things as the other plans do. Thanks to the Affordable Care Act (ACA), all health insurance plans now have to include coverage for pregnancy services. When choosing a health insurance plan, it’s best to go for one that covers all the costs of pregnancy, including prenatal check-ups, tests, and delivery.
In this article, we will discuss factors to consider when choosing an insurance plan for pregnancy, the best plans, and tips for choosing the best insurance. Let’s get started!
Table of contents
- The Average Cost Of Pregnancy In The United States
- Is Pregnancy A Preexisting Condition?
- Factors To Consider When Choosing An Insurance Plan For Pregnancy
- The Best Insurance Plans For Pregnancy
- Pregnancy Supplemental Insurance
- Tips For Choosing The Best Insurance Plan For Pregnancy
The Average Cost Of Pregnancy In The United States
It’s understandable to be concerned about the cost of prenatal care and childbirth. However, many insurance plans cover the cost of these services, and there are also financial assistance programs available to help defray the cost for those without insurance. Additionally, some healthcare providers offer payment plans or sliding scale fees based on income.
Here’s a list of the average cost of pregnancy in the United States, including different aspects of pregnancy and their associated costs (the average cost is just shy of $19,000 with those who have insurance paying out of pocket $2,800).
|Prenatal Care||$0 – $2,000+|
|Delivery (Vaginal)||$5,000 – $11,000|
|Delivery (Cesarean)||$8,000 – $20,000|
|Hospital Stay||$2,000 – $10,000+|
|Anesthesia||$500 – $2,000+|
|Postpartum Care||$500 – $3,000+|
|Newborn Care||$1,000 – $3,000+|
- Prenatal Care: The average cost of prenatal care can range from $0 to $2,000 or more, depending on your insurance coverage and the type of provider you choose (OB/GYN, midwife).
- Delivery: The average cost of vaginal delivery can range from $5,000 to $11,000, while the average cost of cesarean section can range from $8,000 to $20,000.
- Hospital Stay: The average cost of a hospital stay during and after childbirth can range from $2,000 to $10,000 or more.
- Anesthesia: The average cost of anesthesia during delivery can range from $500 to $2,000 or more.
- Postpartum Care: The average cost of postpartum care can range from $500 to $3,000 or more, depending on the type of care you receive (home health care, lactation support).
- Newborn Care: The average cost of newborn care can range from $1,000 to $3,000 or more, depending on the type of care you choose (hospital-based care, home health care).
Note: It’s important to note that these costs can vary greatly based on factors such as location, insurance coverage, and the type of delivery. I recommend consulting with a healthcare provider or financial advisor for more specific and accurate information on the cost of pregnancy and childbirth.
Learn Tips to Save Money on Insurance!
Our newsletter is packed with helpful tips and resources to help you save money and get the most out of your coverage. Sign up now and join our community of savvy insurance consumers.
Is Pregnancy A Preexisting Condition?
Pregnancy is considered an essential health benefit and recent laws say that all health insurance plans, whether through your workplace, the marketplace, or Medicaid, must cover maternity and newborn care. This means that, unlike in the past, you can’t be denied coverage because you’re pregnant.
Here’s a list of some things you’ll need during your pregnancy:
- Going to the doctor’s office every week
- Getting special pictures of your baby (called ultrasounds and sonograms)
- Doing some tests in the lab
- Seeing a special doctor who helps with babies (called an OB-GYN)
- Going to classes to learn about having a baby
- Actually having the baby (called delivery)
As you can see, all of these things can be expensive, especially if you don’t have insurance. That’s why it’s so important to find a plan that will cover all of these things.
Factors To Consider When Choosing An Insurance Plan For Pregnancy
Pregnancy is often an exciting time for many people, however, as an insurance professional, I frequently have clients who are worried about the expenses associated with it. There are insurance plans available for pregnancy that can help ensure you have the coverage you need. There are several factors to consider when choosing the best insurance plan for pregnancy.
- Coverage For Prenatal Care: Prenatal care is essential for the health of both the mother and baby. Make sure the insurance plan you choose covers all necessary prenatal care, including doctor visits, ultrasounds, and any necessary tests.
- Coverage For Delivery: The cost of childbirth can vary significantly depending on the type of delivery and any complications that may arise. Look for a plan that offers coverage for various delivery options, including natural childbirth, cesarean delivery, and any necessary medical procedures.
- Maternity Leave Coverage: Some insurance plans may offer coverage for maternity leave, which can be helpful if you need time off work to care for your newborn.
- Coverage For Postpartum Care: Postpartum care is essential for the health and well-being of the mother. Look for a plan that covers postpartum care, including doctor visits and any necessary medical procedures.
- Cost: Of course, cost is also a factor to consider when choosing an insurance plan. Look for a plan that offers comprehensive coverage at an affordable price.
Does Insurance Coverage Surrogate Pregnancies?
If you’re using a surrogate, you’ll need to provide health insurance for them because the surrogate’s own health insurance won’t cover their pregnancy. You’ll need to use your own health insurance to pay for all the maternity and baby expenses during the pregnancy.
It’s also good to know that there’s no difference in what different health insurance policies will cover, whether you’re carrying the baby yourself or if a surrogate is carrying it for you.
What If I Change Jobs During Pregnancy?
If you are pregnant and have health insurance through work, but you switch jobs, you might have to wait to join a new plan. This could be a big problem if your pregnancy is more advanced. You can get coverage through your old employer’s COBRA plan. It is expensive, but it will cover your medical bills. It is usually harder to get a good plan while pregnant, so it is better to plan before you are pregnant.
The Best Insurance Plans For Pregnancy
As an insurance professional, I know that there are a lot of insurance plans out there for pregnancy. When it comes to choosing an insurance plan for pregnancy, there are a few key factors to consider.
Employer Sponsored Health Care Plans
If you have insurance through your job, that’s great! It’s usually the easiest option for covering pregnancy costs. Health insurance from your job is a good choice for pregnant women, especially if your employer helps pay for it. But, sometimes there’s a waiting period when you first get the insurance where you won’t get benefits right away.
To find out if you have this type of insurance, you should reach out to your HR department or whoever handles your company’s benefits. They’ll be able to give you all the details on what’s covered, what you need to pay, and any waiting periods that might apply. If you’re not sure who to talk to, just ask around the office or check your company’s website for contact information.
If it turns out you don’t have employer-sponsored insurance, don’t worry! You have other options, like Medicaid or getting insurance through the marketplace.
Just keep in mind that there are certain deadlines you need to meet, so make sure to look into this as soon as possible.
Marketplace Health Insurance Options
Another option you might have is marketplace health insurance. This type of insurance is required by the Affordable Care Act (ACA) to cover all of the essential health benefits needed for pregnancy, including prenatal care, labor and delivery, and other medical expenses. Also, the insurance company can’t say no to you just because you’re already pregnant, which is known as a “preexisting condition.”
The only catch is that you can only sign up for marketplace health insurance during the open enrollment period for your state. But don’t worry, if you miss it, you can still get insurance from a different type of policy called an off-exchange plan. Just keep in mind that these policies might be more expensive and might not provide the same savings as marketplace plans.
When choosing a marketplace plan, consider the monthly premium (how much you pay each month) and the deductible (how much you have to pay before insurance starts covering costs). If you choose a plan with a higher monthly premium and a lower deductible, you can save more money on out-of-pocket costs. Look into your state’s Silver, Gold, or Platinum tier health plans to see what works best for you.
Medicaid is a health insurance program for low-income individuals, and it covers the same health benefits for maternity and newborns as other health insurance options. Plus, you can apply for it any time during the year without having to worry about waiting periods or enrollment periods. Just make sure your household income is below a certain limit, and check if your state has expanded Medicaid coverage.
CHIP is another health insurance program that covers children under 19 and pregnant women. It’s like Medicaid, but it’s meant for families and individuals with a low income. Some states even provide full pregnancy benefits without any extra fees. However, it’s always a good idea to check what your state offers under CHIP, because some states might ask you to pay part of the premium or use coinsurance for pregnancy coverage.
Pregnancy Supplemental Insurance
Supplemental insurance is a type of insurance called supplemental maternity insurance that gives you cash payments instead of paying your doctor or hospital. There are two options you can look into: short-term disability and hospital indemnity. Just keep in mind, you’ll need to get this extra insurance before you get pregnant because it doesn’t cover preexisting conditions.
Does Disability Insurance Work For Pregnancy?
If you need to take some time off for maternity leave, you may want to consider a short-term disability or maternity leave insurance plan. This can help cover your income while you’re off work and if you need to rest due to doctor’s orders. Some employers offer full pay during maternity leave, but that’s not always the case.
You should check with your employer to see what their policy is. If they don’t offer much support, getting a short-term disability plan might be a good idea to make sure you’re taken care of. But keep in mind, these types of policies have to be purchased prior to the pregnancy, otherwise the insurance carrier will most likely deny any claim of disability for pregnancy.
Hospital Indemnity Plans
Another option for pregnancy coverage is a hospital indemnity plan. This is different from a typical health insurance plan, but it can still be helpful if you’re looking for more affordable options.
With a hospital indemnity plan, you’ll be covered for any hospital expenses and delivery costs. However, it doesn’t usually cover prenatal care or therapy. But if your baby is born early and needs special care in the NICU, this plan can provide extra benefits for that too. Just keep in mind, it’s not a complete coverage policy like other health insurance.
Tips For Choosing The Best Insurance Plan For Pregnancy
As an independent insurance broker, I have picked up tricks over the years as to how you can choose the best insurance plan for you.
It’s important to understand your insurance coverage needs and what is covered under your plan.
Here are some tips for choosing the best insurance plan for pregnancy:
- Review Your Insurance Coverage Options: Make sure to review your insurance options before deciding on a plan. This includes understanding your deductible, copays, and what is covered under your plan.
- Consider Your Budget: Pregnancy and childbirth can be expensive, so it’s important to consider your budget when choosing an insurance plan. Look for plans that offer affordable premiums and out-of-pocket costs.
- Choose A Plan With Comprehensive Coverage: Pregnancy and childbirth can involve a lot of medical care, so it’s important to choose a plan that offers comprehensive coverage. Look for a plan that covers prenatal care, delivery, and postpartum care.
- Consider The Provider Network: If you have a preferred provider or hospital, make sure they are in-network under your insurance plan. This can help save on out-of-pocket costs.
- Check For Exclusions: Some insurance plans may exclude certain pregnancy-related treatments or procedures, so it’s important to review the exclusions in your plan before making a decision.
By considering these factors, you can choose the best insurance plan for your pregnancy that meets your needs and budget.
As an insurance professional, I know that a lot of people who are or are planning to become pregnant worry about the expenses associated with pregnancy and childbirth. An insurance plan for pregnancy is the best way to ensure you have the medical care and coverage to protect yourself and your family. Be sure to follow the factors and tips outlined in this article, as well check out the best insurance plans to make sure you find the best plan for your needs.