What Is The Cost Of Having A Baby Without Maternity Insurance?

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One of the unfortunate things about healthcare costs in America is this: no one can give you a clear price as to what something costs. Americans and insurance companies constantly feel confused because they can’t go directly to a doctor’s office or hospital and get a clear, reasoned, baseline answer for what to expect.

I tried several times throughout the ordeal of my wife’s pregnancy, to no avail. Only after all the work had been done, did I see the true cost, and boy, it didn’t take them long to tell me what I owed!

Now, before I go on, it’s important to note that this was for a C-section with one minor complication (gestational diabetes). That information is important because healthcare providers are dynamic in how they charge, and they’re very quick to tell you that each pregnancy is different. With that said, here’s what you can expect if you don’t have maternity insurance or a standard healthcare plan that covers maternity.


The ‘True’ Cost Of Pregnancy In America

To start, you have the physician’s fees. If you want a quality doctor to see you without maternity coverage, then you’re going to need to keep him happy. That bill was a non-negotiable $3,370, paid out in six-month installments, and included traditional delivery, which was useless to us since my wife is short of stature and had gestational diabetes with a good-sized baby and narrow hips. The doctor all but begged us to get a C-section, so we did.

Unfortunately, the physician’s fee that we somehow managed to pay for under the doctor’s terms, was only the beginning.

Next, there were lab billings for tests that our doctor did free and clear of his physician’s fee. Those added up to $687. The biggest expenses, however, came with the actual C-section as well as child care for the two days we were all in the hospital. Total cost of the surgery was $11,800. Total cost for the baby was $2,522. (Most of this last amount will be covered once the baby goes on our standard health insurance policy.)


What does all that add up to? $18,379.

The good news is, I do have some options. I am applying for the financial aid program that our hospital has in place. I wish I could tell you the process for doing this is a simple one, but it isn’t. To become eligible for the aid money provided by the hospital foundation, we have to submit last year’s tax return along with 60 days worth of pay stubs, bank statements, retirement account statements, and a lengthy financial aid worksheet detailing all expenses along with copies of our most recent bills.

It’s a couple of weeks’ worth of legwork if you also have to work for a living, and you’ve got a new child to care for. (Bye-bye, sleep.)


Why am I telling you all this?

Two reasons:

1) Because it gives you a clearcut idea of what you can expect a hospital to charge for the costly procedure of a C-section. Traditional delivery is likely less costly than this, though we’re not sure it would be by much since both a standard stay and our own was two days in the hospital. Furthermore, the price will vary if you live in an area with a higher cost of living. However, I feel the information is still helpful in one sense, because it breaks down all the overall costs, blow-by-blow, so you don’t underestimate what the hospital will come up with when they’re determining your final bill.

2) It demonstrates the need for a plan. Going into this, I had no idea how difficult it would be to acquire financial aid and negotiate with the hospital. If I had, I would have definitely found another way, such as signing up for maternity insurance ahead of time or applying for the Patient Protection and Affordable Care Act (PPACA) early in the pregnancy, so that everything after January 1 might have been covered.

That’s not an endorsement for the new health care law, but it is an acknowledgement that pregnancy and pre-existing conditions are no longer uncovered by standard health insurance policies. Depending on how the financial aid application goes, out-of-pocket could still end up being the best option since it goes away once it’s paid off and there is no guarantee the PPACA deductible would have been affordable.

Even so, it feels like a better option now.


In Summary

Healthcare costs are formidable to the standard middle class family, and having a child ranks among the most expensive, outside of treatment for cancer or other chronic and life-threatening illnesses. It is so vital to know what coverages you lack ahead of time and purchase those from your insurer before you need them. If nothing else, it gives you peace of mind that there is a safety net there to catch you, and you’re not simply trying to figure things out as you go along. If you or someone in your family plans on having a baby in the next year, make sure you (or they) know what to expect. We hope this helps!

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