As you decide whether you are ready to start a family, you probably thought about a lot of factors. Maybe you considered your income, your savings, or the size of your home. Perhaps you just felt that you really wanted to be a parent, and that everything else would work itself out. Did you consider your health insurance? Now is the time to take a closer look. Having a baby can be expensive, so save money where you can. Find out if you have a good health insurance for pregnancy, labor, and delivery. Here are a few things to consider.
This post may contain affiliate links, which means I’ll receive a commission if you purchase through my links, at no extra cost to you. Please read full disclosure for more information.
Healthcare for Pregnancy, Labor and Delivery, and Postpartum
First, let’s start by looking at some of the healthcare costs you may find during pregnancy, childbirth, and postpartum care.
Prenatal care is the care you receive while pregnant. This will include routine prenatal visits, lab work, glucose screening, and ultrasounds. Some testing is optional, like Chorionic villus sampling, amniocentesis, and fetal DNA testing. Then, depending on the results of these screenings and tests, you may need further care or treatment. For example, during my pregnancy, I had low Hemoglobin and needed a referral to a hematologist. I then required multiple B12 injections and iron infusions. Some prenatal complications require a hospital stay for monitoring, so you want to be sure you’re well-covered.
Next, labor and delivery! This is the exciting part, but also the expensive part. Whether you give birth in a hospital, birth center, or at home may affect coverage and costs. You may choose to have a Doula for support. You may or may not want an epidural. Costs vary most with vaginal birth vs C-section birth, as C-sections are more costly.
For postpartum care, you should receive at least a postpartum check up with your provider. You may also want to have a visit with a lactation consultant.
Another factor to consider is coverage of treatment for infertility. It is certainly something you hope you never have to deal with, but it is better to be prepared. Some treatment options can be costly. Some treatments that a plan may cover include ovulation-inducing medications, ovulation monitoring studies, procedures to remove obstructions in the fallopian tubes, assisted embryo hatching, semen analysis, endocrine treatments, sperm extraction, and other services. In vitro fertilization (IVF) is often not covered by insurance,
What should I look for when comparing insurance plans?
First, let’s look at some Health insurance terms:
Premium – the set amount that you pay each month for your insurance policy
Deductible – the amount that you will pay out of pocket for healthcare costs before your insurance begins to help pay
Coinsurance – a percentage of the overall bill that you pay out of pocket for a service or doctor visit. The insurance company pays the remaining percentage
Consider your premium and deductible
Often, a plan with a lower premium will have a higher deductible. Generally, young, healthy people can save money overall with low premiums and a high deductible. But you will be using healthcare services regularly during a pregnancy and childbirth, and that may change things.
What if you have a high deductible during pregnancy, and the New Year rolls around? Your deductible will reset. You may have paid lots of costs during prenatal care in the previous year, but it won’t count towards this year’s deductible. So you will likely pay your full deductible again with labor and delivery costs in the New Year. Now, routine prenatal visits and routine testing is usually considered preventative by insurance plans. That means that it is likely covered 100% even before your deductible is met. The concern with the deductible only comes into play if you have other treatment during prenatal care.
If you believe you may need more healthcare treatment during pregnancy, then you may want to consider a switch. Consider if a plan with a higher premium, low deductible may help you. You could also consider taking the money saved from your lower premiums and saving it up. That way, when you need to pay for healthcare due to a high deductible, you’ll be ready.
What kind of birth do you want?
You certainly don’t have to have it all figured out now. However, you may already have an idea what kind of birth experience you may want. If you are leaning towards a birth center or home birth, make sure your plan will cover these services. Maybe you have heard family or friends recommend a good obstetrician; are they in-network with your plan?
When you take a look at in-network providers, also consider that the hospital sometimes contracts providers. These contracted providers may be out-of-network, even though the hospital is in-network. An example of this may be the pediatrician who may see your child in the hospital. If you need a pediatrician, hospital staff will likely ask you who you would like to use. Look at pediatricians in the area who are in-network beforehand, so you will be ready to make the right choice.
I’m not happy with my employer-sponsored health insurance. Do I have another option?
Yes, you do. I wish I had known this before my first pregnancy, so I’m going to share it with you. If your employer-sponsored plan isn’t good, and marketplace plans are too expensive, there’s another choice. Medical Cost Sharing plans are not considered insurance, but they could be the right solution for you.
What is a Medical Cost Sharing Plan?
The short version, is that with Medical Cost Sharing plans, members share each others’ healthcare costs. There are no shareholders, and administrative costs are generally low. Money you pay is going nearly in full to paying actual healthcare costs, not to lining others’ pockets. Medical Cost Sharing is not insurance, but it qualifies for the USA health insurance mandate. If you want more information about Medical Cost Sharing, read my article comparing types of insurance.
I could have saved thousands with Medical Cost Sharing with CHM!
I’m not exaggerating either! I was truly disgusted when I realized how much I could have saved. I actually knew about Christian Healthcare Ministries (CHM), the Medical Cost Sharing plan we use now, before my pregnancy. My parents had used CHM during a brief lapse in employment due to layoff, and spoke highly of it. I falsely assumed that my employer-sponsored plan had to be better. Medical Cost Sharing was just for those who didn’t get insurance at work, right? I was so wrong.
Costs with my employer-sponsored plan
If your employer has a good plan, Medical Cost Sharing may not save you money. But my employer-sponsored plan was not good, and even with my higher premiums I still had a high deductible. I paid more than $6000 out of pocket for my prenatal care, labor and delivery, and postpartum appointment. And I had an uncomplicated, vaginal birth.
Costs with CHM
After giving birth to my son, I stopped working full time and joined CHM to cover our healthcare. For the best CHM plan, I paid only slightly more a month than my employer-sponsored plan premiums. (That includes adding our new baby who wasn’t on my employer-sponsored plan previously). And with a pregnancy, prenatal care, labor and delivery, and postpartum, you pay $1000. That’s it. No scenario in which I’d pay more. It doesn’t matter if a New Year rolls around. It doesn’t matter what complications you have or where you give birth. It doesn’t matter if you need specialist visits. Your personal responsibility is $1000. And that will include seeing a lactation consultant.
I have had 2 subsequent pregnancies, unfortunately both ended in pregnancy loss. But I’ve been so grateful for CHM. When I call with a question, I get an actual person and they are so kind. And even with complications with my first miscarriage, I never paid any more than the $1000. I know with my old insurance, I would have ended up with another really large bill. Since I knew my healthcare costs were covered, I could relax and focus on my physical and mental health. I could also take some time off work without worrying about needing the money to pay the bill.
There are many Medical Cost Sharing plans out there. I would recommend that you check them out, just to see if it is a fit for you. If you have a good employer-sponsored plan, it may not be worth it, but you won’t know unless you compare. And I would absolutely recommend CHM for their prices, customer service, and for your peace of mind.
If you’re ready to start your family, I wish you all the best! I hope this has been helpful as you prepare for the future. Do you have any questions, comments, or Health Insurance experiences you would like to share? Comment below or email me at [email protected]. I would love to hear from you!
And if you have gone through pregnancy loss, feel free to reach out. It’s a hard part of my life that I never saw coming. I want you to know there are more of us out there that share this experience than you might know. And the support we can all give each other is so valuable, holding each other up on the hard days. I’ll be happy to be part of your community and support.
