Getting the Most out of Health Insurance while Pregnant

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Copays and lab tests and ultrasounds, Oh my! Prenatal care has gotten really expensive, even if you are lucky enough to have insurance. Not to mention the biggest ticket item—having your baby! If you are expecting a bundle of joy, you need to check out these tips on how to use your insurance to your advantage so you can save some of that precious out-of-pocket cash! Getting the Most out of Your Health Insurance while Pregnant

The latest estimates from the US Department of Agriculture are that it takes over $240,000 to raise one child from birth to 18 years old!  And that doesn’t include college! That’s an incredible amount of money, but it doesn’t really come as a surprise.  Everyone says that kids are expensive, and we see this coming a mile away.

What you don’t expect is for pregnancy to cost as much as it does—it really sneaks up on you!  Sure, you need some stretchy maternity clothes and a few pairs of new shoes as your feet become clown-sized, but the biggest expenses of being pregnant are medical bills and copays.

You need to go to all of your prenatal appointments, get (some of) the recommended testing and lab work done, and most OBs and midwives tell you that you have to get at least one anatomical ultrasound at 20 weeks.   

All this medical stuff adds up fast!   With my insurance, we had to pay $250 out of pocket just for one ultrasound!  Not to mention the biggest ticket items—the labor, delivery, and recovery when you have your baby.

With healthcare providers and hospitals overcharging for absolutely everything—did you know that full price for one bag of saline at some hospitals is close to $800?!—it is more important than ever for soon-to-be mamas to have a plan for maternity care that takes the most advantage of your health insurance coverage.

Go where you are covered by your health insurance.

It sounds like a no-brainer, but my husband and I made this mistake.  Hoping to cut down on our overall costs and avoid the rushed timeline and common interventions in the hospital, we chose to go to a birth center for our prenatal care and delivery.   We felt confident about our decision to go with the birth center because I had a low-risk pregnancy and I wasn’t interested in a medicated birth.

It wasn’t covered by our insurance, but the out-of-pocket costs were less than that of the hospital covered by our insurance, even with no major medical procedures.   We really thought we had made the best decision for our wallets and for our birth plan.

However, like the best-laid birth plans, labor didn’t go smoothly and I had an emergency transfer to the hospital.  Now we have to pay not only 30% of our hospital bills (it was in-network), but also full price for the birth center.  Learn from my mistake, and just go where you are covered in the first place!

And don’t worry—it is possible to have a natural birth at a hospital, as long as your doctor and team of nurses is on your side.

To find which medical facilities and OBs are covered by your insurance, go to your insurance website and search for in-network care in your area.  Pretty much every health insurance company has this feature on their website and app.

Do your research.

Not only do you need to find out which OBs, hospitals, or birth centers are in-network, but there is a lot more you need to know about your insurance coverage before making decisions about your prenatal care.

Start by looking online for the basics about your coverage, but don’t be afraid to call and ask.  Some companies will only cover certain tests, only one ultrasound, or you may have to meet a deductible.  The more knowledgeable you are about what is covered, the better you will be able to make smart choices when it comes to your prenatal care.

Some insurance companies have pregnancy care programs that cut down on the cost of your hospital stay or offer you samples and coupons when you participate. These incentive programs  are designed to collect information to help you have a healthier pregnancy—and it pays to participate!   

A few of these programs require you to sign up early in your pregnancy, so while you are online collecting information about coverage, be sure to look into this, too!

It is okay to say no.

Did you know you had that power? Well, you do!

Almost everything will cost extra when you are pregnant.  In fact, my copay usually just covered being weighed, peeing in a cup, and being in the same room as the doctor—it’s like paying $40 for someone to tell you that you are gaining weight. Thanks, insurance.

With my particular insurance coverage, it cost $250 for each ultrasound!  Yikes!  It is okay to only have the ultrasound you really need—the anatomical ultrasound at 20 weeks.  The dating ultrasound is just as costly and completely unnecessary.  It is okay to say no!

Lab testing costs extra, too.  Take time to do research about each test, talk to your doctor about why it is being offered, look into what is covered, and talk to your partner about what you want to do. Pick and choose the tests that are important to you.  You don’t need everything just because the doctor offers it or tells you it is “standard”.  Educate yourself about each test—its benefits, risks, and cost—before signing on the dotted line.

If you have a high-risk pregnancy or any medical problems, let your doctor know your concerns and decide together about what testing is important for your particular case.

Get your free breast pump!

Your health insurance company will provide you with a breast pump!  New mamas everywhere, rejoice!   

These suckers are expensive when you have to pay out of pocket—the good ones can be over $300!  Breast pumps are a godsend for breastfeeding moms, and absolutely necessary for moms who are going to work outside of the home while breastfeeding.

Call up your insurance company and request your pump at least 3 months before your due date.   I waited until after my son was born to get my free pump, and I wish I had it on hand from the moment he was born.

Some companies let you choose what pump you want, but mine did not—they just sent me a nice Medela double pump.  Honestly, it works great, and I haven’t had any issues.  This is by far the most amazing program for new moms if you have health insurance!

Prenatal care can be expensive and the cost of having your baby is incredibly high, even when you have health insurance.  Maximize your insurance benefits by going to an in-network doctor and facility, doing your research about coverage and incentive programs, saying no to unnecessary testing, and getting a free breast pump.   Before you know it, your baby will be here, and you can enjoy this precious time knowing that you used your insurance to your advantage.

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