Your hospital bag is packed, your baby’s name is chosen, and your birth plan is ready. But wait! Have you double-checked that your hospital or birthing center is in-network? And are you sure the care you need will be covered by insurance?
A little advanced planning can go a long way. Before things get too hectic, make some time to sit down, review your health insurance plan, and write down any coverage- or cost-related questions you might have. This will not only put your mind at ease, but it may also help you save money in the long run. Here are some things to consider that will help you get started.
What is considered labor and delivery?
Labor and delivery includes the time spent delivering your baby and your recovery right after your baby is born. You will be responsible for paying part of these costs.
Does insurance cover childbirth?
In most cases, yes – insurance will help cover childbirth. However, to what extent really depends on the kind of coverage you have. Here’s how to find out how much your health insurance will help pay and how much you’ll pay:
- Call your member services and let them know about your upcoming delivery. They can give you a cost estimate based on the hospital or center you’re going to. They can look at costs for both a caesarean section (C-section) or vaginal delivery.
- Check the “inpatient hospital visit” section of the paper copy of your insurance plan benefits, if you have one. If you can’t find that paperwork, you may also be able to check your benefits documents online.
- Many insurance plans offer online cost estimates. Log in to your online account and search “inpatient hospital visit.”
HealthPartners members: Check your costs and coverage in your online account
Childbirth insurance coverage and the cost of labor and delivery
It’s estimated that average out-of-pocket costs for childbirth in the United States are anywhere from $3,000 to $6,000 – and this is after insurance pays its part. However, each situation is different. Your individual costs will depend on a host of factors, and it’s important to have an idea of what you can expect in advance.
Delivery type
When it comes to labor and delivery costs, one of the biggest determining factors is delivery type. This might be a vaginal birth, scheduled or unplanned C-section, "natural birth", scheduled induction or something else entirely. Labor is different for everyone, and there are many ways to give birth.
But what’s actually covered? Does insurance cover a C-section? What about a natural birth or water birth? In general, both a C-section and vaginal delivery are covered at different levels, and it depends on any extra medication or services you might require. In fact, most delivery types that are performed in-network at a hospital or birthing center are covered, to some extent, by insurance – this includes methods like water or natural birth.
In any case, it’s good to be prepared. Your needs and your baby’s needs can change, so it’s a great idea to discuss many different types of delivery, and possible coverage options, with your provider well in advance so you know what to expect.
Delivery location
You can choose to deliver your baby in a hospital, hospital-based birth center, freestanding birth center or at home. However, not every hospital or birthing center is included in your health insurance plan. A call to your health insurance provider can help make sure the location you’re having your baby at is in your plan’s network.
Inpatient stay to recover from your baby’s delivery
The length of your inpatient stay and the costs associated with it will vary based on your insurance coverage and medical needs. The average post-childbirth stay is about two days – although many who undergo C-sections or experience more complex birthing situations may stay longer. Every plan is different and certain states sometimes require insurance providers to help cover post-birth inpatient care for a specific period.
Medicines during childbirth
There are many different types of safe, effective medicines that can help with pain during and after labor and delivery. This can include an epidural, spinal block, local anesthetics, pregnancy-safe narcotics and more. You can often plan what medicines you’d like to take during labor, but needs sometimes change during the delivery process.
So, is an epidural covered by insurance? What about these other medicines? When it comes to an epidural, it’s important to make sure that your anesthesiologist is in-network. This way you don’t get hit with any unexpected costs. Most general medications will be covered, to some extent, by your insurance. However, some might need a prior authorization. We recommend confirming pricing and asking coverage-related questions directly with your provider well in advance.
How expensive is childbirth without insurance?
It’s no secret that the overall cost of labor and delivery can get very expensive very quickly. In many cases, not having coverage can more than triple your out-of-pocket costs – and that’s just for a typical vaginal birth. More complicated forms of delivery that need surgical intervention or extensive care can easily reach up into the tens of thousands, often unexpectedly. Childbirth insurance coverage will ensure that you and baby get the medical and financial help you need.
How to reduce costs of childbirth with insurance
While there are a lot of unknowns associated with labor and delivery, pricing and coverage don’t have to be one of them. There are many ways you can reduce costs, and it all starts with staying informed.
Give your insurance provider’s member services a call. They’ll walk you through your potential costs and give you ideas for what to think about when you’re in the hospital. They’ll also help you find an in-network provider, which should mitigate costs, and help you better understand what insurance does and does not cover well in advance.
Have more health insurance questions?
At HealthPartners, we help people in Minnesota and Wisconsin find the right plan with the right coverage. We’re here to help make things simple. That way, you can choose a health insurance plan you’re confident in.