For some would-be parents, the wonderful news that a baby is on the way is tempered by the sober realization that a lot of expenses are coming, too. Among the most overwhelming costs are those associated with the delivery of a baby -- especially if you don't have health insurance.
The health care system may be revamped, with millions more Americans accessing health insurance thanks to the Affordable Care Act, but it's still possible to find yourself pregnant and lacking coverage. So what happens if that's the scenario you're in? Start putting money aside, and consider the following.
Are you under age 26? If you are, look into joining your parents' health plan, stat. Federal law allows you to be a dependent on their plan, and pregnancy is considered a pre-existing condition. That used to be a problem if you were seeking coverage, but it's generally no longer an obstacle.
You don't have to live with your parents to be considered a dependent. It also doesn't matter if your employer offers insurance, and you don't have it. Even if you're 25 and will be 26 before your baby arrives, you should look into joining a parent's health plan.
According to Healthcare.gov, once you lose coverage on your 26th birthday, you'll qualify for a special enrollment period. It won't matter if it isn't yet November 15 through February 15, the open enrollment period when people can buy health insurance through the Health Insurance Marketplace, the exchange run by the federal government and numerous individual states.
The money problem may not be as bad as you fear. You're going to spend a lot, but maybe it won't be as much as you expect. In fact, Tiffany Powell, a 27-year-old in Glendale, Arizona, recently became a mother and was uninsured during most of her pregnancy -- on purpose.
"It was for us going to be cheaper to pay cash for the entire pregnancy than to have the insurance and then pay the copays, deductible and out-of-pocket max," she says. If she had been insured the entire pregnancy, she estimates she would have paid $7,500 to $10,000, which includes the $400-a-month premiums.
Instead, uninsured, Powell paid $6,000 for all prenatal and delivery costs, as well as the lab tests, ultrasounds and an epidural, which she hadn't planned on getting, but her physician advised her to do so. "My muscles had basically turned into a large knot and couldn't relax," Powell says.
Powell adds that she did get insurance until the last month of her pregnancy in case of complications.
That isn't to say everyone should try this. For starters, if there are complications, there's no guarantee that every woman delivering a baby will have a cost-effective and pleasant experience with her insurer. Powell and her husband, Jon, have their own business, Sapphire Bookkeeping & Accounting Inc. When she crunched the numbers in determining how much her pregnancy would cost, it's fair to say she really knew what she was doing. And if things had gone badly for the couple financially, it's reasonable to think that with their money management skills and savings, they would have managed fine. Not everyone will be so prepared.
"If you plan on getting pregnant, you should sign up for health insurance before you need it," advises Michael Mahoney, senior vice president of GoHealthInsurance.com. His advice may be self-serving, but it's hard to discount.
Still, if you are uninsured and can't get coverage, you may get relatively lucky like Powell did. Epidurals aside, Powell delivered a healthy daughter, Lillian, on May 4.
Shop around. If you are stuck in a situation where you're going to pay for the prenatal care and delivery yourself, "look into all of your options," Mahoney urges. "The cost of a birth is vastly different at different hospitals."
For instance, in Chicago, where Mahoney is based, he says MRIs can range from $300 to $12,000.
So don't automatically settle for Hospital A because you were born there and have warm feelings about the place. Hospital B might be just as competent but far cheaper. And you'll want to investigate more than just the delivery costs during the pregnancy -- look into the costs of prenatal care, too.
[Read: The Hidden Costs of Pregnancy .]
"It's crazy, but once you realize what something is going to cost you, and that this is happening even for people who have insurance, since insurance increasingly has rising deductibles, shopping for health insurance is going to look like Amazon.com," Mahoney says.
In other words, just as you shop around for the best price for a book or pair of sneakers, Mahoney thinks consumers will have to be just as price-consciousness when it comes to their health care.
And if you are price-conscious, you may not be crazy about the idea of a home birth, but there's no doubt that it's cheaper than a hospital bed.
"The average cost you'll spend having a baby delivered in a hospital is $30,000 without insurance," Mahoney says. "If you have insurance," he adds, "the out-of-pocket costs are around $2,000."
The finances worsen with a cesarean section, which, on average, can easily cost another $20,000, according to a 2013 report by Truven Health Analytics.
At least if you start off with a home birth, your costs will start lower. The average price of a home birth -- at least in Chicago -- is $4,000 to $6,000, says Kristine Tohtz, clinical director of Serenity Family Wellness, a holistic medical practice.
People who are worried about giving birth at home should know that there's a lot of scrutiny in the home birthing industry, according to Tohtz, who is also a certified postpartum doula and occasionally assists in childbirths.
"I think there's even a slightly higher level of scrutiny precisely because the birth is happening in the home," Tohtz says. "You have to be healthy, and the baby has to be. If you aren't a home birth candidate, [the midwives] won't take you."
Mahoney, in fact, says he and his wife recently had a baby and were planning on delivering at home -- and they're insured. But their son was born five-and-a-half weeks early, and they were told to deliver at the hospital in case of complications (there weren't any).
Another alternative is a birthing center, a health care facility that, on average, charges half the cost of a hospital delivery, according to the American Association of Birth Centers.
Whatever you do, you'll do well to price everything you can beforehand and consult your physician and hospital to see if they have any suggestions for cutting costs without cutting care.
Because Tohtz isn't kidding when she says, "From a financial standpoint, if you can help it, you don't want to have your baby come out and you're already $25,000 in debt. Because now you have to raise your baby, and they aren't that cheap once they're on the outside, either."
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