Almost 3.9 million women in the United States give birth each year — and new deliveries don’t come cheap. Even for those who are lucky enough to experience healthy pregnancies, hefty expenses for prenatal, labor and delivery, and postpartum care can (and often do) crop up. Worst of all, 12% of childbearing age women do not have insurance to buffer the blow of these costs.
If you’re one of them, how much should you expect to pay to give birth without insurance coverage?
- Counting the Costs
- Expenses to Expect
- Are You Really Covered?
- Tips to Handle Maternity Care Expenses
- Helpful Resources for Pregnant Women
- Can You Get Health Insurance After Becoming Pregnant?
- Prenatal Care Should Not Be Optional
Counting the Costs
What you’ll end up paying for childbirth without insurance depends largely on the state you live in, its cost of living, and the type of delivery — vaginal or C-section. The average cost of having a baby without complications ranges from almost $5,000 to $11,000 for vaginal delivery. This could go over $30,000 if you include care provided before and after pregnancy, such as checkups and tests.
Women are increasingly likely to get a C-section, which is more costly. Today, pregnant women are undergoing C-sections 500 times more often than women did in the 1970s, and C-section births cost from $7,500 to $14,500 — almost 150% as much as vaginal deliveries on average. Checkups, tests, and complications will only add to these figures.
Though the exact amounts tend to differ by location, the cost of not having health insurance can cause a near doubling of the out-of-pocket expenses for having a baby. Hospitals typically charge uninsured patients much more than they charge those covered by private and public plans. Women in Alabama see the lowest costs, about $4,884 for a vaginal delivery with insurance and $9,013 with no insurance. On the other hand, women in Alaska pay about $10,681 to deliver a baby with coverage and $19,775 without insurance.
Expenses to Expect
From the first OB-GYN appointment, expectant moms have an average of seven to 12 prenatal visits. These appointments and tests could include:
- Doctor’s visits: $90 – $500 per appointment
- hCG test: $39
- Ultrasound: $280 – $600
- Amniocentesis: $2,500
- Blood tests: $39 – $63 each
- Chorionic Villus Sampling (CVS): $1,300 – $4,800
- Amniocentesis: $1,000 – $7,200
After childbirth, postpartum care will likely incur additional costs. New mothers may experience a wide range of serious ailments following birth, including infection, cardiovascular conditions, and postpartum depression. Insured women spend an average of $3,100 within a year after giving birth; uninsured mothers can expect to spend much more.
Priced Out of Insurance
Among adults with no health insurance, almost three out of four reported being uninsured because they could not afford the cost of coverage. Many don’t have access to coverage through their employers or can’t afford their share of the premiums, either. In 2019, 72.5% of uninsured workers said that their employer did not offer health benefits.
Among workers who are offered coverage at their jobs, cost often keeps them from taking advantage of the opportunity. Workers’ shares of premiums for family coverage have increased by 40% — much faster than wage growth.
In the Coverage Gap
Millions of women and their households earn too much for Medicaid but not enough to get Marketplace premium tax credits. The dilemma, known as a coverage gap, affects 12% of uninsured women. This problem is especially prevalent in states that have not expanded Medicaid under the Affordable Care Act.
Conundrum for Immigrants
Legal immigrants under 400% of poverty can qualify for Marketplace tax credits. However, they must have passed the specified period after receiving qualified immigration status. However, undocumented immigrants cannot receive any Medicaid or Marketplace coverage.
Coverage Can Be Confusing
Some uninsured individuals who qualify for help may be unaware of coverage options. They may find the selection process too complicated and give up on securing a plan at all. ACA outreach programs are short-staffed and in high demand, leading to decreased accessibility to information for some women.
Are You Really Covered?
About 4.2 million women ages 19 to 25 are dependents on their parents’ health insurance plans. Although you can remain on your parents’ insurance until age 26 regardless of marital status, you may still find yourself carrying the bulk of expenses for your prenatal care. Large employer insurance plans do not have to comply with ACA’s stipulations requiring insurers to cover pregnant women.
The law’s essential health benefit stipulations only apply to plans offered by companies with fewer than 50 employees and individual health care plans, a small percentage of plans nationwide. Unless mandated by state law, employers with self-insured health plans are exempt from offering maternity care. University student health plans might cover prenatal and childbirth services, but you may need to pay upfront and receive reimbursement.
Tips to Handle Maternity Care Expenses
Whether your pregnancy is planned or a surprise, setting your finances in order can alleviate the stress that the uncertainties of expectancy can bring. Anticipate potential costs and seek ways to reduce them or spread them out. Here are a few ways to lighten the financial load of childbirth:
- Negotiate payments up-front: Ask for a discount, especially if you can make full payments up-front.
- Set up a payment plan: Your hospital’s ombudsman can explain options if you cannot afford your hospital bills. They may offer a hospital indemnity policy, which will cover limited pregnancy benefits compared to a major medical plan.
- Review bills for hidden costs and errors: Check and confirm each charge before paying the provider.
- Call for legal help: If you were denied coverage for prenatal care that you believe you’re entitled to, call Cover Her, the National Women’s Law Center’s hotline.
- Choose an alternative to the hospital: Home and birth center deliveries are growing in popularity, and these options could save you thousands if your pregnancy is low risk.
Helpful Resources for Pregnant Women
Being pregnant with limited financial means can be extremely stressful. Fortunately, multiple federal, state, and local organizations are standing by to offer a wide range of supports:
- Children’s Health Insurance Program (CHIP) may help you find low-cost medical care if you aren’t eligible for Medicaid.
- Women, Infants, and Children (WIC) provides food and health care referrals for needy pregnant and postpartum women.
- Text4baby sends free, weekly SMS text messages to expectant and new mothers to help them manage their health.
- Maternal and Child Health Bureau provides information about health insurance and medical support for pregnant women.
- Pregnancy resource centers offer medical services, counseling, and connections with local financial resources.
Can You Get Health Insurance After Becoming Pregnant?
Thanks to the ACA, health insurers cannot deny you coverage or charge you more for premiums if you are already pregnant. If your or your partner’s employer offers health insurance, you may get better coverage at a better price. You might also find affordable coverage through the health insurance Marketplace. If your income is low, you may be eligible for Medicaid.
Employer and Marketplace plans usually require that you enroll during their open enrollment period. If you experience what’s called a qualifying life event, such as moving to another state or losing other health coverage, you may qualify for a special enrollment period. Unfortunately, pregnancy does not qualify as a life event, but childbirth does. However, Medicaid lets you enroll at any time. We at TrueCoverage can help you determine the best option.
In 47 states, pregnancy-related Medicaid covers benefits similar to Medicaid for other adults and is considered minimum essential coverage. In Arkansas, Idaho, and South Dakota, pregnancy-related Medicaid is limited to maternity care. If you enroll in pregnancy-related Medicaid in the other 47 states, you will no longer qualify for premium tax credits while enrolled in Medicaid. In every state, though, you will qualify for a special enrollment period for marketplace coverage and premium tax credits once your pregnancy and pregnancy-related Medicaid ends.
Prenatal Care Should Not Be Optional
With or without health insurance, prenatal care is essential for you and your developing baby. Regular medical attention helps to detect concerns early and reduce the chance and impact of pregnancy- and birth-related complications. Under an obstetrician’s watch, you’ll learn how to control existing conditions that could lead to dangerous issues without care.
Having a health care plan in place will ease the financial burden and uncertainty of pregnancy and childbirth. At TrueCoverage, we give you access to hundreds of comprehensive, budget-friendly insurance options. The sooner you’re protected with health insurance, the more likely you will be able to get all the prenatal care you need to ensure the best outcome. Contact us today to find the perfect plan for you and your growing family.