Every year, nearly 4 million women in America give birth. But with this little bundle of joy comes a big question: How much will it cost to give birth? How will I pay for it?
While well-known raising a child is expensive, you might not anticipate the costs of giving birth. Having health insurance is an important first step so you can avoid hefty out-of-pocket bills for screenings and prenatal care. However, even with health insurance, pregnancy and childbirth can be expensive.
Read on to learn more about the costs and options to consider when having a baby.
The Affordable Care Act and Pregnancy
In the past, insurers could refuse coverage or charge higher rates to pregnant women because the pregnancy was considered a preexisting condition. It’s important to know that since 2014, the Affordable Care Act has prohibited providers for discriminating against any individuals with preexisting conditions, including pregnancy. The ACA requires all Marketplace, Medicaid, and individual and small employer insurance plans to cover maternity and newborn care, both before and after the baby is born. This is because maternity care and newborn care are considered essential health benefits.
If you have a Marketplace plan, it’s recommended that you report your baby’s birth by updating your application, because your coverage might change. According to Healthcare.gov, having a baby could qualify you for greater savings and lower monthly premiums.
How Much Does It Cost?
According to a study by Health Affairs, the cost of giving birth has been rising. In 2015, the average cost of childbirth for women with health insurance through their employer was $4,569. More recent data from FAIR Health found that the average cost to have a baby in the United States – without complications – is a whopping $10,808.
The costs of giving birth also vary depending on your state, your insurance, and whether or not the baby is delivered vaginally or by cesarean (C-section). For example, the average cost of vaginal birth in Alabama with insurance is $5,230. Still, the cost of having a C-section without insurance in a state like California could cost you $19,184. These expenses are even higher with complications.
Researchers have found that the increased costs of giving birth, even with health insurance, are due to the rise in high deductibles. Studies show that about 87 percent of women have a plan with a deductible, and 28 percent of insured employees have a deductible of at least $2,000.
Despite this, clear that having a health insurance plan will help offset some costs of pregnancy and childbirth. And you can discuss payment plan options with your hospital’s ombudsman if you find yourself unable to afford your hospital bills.
Special Enrollment Period
Every year, there is an Open Enrollment Period for the ACA, during which you can select your new Marketplace plan for the following year.
The Open Enrollment Period for 2021 starts November 1st, 2020 and ends on December 15th.
However, if you’re planning on having a baby but have missed the deadline, there’s no need to worry! Having a baby qualifies for you for a Special Enrollment Period, which means you can enroll in a new plan or change your Marketplace coverage after you give birth, even if it’s outside the Open Enrollment Period. Once you are enrolled, your coverage will be valid from the day the baby was born. The plan will cover you, your baby, and any other household members. The only stipulation is that you must apply within 60 days of childbirth. And waiting until after your baby is born means you won’t be able to receive health insurance coverage during your maternity.
If you have Medicaid coverage at the time of birth, your baby will automatically be enrolled in a Medicaid plan. This will remain active for at least a year.
Deciding to have a baby can be both exciting and overwhelming. Here at TrueCoverage, we offer affordable healthcare plans to help make your pregnancy and birth easy. The Open Enrollment Period for 2021 is almost upon us, and if you’re planning on having a baby soon, it’s a great idea to pre-register now. This will ensure that you’re protected with health insurance throughout your pregnancy and newborn care. If you’re interested in exploring your options but don’t know where to start, contact us! Our insurance experts will help you find the plan right for you and your baby.