11/28/2012 3:30 PM ET|
Having a baby? Keep the costs down
Plan early and ask specific questions of your health-care team to make sure your joyous occasion isn't marred by big or unexpected bills.
When Jeremy Price learned he was going to be a dad, he didn't go looking for strollers -- he shopped for health insurance instead.
Taking advantage of the open enrollment period for his health insurance, Price switched from a high-deductible plan to one with a lower deductible. This increased his monthly cost by $200, but the switch paid off, says Price, marketing director at American Trust Bank of East Tennessee in Knoxville.
Max was born in August, and the medical costs for the pregnancy and birth -- for which they are still getting bills -- will be about $3,000 out-of-pocket rather than the $6,000 they would have paid with their old, high-deductible plan, he estimates.
"That really did help us out," says Price, 32. "Cost was one of the things we worried about."
For most families, baby expenses start well before it is time to buy a crib. Prenatal and birth medical costs can add up to thousands of out-of-pocket dollars, even for families with health insurance.
An increase in prenatal testing and cesarean sections means the total medical costs of having a baby have risen, says George Macones, chairman of the committee on obstetric practice at the American College of Obstetricians and Gynecologists.
"Patients need to understand their out-of-pocket costs," Macones says.
Mothers paid an average $1,148 out of pocket in 2009, versus $661 in 2004, a 74 percent increase, according to the most recent data from the Medical Expenditure Panel Survey, which is sponsored by the U.S. government. These numbers can more than double for complications such as C-sections and premature delivery.
The Affordable Healthcare Act, in full effect by 2014, will help ease the burden, since more will be covered.
Health plans will be required to cover 100% of the costs of many maternity-related services, including gestational-diabetes screening, DNA testing, HIV screening and counseling, as well as breastfeeding support, supplies and counseling, according to an email from Patricia Stephenson, a medical director at Cigna, an insurer in Bloomfield, Conn.
Planning to save
Still, if you're planning on getting pregnant, there are ways to save.
Like the Prices, you can switch to a lower-deductible health insurance policy with a higher monthly premium to help offset costs.
For a high-deductible plan, consider a health savings account through your employer to set aside a tax-deductible portion from each paycheck.
At work, get in touch with your human resources department, because it may have valuable information on how to lower costs. Billing staff at the obstetrician's office can also answer questions about in-network coverage and policy specifics.
Examine details of what's covered by your particular plan. Cigna customers can go online to compare costs of services such as blood testing or prenatal exams from specific providers or sign up to speak with a maternity case manager to discuss individual coverage, Stephenson says.
Understanding the coverage early on can help reduce costs through the nine months, she explains. For example, women with severe morning sickness can opt for in-home intravenous treatments rather than taking them overnight in a hospital, which can increase costs, Stephenson says.
For prescription drugs, you can save by opting for generic versions when they are available.
Some commonly prescribed services are not always covered by insurance, says Dr. Angela Chaudhari, an obstetrician and attending physician at Northwestern Memorial Hospital in Chicago. Most insurers won't cover extra ultrasounds or genetic tests for diseases such as cystic fibrosis, a chronic lung disease, for patients with a low-risk pregnancy, she says.
Since most genetic tests can be scheduled ahead of time, Chaudhari tells patients to check with their insurer before committing to blood work.
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