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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During pregnancy
Make sure all of your physicians and secondary providers are in your plan’s network, advises Joanne Armstrong, the head of Women’s Health at Hartford, Conn., insurer Aetna. Insured individuals usually pay less when using an in-network provider.
Also confirm that "the lab work and radiology center for the ultrasounds are also contracted with your health plan," Armstrong says. Additionally, hospitals may have anesthesiologists on staff during the birth of your child whose services are not covered by your specific insurance, so it's important to research physicians throughout your pregnancy and before delivery, she adds.
Considering where and how you give birth can also decrease costs. For low-risk pregnancies, depending on the mother's age and any pre-existing conditions, choosing a birthing center or working with a midwife, rather than with an obstetrician in a traditional hospital setting, can cut costs, Macones says.
"Birthing centers are a nice option for low-risk pregnancies," he says.
At the birth
Most expenses are racked up during the hospital stay. Premature birth or inducing a birth can increase costs even further because of neonatal care costs for the child. While inducing labor is typically covered, it can raise costs because there is an increased risk of C-section, says Aetna's Armstrong.
To get a more complete picture of unexpected costs, visit the hospital billing center and ask specific questions about the cost of epidurals, C-sections, private rooms, labor induction and other common expenses, Macones recommends.
"Physicians don't know these types of answers off the top of their head," he says.
Take advantage of free in-hospital classes, such as lactation counseling.
After delivery, expect multiple bills, says Lindsay Durrenberger, 26, who gave birth to son Dax in July in Tallahassee, Fla.
While her Blue Cross Blue Shield plan covered most of the $8,000 in birthing expenses, she was surprised that opting for an epidural meant she paid $550 for the out-of-pocket cost to the anesthesiologist. Another surprise: $200 extra for two in-hospital pediatrician visits. Her son's circumcision added $400.
Getting the bills can be overwhelming, says Durrenberger, whosays she expects to pay $1,349 total out of pocket for the birth.
"At this point, it's kind of nerve-wracking," she says. "I'm still waiting for the bomb to drop."
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