5 tips to help you prepare for pregnancy costs
Expecting a baby?
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you → help → baby
5 tips to help you prepare for pregnancy costs
As Grace Griffin and her husband were welcoming their long-awaited baby — a daughter — Griffin found herself worried about looming medical bills and unsure whether the family could pay for the care needed.
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family → help → care
"This whole experience has me wondering (keeping me up at night, actually): Can we ever afford to have another child?"
— Grace Griffin, Calumet, Michigan
Grace and Daniel Griffin, both 26, knew money would be tight once they had their first child.
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they → have → child
So, even before the Calumet, Mich., couple tried to conceive, they began crunching the numbers to figure out the cost of pregnancy.
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they → try → pregnancy
"We wanted to save up enough to pay for those medical bills right away, if possible," Grace said.
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Grace → want → bills
But the cost estimator that she found linked to her UnitedHealthcare student plan asked for medical billing codes for each procedure that Grace was likely to receive.
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Grace → find → that
That's information she didn't have.
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she → have → ?
So, she kept digging until she found the Summary of Benefits and Coverage information on the health plan's website, which estimated out-of-pocket costs for a routine pregnancy and delivery at about $2,700.
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which → keep → 2,700
"We thought, 'OK, that's doable,'" she said.
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she → think → ?
"We should be able to save up that much and pay for that out of pocket.
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We → save → pocket
But as the expenses piled up, it was clear the estimate wasn't even close.
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estimate → pile → ?
Early in the pregnancy, Grace met her $500 deductible, the out-of-pocket cost she had to pay before insurance pitched in.
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insurance → meet → pocket
Her plan also required her to pay 20% coinsurance for in-network care.
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plan → require → care
This meant that for every $100 billed for things like routine blood work and other needed care, she was on the hook for $20.
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she → mean → 20
"When I started getting lab work is when we started realizing expenses would add up quickly," Grace said.
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Grace → start → work
Routine blood tests to check iron levels or for gestational diabetes were a couple of hundred dollars every visit, she said.
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she → check → diabetes
In June, after what Grace described as a routine pregnancy and delivery, the couple welcomed their daughter.
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couple → describe → daughter
Then the Griffins received an "explanation of benefits" notice that showed the hospital charged about $18,000 for the delivery, with the family on the hook for a sizable portion.
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family → receive → portion
"I thought, 'Oh no, it's going to be a lot,'" she said.
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she → think → ?
"Much more than we budgeted for.
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we → budget → ?
In early October, Grace said, her family's out-of-pocket expenses had totaled more than $9,000, over three times the general estimate published by her insurer for pregnancy-related costs.
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expenses → say → costs
Meanwhile, Grace and Daniel are scrambling to cover their bills.
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Grace → scramble → bills
For years, federal lawmakers have tried to remedy this issue, said Sabrina Corlette, a research professor and co-director of Georgetown University's Center on Health Insurance Reforms.
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Corlette → try → Reforms
To make healthcare costs more transparent and accessible to patients, Congress required insurers to provide consumers with an individualized "advanced explanation of benefits" estimating what scheduled care would cost them.
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care → make → them
The rule, part of the 2020 No Surprises Act, was due to take effect on Jan. 1, 2022, but federal regulators have yet to make that happen, despite ongoing pressure from members of Congress.
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that → take → Congress
"So, it's basically 4 1/2 years since this was supposed to be available, and I think it's a source of a lot of frustration for a lot of folks," Corlette said.
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Corlette → suppose → folks
"People have a right under the law to know these things."
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People → have → things
Meanwhile, she said, another change is pending.
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change → say → ?
Beginning Jan. 1, 2027, long-standing maternity billing codes that bundle much of pregnancy care will be replaced with more detailed coding for prenatal care, labor, delivery and postpartum care.
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that → begin → care
The change could make it easier to see what individual services cost, but Corlette said it's not yet clear whether the change will make it easier for people trying to stick to a budget.
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it → make → budget
"I could see where it might be advantageous to the provider," she said.
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she → see → provider
"But I'm not sure I'm seeing benefits to the patient."
Until out-of-pocket maternity expenses get easier to estimate, here are some tips to help you budget for the cost of pregnancy.
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you → see → pregnancy
1. Enroll your baby before the clock runs out
Ensuring your newborn has health coverage is one of the first paperwork responsibilities that parents face in the whirlwind of bringing a baby home.
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parents → enroll → baby
Birth creates what's known as a special enrollment opportunity, meaning you don't have to wait until the annual open-enrollment period to sign up a newborn.
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you → create → newborn
Many employer health plans require parents to request enrollment within 30 days of birth.
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plans → require → birth
Marketplace plans — for those who buy their own insurance rather than get it from an employer or the government — generally allow 60 days.
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who → buy → days
Wait too long, and your baby may be left uninsured until the following year.
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baby → wait → year
Michelle Critzer of Ventura, Calif., learned that lesson the hard way.
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Critzer → learn → lesson
She works as a sales rep and is the mother of a toddler and a newborn.
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She → work → toddler
Her second son, Hudson, was born in February, and Critzer missed the enrollment deadline for him.
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Critzer → bear → him
…and 35 more, not listed.
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