High-Deductible Health Plan? Giving Birth Without the (Financial) Pain

When I became a parent three years ago, I was excited to finally see my baby’s face for the first time...I was less than excited to face a five-figure bill mere weeks after giving birth. I found a way to cover the costs, but my high-deductible plan meant financial stress in addition to the usual sleepless, getting-used-to-being-a-parent thing.

As it turns out, my experience isn’t as uncommon as you might think.

It’s no secret that having a baby is expensive.

For many, sticker shock begins at the very first OB appointment, just weeks after becoming pregnant. Sure, the Affordable Care Act made maternal care coverage mandatory among health insurance plans, but that doesn’t mean it’s cheap.

And of course, if you don’t have insurance, the cost of having a baby can be staggering.

Here are some ways to keep your costs in check:

Find Out What You’re Dealing With (When It Comes to Health Insurance, At Least)

As soon as you or your partner gets pregnant, call your insurer to find out what is and isn’t covered under your policy.

Ask about preventative services like folic acid supplements, anemia screening, and breastfeeding supplies and counseling. What steps should you take to get your newborn on the plan immediately? Are there any limitations on your newborn’s care?

For example, if you deliver at an in-network hospital, do you need to worry about whether the pediatrician who discharges your baby is also in network?

Talk With Your Doc

Ask your doctor’s office how the practice bills for prenatal care.

Many offices operate on a “global billing” policy, where all costs of prenatal care and delivery are lumped together in one fee. Especially if you’ve conceived in one calendar year and will deliver in another, find out whether your deductible will reset at year-end (potentially costing you hundreds or thousands of extra dollars).

Make the Most of Your FSA or HSA

If you or your partner has health benefits including a flexible savings account (FSA) or a health savings account (HSA), the money in these accounts can be used to pay for deductibles, co-pays, and even a doula or lactation consultant.

Learn all the ins-and-outs of what your FSA covers to help your dollars go as far as possible.

Anticipate the Un-Anticipate-Able

Especially if you’re a new parent, there’s a good chance you’ll face costs you couldn’t have predicted. Recovering from childbirth is hard enough without worrying about how you'll pay for it.

For example, my daughter was diagnosed with a tongue tie that made it difficult for her to effectively breastfeed or even take a bottle. The laser procedure to fix it cost over $1,100 out of network, on top of my already large deductible.

Consider saving up a “just in case” fund for any unexpecteds that might pop up.

Also think about any paid help you might need. For example, many new parents consider a baby nurse, postpartum doula or night nurse to be invaluable during the first few weeks post-delivery.

These professionals are not covered by insurance, so you’ll need to budget accordingly. Some lactation consultants are covered by insurance and some aren’t, so do a little research before baby’s born.

Throw a Tactical Baby Shower

While it may be controversial to request cash in lieu of baby shower gifts, consider leveling with your friends and family if you’re facing down a staggering deductible payment. Instead of giving you onesies or toys your baby may play with once, consider an “alterna-registry” like SoKind, where you can “register” for gifts like 529 contributions, date night cash, free nights of babysitting or home-cooked meals (saving you money on those items down the line).

You could set up a general “baby fund” to defray expenses.

Make Sure You’ve Got Your Newborn Covered

Under most insurance plans, you have a window of time (often 30 days) to add your baby to your policy. As if early-morning feedings and generalized baby haze weren’t enough, try adding a calendar reminder to your schedule before you give birth so you don’t forget once you’re in the thick of it.

If you don’t have insurance (or don't have workplace-sponsored insurance), be proactive and explore options as soon as possible. Medicaid income caps vary from state to state, with pregnancy counting as a “medical need” that may have unique income requirements.

Your doctor, too, may have options; some doctors’ offices offer prepaid or discounted plans for those paying in cash. Working with a midwife, as opposed to an obstetrician, might also cut down on costs.

Regardless of your health insurance coverage, now may be a smart time to make sure you have all your financial to-dos squared away. If you don’t yet have life insurance, consider whether purchasing an individual policy could help protect your family and provide peace of mind. (Here's what you should know if you're pregnant and thinking about life insurance.)

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