Listen Now

Episode 111 Content and Overview

In the United States, the average cost of a vaginal birth is over $18,000 and the average cost for a cesarean section is almost $28,000.  Health insurance is important because it will help to cover some of these costs and minimize the amount you will need to spend on medical bills.  The first step is to find the right insurance coverage for pregnancy and birth.  This is going to get you off on the right foot to minimizing your costs and making sure you are covered.  Next, you should know how your insurance works so you aren’t surprised by medical bills after your baby arrives.  If you already have health insurance that you are happy with this episode is going to help explain how health insurance works during your pregnancy and birth and how to understand what your cost is going to be. If you do not have health insurance or you are in the process of changing your insurance this episode will help you figure out how to choose the right plan.

Included in This Episode
  • Study on the cost of birth in the United States
  • Contacting your insurance company
  • Working with your care provider
  • How health insurance works
  • Important terms and what they mean:
    • Coverage
    • Premium
    • Copay
    • Deductible
    • Co-insurance
    • Out of pocket maximum
    • Explanation of benefits
  • PPO vs HMO
  • Provider Networks
  • Prenatal Care
  • Understanding your cost
  • Hypothetical examples:
    Sample HMO Health Plans Bronze Silver Gold Platinum
    Deductible (calendar year) $4,800 $2,500 $0 $0
    Out of Pocket Max (calendar year) $6,550 $7,000 $6,000 $3,350
    Prenatal Care $0 $0 $0 $0
    Maternity Labor & Delivery Co-ins. 40% 20% $600 copay $250 copay
    Estimated Cost of Vaginal Delivery $18,000 $18,000 $18,000 $18,000
    Deductible $4,800 $2,500 $0 $0
    Co-insurance for Labor & Delivery $5,280 $3,100 $600 $250
    Total $10,080 $5,600 $600 $250
    Lower of Total or Out of Pocket Max $6,550 $5,600 $600 $250
    Monthly Premium $262 $375 $416 $596
    Total Annual Cost of Insurance $9,694 $10,100 $5,592 $7,402
  • Sample PPO Health Plans Bronze Silver Gold Platinum
    Deductible (calendar year) $6,300 $2,500 $0 $0
    Out of Pocket Max (calendar year) $7,000 $7,000 $6,000 $3,350
    Prenatal Care $0 $0 $0 $0
    Maternity Labor & Delivery Co-ins. 100% 20% 20% 10%
    Estimated Cost of Vaginal Delivery $18,000 $18,000 $18,000 $18,000
    Deductible $6,300 $2,500 $0 $0
    Co-insurance for Labor & Delivery $11,700 $3,100 $3,600 $1,800
    Total $18,000 $5,600 $3,600 $1,800
    Lower of Total or Out of Pocket Max $7,000 $5,600 $3,600 $1,800
    Monthly Premium $287 $375 $550 $673
    Total Annual Cost of Insurance $10,444 $10,100 $10,200 $9,876
  • Your health insurance & the calendar year
  • Obtaining health insurance
  • Penalty for being uninsured
  • HealthCare.gov
  • Affordable Care Act (Obamacare)
  • Future changes (Trumpcare)
  • Healthcare for low-income individuals
  • How to find a provider
  • How to choose the right insurance plan
  • Communicating with your doctor or midwife (choosing your provider & how it impacts your birth)
  • Midwife or OBGYN?
  • Choosing a Pediatrician
  • Deducting medical expenses
  • Flexible Spending accounts
  • Health savings accounts
  • Consulting your CPA, accountant, or tax professional
  • Your Birth Plan book
  • Get the weekly Pregnancy Podcast newsletter
  • Join the Pregnancy Podcast Community on Facebook
Listen on iTunes or Stitcher Radio