Preparing for a new baby is an exciting and often overwhelming time for a family. In the hustle and bustle of decorating the nursery and applying for daycares, it’s easy to forget to plan for the bill due after the baby arrives.
The cost of delivering a baby in the United States varies significantly by location, hospital, the complexity of childbirth, and more. Insurance and significant financial planning can mean the difference between a manageable expense and an overwhelming bill.
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What’s in a Bill: The Components of Routine Childbirth in a Hospital
Childbirth is incredibly complex, and much more goes into the final bill than parents may initially think. Beyond the various line items billed, the biggest difference in how much you pay for childbirth comes down to insurance.
Cost With Insurance
Cost Without Insurance
These prices reflect the culmination of fees accrued across pregnancy, delivery, and the postpartum period. It’s important to remember that these costs depend on many factors and vary between each childbirth. One of these factors is location. In Massachusetts, the total cost of childbirth runs parents nearly $35,000, while having a baby in Alabama averages around $14,000.
A facility fee is a fee that hospitals charge their patients to keep the facility up and running. You may be asked to pay a facility fee when you see a doctor at a facility that he or she doesn’t own or that is owned by a hospital. This fee includes the hospital’s overhead, which keeps the machines running, the doors open, and the lights on. The hospital is under no obligation to disclose the facility fee beforehand, so the patient is often surprised when they receive their bill.
Hospitals justify the facility fees by noting that they must be open 24/7 and ready to treat anyone who comes through the door. Patients mainly see facility fees at emergency room clinics or after inpatient hospital stays. They’ll also vary based on how much work a patient has done while in the facility. Depending on various factors, facility fees can range from $25 to upwards of $1,200.
Room fees are fees that the hospital charges for the patient to occupy a room for however long they stay. The price depends on whether two patients share a room or if a single patient has a room to themselves. Room fees can range from a few hundred dollars to a few thousand dollars per day of occupation.
- The cost estimate for room usage for insured vaginal delivery patients nationwide is $5,063. That same room is $12,443 for uninsured patients.
- The room cost estimate for insured C-section patients nationwide ranges from $705 to $913+ per day. It is $1,911 per day to $2,776+ per day for uninsured patients.
Most hospitals only have private rooms for their birthing patients. If, however, a patient wants to upgrade from a semi-private to a private room, they can expect to pay anywhere from $50 to $2,000+ per day on top of their other expenses. These costs can quickly increase if you experience a difficult childbirth and need additional recovery time.
Anesthesia is a cocktail of medications administered to relieve pain, numb specific areas of the body, or sedate patients entirely. Patients in labor can receive an epidural, which delivers pain relief throughout the delivery, or a spinal block, which lasts a few hours.
Patients who deliver via C-section are mostly kept under local anesthesia during the procedure. However, doctors can put them under general anesthesia in medical emergencies. The average out-of-pocket cost for anesthesia ranges from $500 to more than $3,500 for those without insurance. With insurance, new parents can expect to pay coinsurance of 10%-50% of the total cost. The cost also depends on the type of anesthesia required.
Vaginal Delivery Procedure
A vaginal delivery starts at home when the patient goes into labor. The hospital will admit the patient once their contractions occur at a certain frequency. During labor, the patient’s body is doing the painful work of preparing for the baby to move down the birth canal. Close monitoring during this portion of childbirth is vital as a lot can go wrong to risk the patient’s and the baby’s lives.
If the doctor needs to intervene, they and their medical staff will be on hand to perform whatever emergency maneuver necessary to save the baby and the patient’s life. The average cost for a vaginal delivery is $14,768 without insurance or through out-of-network providers. With insurance, the family is responsible for $2,655 for the same delivery. Emergency maneuvers and other complications can raise these costs.
Cesarean Delivery Surgical Procedure
A C-section is a type of delivery that requires the medical staff to deliver the baby directly through the abdomen. With this delivery, the patient moves to an operating room. The doctor cuts through the abdomen and the various layers of tissue to the uterus to remove the baby from the patient’s body.
This type of delivery can also either be planned or an emergency. It’s typically more expensive than a vaginal delivery because much more medical intervention is involved. The average cost for a cesarean delivery is $26,280 without insurance. With insurance, the family is responsible for paying $3,214. C-sections come with extended recovery time, which usually equates to higher medical bills.
Other Fees from Complications
A complication as simple as a longer labor and hospital stay or as complicated as an emergency C-section can add to the patient’s bill. This can mean an extra few hundred to a few thousand dollars, depending on the level of medical intervention.
Insurance Costs to Keep in Mind With Childbirth
Health insurance is critical in keeping out-of-pocket prices for healthcare as low as possible. The best way to utilize your coverage is to fully understand the various components before getting medical care.
- Deductible: A deductible is how much of the hospital bill the patient is responsible for before the insurance coverage begins. Plans with higher deductibles typically have lower monthly payments and vice versa. The patient must pay the total deductible for care before the insurance plan starts to pay.
- Copays: A copay is a flat fee a patient pays each time they see a doctor. The fees are between $20 to $100+ depending on the insurance plan and the type of care they receive.
- Provider Network: A network is a group of medical care providers and doctors across varying specialties that agree to provide care to members of a particular health insurance plan. The insurance will cover the majority or all of the bill if the patient uses the doctors within their network. If a patient uses an out-of-network doctor or hospital, they could be responsible for the entire bill that stems from that care.
- Out-of-Pocket Maximum: An out-of-pocket maximum is the maximum amount a patient is expected to pay for their insurance services during their plan year. After they’ve paid the out-of-pocket maximum in deductibles, coinsurance, and copayments, the insurance covers services 100%.
The Cost of Childbirth Across the Nation
The cost of childbirth across the nation varies significantly between location, manner of delivery, and other emergency and non-emergency services. The best way to avoid surprises when the bill comes is to be as knowledgeable as possible beforehand.
Pick a hospital with the most in-network doctors you can. Save money for the out-of-pocket fees. Have a birth plan and stick to it as closely as possible while accepting that often this situation is out of your control. Welcoming a new baby into your family is one of the most exciting and wonderful experiences; just be aware of the potential costs so you’re not taken by surprise.