Midwife/Birthing Center VS Hospital Costs?

Jdunk2008

Just curious if anyone has expereinced both a hospital birth and then seperately a birthing center or at home experience?

Anyone aware of the costs associated with both and how different it was? I'm just wanting to compare.

 Thanks!

StefandTodd

I had a hospital birth with my first, and am planning a home birth with my 2nd.  The hospital birth cost me $5 per office visit and $250 for the hospital birth and hospital stay.

The homebirth will cost me $5000 total for prenatal and postpartum visits, and the birth.  There will be additional costs for vitamin K, eye ointment, etc. as well as for us to purchase a birth kit, etc.  All in all, I think we'll spend about $5500 out of pocket, compared to about $400 with my first.

I'm 99.9999% certain my insurance will never pay the homebirth costs (there is an old wives tale that this particular insurance did once, for one woman once upon a time, but overall it's generally understood they will not).  And I'm pretty pissed about it, but still (obviously) considering it worthwhile for continuity of care with a midwife, giving birth at home, not being forced to stay in the hospital despite a complication-free delivery (as I was with my first), and being able to include rather than leave my son for the birth and overnight immediately prior to introducing him to his sibling.

Jcrab

My C/S with DS was definitely more than 20k but I have double HMO coverage and did not pay a penny. With DD we paid between $4500-5000 for our home birth; I had concurrent OB care with a NP to get labs and ultrasounds covered through insurance. It makes me mad that insurance likely paid more for my duplicate OB care than the entire cost of my home birth and that they won't be paying anything for my delivery but it was definitely worth it to me. In CA at least I believe a vaginal delivery is $15k and up, C/S usually $20-30k!

Jdunk2008

Thanks for your response! I work on and L&D unit at a large hospital and very few deliveries are natural or with midwives but I'm interested in all the aspects & I was curious if cost would be much different. Insurance would be the biggest difference between everything. I'm curious about birthing center costs versus the hospital too.

 

drpayne

Our BC is about $4000, a little less this time since it's our 2nd (I think $3400).  We paid out of pocket for a hospital last time and it was probably around $9000-10,000.  The hospital part is tricky because you get bills from twelve different places (hospital for you, hospital for baby, hearing test, OB, anesthesiologist if applicable, etc.)  We signed a waiver for early release, too (only stayed one night, not the recommended 2).  We were supposed to deliver at the BC but I was transferred...so we paid for both

RockyMtnMama

With my insurance I ended up paying about $3500 for a hospital vs. $2200 for a free-standing birth center...both times I didn't have pain meds or added costs.

However, the hospital costs were larger since my OB/midwives charged about $2200 to my insurance for prenatal/labor/delivery and then the hospital charged like $3000+ for my stay and about $1000 for my son's charges - overall with my deductible and 80/20 plan I paid around $3500 total.   

My midwives charged $2800 for labor/delivery/prenatal/birthing center costs for me and my son and I ended up needing a $1000 repair by a pernatologist, so overall after deductible and 80/20 plan I paid around $2200.

Not significantly different really.

ETA: Oh and those hospital rates are based on what my insurance negotiated b/c if we didn't have insurance the OOP cost for the hospital alone was almost $10k, but with insurance it was discounted to $3500.  For the birth center the cost is the same with and without insurance.

 

drpayne

Wanted to add.. you can't go by what people say their EOB listed as "cost."  Had they not had insurance, it would have been discounted a lot.  For example, my portion of the hospital bill initially was $12,000.  The private pay/no insurance cost was close to $3000.

MrsPez07

My insurance has changed quite a bit since I had DS 3 years ago. With the 80/20 co-insurance, that increases my out of pocket for either hospital or the birth center, though it would be the same maximum OOP for either.

With that being said, I had a vaginal delivery with some IV fluids at a hospital and only paid the $500 deductible with DS, because the co-insurance at the time was covered 100%.

This time with the birth center, they calculate based on your insurance  and back out the global fees, etc. from there. We're paying around $2000 total because of my 80/20 co-insurance coverage. I will likely get some of that back though from them, because I have already put money towards the co-insurance for U/S and labs not part of my pre-natal coverage in seeing them.

Here's my birth center's estimate/example on cost variations between the two (scroll to the bottom):

https://www.mountainmidwifery.com/Services

StefandTodd

drpayne:

Wanted to add.. you can't go by what people say their EOB listed as "cost."  Had they not had insurance, it would have been discounted a lot.  For example, my portion of the hospital bill initially was $12,000.  The private pay/no insurance cost was close to $3000.

Yeah...I wish I knew what my insurance paid for my hospital birth actually.  I might try to look it up.  I had an intervention-free, uncomplicated vaginal delivery in the hospital with a midwife, and then was required to stay 48 hours...so I know just the long stay cost a pretty penny.

wannabigfam

We looked into this extensively w/ our first (2 years ago).  Hospital cost us our out-of-pocket maximum, which was around $2000 or $2500 (can't remember).

Birth center would have cost us $4000 IF insurance didn't cover it.  We could have applied for an out of network exception, where they would 1) consider covering it out of network or 2) they would have considered covering it in-network since there was no similar-type in-network provider.  However they couldn't tell us until after we submitted our first claim if it would or wouldn't be covered (officially) and since the birth center required us to start paying, this made us nervous.  Since then, the birth center has gotten more organized (it was the first year they had opened) and now they are pros at getting in-network exceptions and coverage.

 What made our final determination was that if I had to transfer from the birth center to the hospital, I'd be on the hook for the full $4000 for the birth center PLUS my hospital cost through my insurance, so it would have been like $6500.  My husband just couldn't get on board w/ that. 

webMistress0609

I just switched to a homebirth midwife from a midwife practice in the hospital. 

The "global maternity fee" (including delivery) @ the hospital was just under $1000. The MW I'm seeing now is charging $3000. 

Aiobheann

I researched the cost of each while we were ttc.

Hospital birth at my hospital, med free, vaginally= approx 13k before insurance.

Home birth with team of MW=4500 before insurance.

Taking into account how much our insurance would cover of a hospital birth the total cost to us would be 5200$ for a hospital birth approx. not including the 15$ copay per prenatal visit.  

So if I don't have to transfer we'll save 900$ approx. 

Harper'smom

My c-section cost $2500 after insurance. My out of hospital VBAC cost $7000 OOP and insurance had contributed $900. The system is broke that is for sure but I do not regret 1 cent of my VBAC.

celiabwatson

With my son we planned to deliver at the birth center but ended up delivering at the hospital because he was 4 weeks early. The birth center was $6000 and the hospital was $12,000. However, in both cases we paid the out of pocket max of $3000. In our case we'd paid the birth center ahead and they refunded what we'd paid them and we gave it to the hospital (although they didn't refund the whole thing because we did use their prenatal care and their midwife for the delivery, but they refunded the same amount we were being billed by the hospital). 

After my son's birth and before my daughter's birth my insurance changed and even though the birth center was still in network our coverage for out patient procedures had basically gone away and birth at the birth center was considered out patient so insurance would have paid only $800 and we'd be responsible for the rest. If we'd paid cash it would have been discounted to less. However, I got on my husbands insurance and that was better, though we're still working it out because they're billing both insurances and no one can tell me how that works, even though it's been 6 months since the birth, but we have paid them about $1500 this time and are hoping for a refund since I was double insured. 

rels09

Yes, not sure about hospital costs, but my birth center is on par with PPs. The fee for all prenatal visits and a delivery at the birth center is $4500. This does not include labs, so bloodwork and ultrasounds would be additional. Our insurance pays it all in my case, but a birth center is significantly cheaper around here.

VABride2008

I have not had a home birth but I have had 2 hospital births.

For my daughter - $150.00 total

For my son - $300.00 total ($150.00 for hospital stay and $150.00 for circumcision).

I have a friend who did a homebirth and her costs were upwards of $2,000 out of pocket (she has insurance but insurance didn't put a dent in the costs).

SWBs Wifey

I have but I'm not much help.  With DS1, I had a hospital birth on Tricare Prime.  Total cost OOP = $0.  DS2, I had a BC (at a hospital) birth on Tricare Standard.  Total cost OOP = $25 (got the bill yesterday, actually).  But it would have been $25 at that hospital too because of my insurance.  I changed to standard specifically to be able to deliver at the BC.  Had I stayed on Prime, I'd have had to go to the hospital on base and I hear horror stories...