Out-of-pocket costs for childbirth?

EmilyJBrown · May 2011

Hello ladies! For those of you who have given birth already, how much did you end up paying out of pocket for your L&D charges (and where)?

I have talked to some people who have been billed A LOT, and others who paid next to nothing (depending on insurance and the situation) and it got me wondering what the range might be?

kinibruin · May 2011

hi!

it really does range a lot. we have a great PPO. our insurance covered 90% until we met our yearly out of pocket and then after that paid 100%.

besides calling my insurance and seeing what my breakdown would be, i called the hospital directly and got a quote for how much my delivery would be and what the costs generally are.

i live in the sf/bay area and delivered at a really nice hospital.

i had 3 separate bills:

the hospital where i delivered
my OB
the anesthesiologist

for a vaginal birth with a 2 day stay, the average was 5-8K i think. for a c-section with a 4 day stay, the average was 40K. of course, the insurance would cover a majority of that.

i had many many complications so my bill was very much over the average. also, D spent time in the NICU, so he had quite a few costs as well.

suffice it to say, even though we needed treatment and the bills were through the roof, the level of care we received was awesome so i don't think we would have had it any other way.

again, my insurance cover pretty much 100% of both my costs and D's costs, so we were very very lucky. i can see how many people can get in a bad financial state if they get sick and have bad/no insurance.

Married2MrWright · May 2011

We paid $15...just our copay. I have REALLY good insurance.

lelekay · May 2011

I paid my $10 copay just once for the whole pregnancy and delivery....yay! (especially considering the statement we got was over $17,000 for me and almost $3000 for Henry). We have BCBS HMO of IL.

SanHawaii08 · May 2011

I have Cigna HMO, they cover everything for L&D (and pre-natal visits, and well-baby visits. no copays - yay!). Which is beyond awesome, b/c my midwife-attended vaginal birth (I did end up with an epidural) was over $10k, and LO's bill was around $92k - he spent 2+ weeks in the NICU.

lola808 · May 2011

We supposedly have "good" PPO insurance here in HI, but had I not been dually covered that month due to DH switching jobs, I would have had to pay 10% of everything. $700 to the hospital (normal delivery) and about $500 my OB and other docs... so at least $1200 for my services. Can't remember LO's charges, if any. Thanks our dual coverage, we didn't have to pay anything, though. I was really surprised by the out-of-pocket expenses and wondered how many people aren't prepared when all the bills roll in.

EmilyJBrown · May 2011

Thanks guys! I had called the insurance company, and they told me that the only guaranteed cost will be my copay ($100 at admitting) which covers my whole pregnancy up until this point, but they cannot say what other out of pocket costs will arise until they know the hospital/OB/anesthesiologist charges from the delivery and stay. I imagine it will be something more, but I was shocked to hear from my sister that she and her husband are paying a $6000 bill for a delivery in Tennessee.... wow.

mrs.winter · May 2011

I only paid $15 out of pocket the day I found out I was pregnant via a urine test at Kaiser with my plan.....nothing for the rest of the pregnancy or the 8 weeks after for me and the well baby check up's for my son are also included.

Married2MrWright · May 2011

EmilyJBrown:
Thanks guys! I had called the insurance company, and they told me that the only guaranteed cost will be my copay ($100 at admitting) which covers my whole pregnancy up until this point, but they cannot say what other out of pocket costs will arise until they know the hospital/OB/anesthesiologist charges from the delivery and stay. I imagine it will be something more, but I was shocked to hear from my sister that she and her husband are paying a $6000 bill for a delivery in Tennessee.... wow.

My BFF had Blue Cross PPO and paid $6K for her first born. Then she switched to Kaiser (she is self-insured and self-employed) and only paid $1500 with her second.

It all depends upon your specific plan, copays, deductibles, etc. You should be able to take your plan to your doctor's office and talk with the person who does the billing about what your costs will be.

MrsNJSwimmer · May 2011

I'm pretty sure my OB's office called my insurance after we confirmed the pregnancy so they could tell me what would be covered. I remember them telling me that if it was a boy, the circumcision (sp?) would be covered if we chose that.

I had one copay for all my OB office visits, including the one after delivery (I was pleasantly surprised by that!).

I had a "confinement fee" of $200 for delivery and hospital stay and another one for DS (so $400 total there)

Our PPO is really good, so I think that the anesthesia was covered b/c he worked in a hospital that's covered in our insurance.

I think that's it. We're near DC.

eacerna · May 2011

i live in DC and paid $10 co-pay for my L&D.

MrsNicole&Brian808 · May 2011

I had LO at Kapiolani and have PPO single coverage. Here's what we paid out-of-pocket:

4-night hospital stay for me (most of Kapiolani's recovery rooms are private): $100
Nursery for LO: $100
Anesthesia (epidural): $243 (PPO only covered 80%)
Anesthesia (unplanned c-section): $82 (PPO only covered 80%)
Copay for extra pediatrician during c-section (there was concern about MAS): $15

ETA: I calculated our total expenses just for our time in the hospital (L&D) and I think it came out to $35K! So the $540 we ended up paying OOP wasn't too bad, IMO.

Everything else was covered 100%: prenatal care, surgical services, drugs, etc.

HTH & best wishes for the remainder of your pregnancy!

EmilyJBrown · May 2011

Thanks everyone! Big Smile

mrspresley · May 2011

i had a c/s and an $800 deductible to meet ($400 for medical, $400 for hospital stays), after that insurance covered 80%.... so with my epidural, c/s, hospitalization (4 nights), etc it all came out to about $4-6k out of pocket (i don't remember the exact amount anymore)

your insurance company can't tell you what it will be b/c they can't anticipate some things, but they can at least give you a ballpark based on vaginal vs c/s delivery, whether you want an epidural, etc. if they talk to your ob about it

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