Pregnancy
The Cost of Pregnancy and Delivery

What is the cost of pregnancy and delivery in 2017? Sierra is pregnant for the first time and is getting a frustrating education in the delivery and cost of healthcare.

An Education in Healthcare – It’s Complicated

SS: I am 14.5 weeks along in my pregnancy. This week, I received my second medical bill, from my physician (the first was from the hospital my physician is affiliated with). I started a folder for any and all medical expenses resulting from this pregnancy, and it occurred to me that I have no idea what I am being billed for (or really how the insurance determines how much they cover).

PF: I’m SO happy you’re talking about this. Your timing couldn’t be better, considering that Congress has proposed a bill that would take healthcare away from millions.

SS: Why is insurance so secretive? Why don’t we ask more questions? Is this just me? Maybe you would be able to provide some more information from the professional’s perspective.

PF: Secretive is not quite the right word. Rather, it’s complicated.

Healthcare “Middleman”

SS: After my first appointment, I contacted my “middle man.” According to my employer, they are the small and friendly neighborhood company that brokers our medical insurance. They’re supposed to be a “real person” explaining benefits and playing interpreter for the insurance company.  I reached out via email asking about which medical labs my insurance would cover, and to learn about the services and associated fees associated with a healthy pregnancy. My question felt vague, but our area only has a handful of hospitals and professionals who provide care through delivery. I assumed  there had been other woman who had similar costs. I immediately received a response from someone named Amy, who would forward my questions to some other department. The next email didn’t come for TWO WEEKS. It confirmed that the specific medical lab I had inquired about was indeed within my network, but NOTHING ELSE.

Life got busy, and I promptly forgot that I still had no idea what costs to expect.

PF: Why do you even need a “middle man?” I have been perplexed by this concept. It seems to be an attempt to contain healthcare costs for employers.

SS: From what I understand, the middle man is like an interpreter. Insurance is so complicated, as you say, that the middle man is necessary for Joe Businessman to understand what cheapest and fairest approach to providing healthcare to his employees. The fact that you need an interpreter makes me think there is something wrong with insurance as a whole. You don’t need a middle man for car insurance or home owner’s insurance.

Multiple Bills for Pregnancy 

SS: Fast forward to yesterday. I received my second bill for my first prenatal appointment and quickly remembered that I had no idea why I was paying both the hospital and the physician, what I was paying for, and how many times I will be receiving more than one bill for what I perceive to be the same service. I called the billing departments at both entities, and some very helpful personnel gave me slightly more information. The bill from my doctor was for the visit. The bill from my hospital was for lab work (I didn’t even realize I had lab work done). An ultrasound will also result in two bills – one for the technician, another for the equipment. Other routine appointments won’t be billed, and instead, are considered a part of the cost of delivery.

SS: Last night I mentioned my new findings to my friend who is a physician assistant (PA). She informed me that a single trip to the hospital may result in multiple bills! There is a bill for the visit to the doctor (or the PA). Then, another bill if you need X-rays or some other service that requires fancy medical equipment. Did you take an ambulance? Were you life-flighted to another hospital? Did you know that you would receive a physical therapy bill for that ice pack?! Essentially, bills can come from everywhere.

PF: You’ve heard me say this before, but the pregnancy process feels SO much more complicated for your generation.

Healthcare Coverage for Pregnancy Varies 

SS: Now, I realize that as a young and generally healthy person with no children, it is totally a possibility that I am in the minority as far as medical bill ignorance goes. Maybe people will read this and shake their heads at my ineptitude, but just hang on. I also happened to mention my frustration to another woman my age with children. She was astonished. She did not receive a single medical bill for any of her three pregnancies. Evidently, she has phenomenal healthcare coverage with no deductible.

PF: Your experience is common. Most people don’t understand their healthcare insurance until they have to use it. Then, as you’re learning, it only gets more complicated as you begin using it.

Comparing Healthcare Costs

SS: So this is my question: Why isn’t there adequate information out there about what it costs to have a child (medically speaking)? Is it because so many people are entirely covered by their insurance that it doesn’t matter anyway? Or, perhaps they have already met their deductible and they are somewhere else complaining about bills from some other medical subfield? I simply refuse to believe that is true. There is a plethora of information on EVERYTHING else. Where are the lists of medical procedures and their costs? Wouldn’t that help me make better decisions as to what kind of healthcare I would like to purchase? Wouldn’t that help me decide which hospital or doctor I would like to go to or see? OR, might people sacrifice their own health in order to save money?

PF: You’re asking all the right questions. The delivery of healthcare has become too complicated. Comparing prices, like you would for a sweater or a car, has become almost impossible.

SS: Here is where I can go into a rant about universal healthcare, but I won’t, not in the middle of this rant.

Making Good Financial Choices Without Good Information

SS: Sometimes in life, we make decisions while ignoring the financial aspect. For example, I think we often choose a college not fully understanding the credit costs or the magnitude of that student loan interest rate. People graduate college every day, pay their student loans, and manage just fine. We decide to have big, grandiose weddings not fully comprehending that every little detail will cost money and adds up quickly. The information is there. It’s just sometimes you avoid the hard-to-swallow numbers because you make the decision that the whatever the cost, it is worth the return.

I feel the same way about having children. Steve and I both wanted children regardless of the overwhelming costs because of it’s right for us. However, I am coming to the possibly ignorant conclusion that the medical cost of being pregnant and giving birth is not something someone can thoughtfully examine and reach a conclusion aside from not having children at all. Perhaps it’s impossible to determine what it costs to have a child because everyone’s experience is so different, but shouldn’t that make it all the more important to make the known information and costs as transparent as possible?

Check out this terrific resource from NerdWallet, a personal finance website, about the cost of pregnancy and delivery.

This post was edited on 8.29.17 after Sierra and I talked, and she asked for more information.