20.11.2013

Cost of having a baby at kaiser

Which hospital parents pick to deliver their baby can have serious cost consequences, according to a new study. Hospital costs for women who had no maternal or obstetric risk factors to complicate childbirth ranged from less than $2,000 to nearly $12,000, the analysis of discharge data found.
Since consumers increasingly face high deductibles and increased cost sharing for medical care, giving birth at a high-cost hospital could add significantly to their out-of-pocket costs, Illuzzi says.
The study found that hospitals with higher rates of cesarean deliveries, among other factors, were more likely to have higher facility costs. The study notes that adding professional fees to the cost estimates and including newborn care in addition to maternal care might result in different cost patterns than those found in the study.
Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column. Since pregnancy is a high-cost health expense even for women with health insurance, you’ll want to focus especially on the cost of premiums and the co-insurance to keep your overall costs as low as possible. So counting the deductible and out-of-pocket costs for labor and delivery, a Silver-tier plan would cost $6,700 total for a vaginal delivery (add about $1,500 more for a C-section). If your employer or your spouse’s does not offer health coverage, you may be eligible for subsidies to help pay for the cost of Marketplace insurance premiums if your income is 400 percent of the federal poverty level. If you have private health insurance, a 2014 Kaiser Family Foundation survey found that average premiums for employees of large firms are similar to the Marketplace ones for the Silver plan, though the co-insurance tends to be lower (80 percent is covered by insurance) and the out-of-pocket maximums are sometimes lower. Maternity costs can also vary from state to state by 50 percent and even more within some states, according to the Truven report.


Once your baby comes you’ll have up to 60 days to review your coverage and make changes that could save you money.
Having a baby is a common women’s health event, yet insurance coverage isn’t always assured. Although the federal government recently clarified that many insurance plans must cover prenatal care as a preventive service without charging women anything out of pocket, it didn’t address a crucial — and much pricier — gap in some young women’s coverage: labor and delivery costs. In May, the federal government clarified that dependent children are covered by the health law requirement that preventive services, including preconception and prenatal care, be covered without cost sharing in all plans, except those that were grandfathered under the law.
But prenatal care is a small portion of the cost of having a baby, and families that have to pay for an adult child’s labor and delivery charges, including the hospital bill, could be on the hook for thousands of dollars. Hospitalization made up between 81 and 86 percent of the total cost of maternity payments, the largest proportion by far, the study found. Continuing a slow upward trend, the average age at which women have their first baby was 26 in 2013. Meanwhile, the proportion of first births to teenagers continues to decline.
Estimated average hospital childbirth facility costs per maternity stay ranged from $1,189 to $11,986, with a median of $4,215.
Some government agencies and other organizations now report data related to childbirth, including cesarean delivery rates and details about delivery costs and charges by hospital. Hospitals with higher estimated costs were significantly more likely to have serious complications among low-risk childbirths. A 2010 report by research firm Truven Analytics, The Cost of Having a Baby in the United States, estimated the average Medicaid out-of-pocket expenses for a pregnancy at less than 1 percent of the total costs.


The Truven Report put the uninsured cost of having a baby at anywhere from $30,000 for an uncomplicated vaginal birth to $50,000 for a C-section. If you’re signing up for private insurance through an employer, compare plans to see whether it or a Marketplace plan would likely cost you less out-of-pocket for pregnancy.
Avoid going outside of your network of doctors and hospitals, if possible, or you’ll pay more (as much as 50 percent of the cost).
One thing to keep in mind if you aren't yet pregnant but are thinking about conceiving: If you get pregnant one year (say June) and give birth the next (in March), you'll likely have to pay the deductible twice, which could be a sizable cost.
While this is just an example, a look through other zip codes found plans costing in the same range — some with premiums or deductibles that are higher or lower.
If you’re signing up for coverage through the Marketplace, compare costs online or call the insurer listed for more information. Getting pregnant and delivering your baby within the same year (if at all possible) could bring some savings.
From Catastrophic up to Platinum, the premiums go up, while out-of-pocket cost-sharing goes down (but never completely away). If you expect to have a baby in the year and don’t qualify for Medicaid or have employer-subsidized insurance, the Silver plan is your best option, say health advocates who have reviewed the plans.




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