Pregnancy brings joy, excitement and maybe even a little apprehension—especially for new parents-to-be. And, while many families understand that a new bundle of joy also means more expenses, those expenses often arrive sooner than the baby. Once that pregnancy test turns positive, couples are faced with new bills that may bump the budget significantly.
A healthy pregnancy requires regular prenatal checkups. In the beginning those checkups are monthly, but as the belly expands and baby’s due date approaches, the appointments become more regular—eventually resulting in weekly visits. But checkups are just one part of the expenditures that couples face during pregnancy. Ultrasounds, prenatal vitamins and other medications, and various prenatal tests may add to the growing pile of bills.
Not all insurance plans provide the same level of coverage for maternity benefits—that is, deductibles and out-of-pocket expenses vary by plan. Business Insider listed the costs associated with both vaginal and cesarean deliveries in every state. In Alabama, an in-network vaginal birth cost nearly $5,000 but in Alaska that cost is doubled to more than $10,000. Once that plus sign appears, it’s time to start budgeting for pregnancy costs. You need to know your financial responsibility so you can plan your budget and cut unnecessary expenses as needed.
Looking to plan for pregnancy costs? Here is a general rundown of the typical expenses you can expect for each trimester; every pregnancy is unique, though, and this list should only serve as a basic reference. Here is a guide to the costs of parenthood during pregnancy.
First Trimester Expenses
Tests will begin once that pregnancy test reveals two lines (or a plus sign!). While a positive at-home test confirms you’re pregnant, most obstetricians also will order a blood pregnancy test to measure the level of the pregnancy hormone human chorionic gonadotropin (HCG). Prepare to head to a local laboratory like Quest or your hospital to have the tests completed. Before you go, check with your insurance company to find out which labs are in-network or have the best deals with your insurance company. Some major insurance providers prefer that you use specific labs, but this is a detail you’ll need to find out through a phone call to your insurance company’s customer service department. Making this call could save you hundreds in charges, because while other labs also may be in-network, they might still command higher fees for their services. You may have to endure multiple blood tests to measure HCG and/or progesterone—the number of tests depends on your doctor. However, many doctors order two consecutive blood pregnancy tests to ensure that the HCG level is rising appropriately for a healthy pregnancy.
Your blood tests will confirm a positive pregnancy, but your doctor also will need to confirm the health of the developing embryo via ultrasound. Your first ultrasound is typically scheduled at around six or seven weeks. An early ultrasound should reveal a fetal heartbeat (though not always if the test is done too early) and evidence of the developing pregnancy.
So how much is an ultrasound? The price depends on your insurance coverage specifications and whether you are using an in-network doctor and/or facility. Some insurance plans apply ultrasounds toward the deductible, and this means you’ll have to pay the majority out-of-pocket. However, some plans charge a copay for diagnostic tests. Before you head to your ultrasound appointment, check your coverage details regarding ultrasound charges. If the test is applied to your deductible, the final cost could vary. If you want to plan ahead for that ultrasound bill, ask your doctor’s office for a cost estimate at your appointment. That way you won’t suffer from sticker-shock when the bill arrives later!
Vitamins & Medication
Prenatal vitamins are specially formulated for pregnancy, and they typically include a higher dose of folic acid (this helps prevent neural tube defects), calcium and other essential vitamins/minerals. Some pharmacies provide prenatal vitamins free of charge during pregnancy with a doctor’s prescription. However, you also can buy prenatal vitamins at most drugstores and grocery stores. Your doctor also may have a specific formulation that he or she recommends. Ideally, all women who are trying to become pregnant should be taking a prenatal vitamin, but once that you confirm a pregnancy you need to begin taking them ASAP (if you’re not already!).
Some women also may need to take a progesterone supplement to help sustain a healthy pregnancy. If your doctor has prescribed a supplement, check your drug plan to estimate your copay cost.
Second Trimester Expenses
At 12 weeks, you will begin the second trimester of pregnancy. Your doctor will schedule a 12-week appointment, and this is the time that you may hear the baby’s heartbeat via Doppler. You also may need to inquire about how your doctor bills for pregnancy visits. Some use ‘global billing,’ which means that all your visits and charges are grouped into one packaged bill. Other doctors may bill each visit separately. This means that you will need to begin budgeting for monthly office visit copays.
The second trimester also may mean more ultrasound—many doctors schedule a 20-week ultrasound to check the baby’s development and anatomy. But doctors may require more frequent ultrasounds, especially if your pregnancy is deemed ‘high-risk.’ Again, be sure to estimate your ultrasound costs so you’re not caught off-guard when the bill arrives.
Gestational diabetes is a common condition in pregnancy, and doctor’s test for it during the second trimester. The test involves drinking a very sweet syrupy concoction and then having your blood drawn to check your blood sugar levels. If the test reveals that you might have gestational diabetes, your doctor will order another test to confirm a diagnosis (you’ll have to fast for it!). A diagnosis of gestational diabetes may mean that you need medications to control the condition, and, again, this might mean more medication costs. Review your drug plan to see if there are specific brands of medication that your insurance provider prefers—some brands might not be covered. If you’re worried about drug costs and coverage, talk to your doctor. He or she may help you find low-cost options or possibly even financial assistance. A hospital social worker also may help you with options or financial aid.
Third Trimester Expenses
Once you hit the third trimester, it’s all about the waiting game for baby to arrive! But during this time, you’ll see your doctor more frequently. By the end of the third trimester, you may be having weekly office visits to check for impending labor, dilation and the baby’s health.
You also may have more ultrasounds to check the baby’s weight and health. At this point, you likely already know how much those ultrasounds cost. And, hopefully, you’ve met your deductible!
Of course, the big event in the third trimester—and the biggest cost—is the baby’s birth! Most women will stay in the hospital for about 48 hours after the baby is born. If you have a cesarean section, however, your hospital stay will be longer. For non-cesarean delivery, anticipate two days worth of hospital charges, plus costs associated with the birth, any anesthesia you received (epidural!) and the charges for all doctors involved in the labor and delivery. In-patient hospital visits are typically applied to your deductible, but some plans charge a daily copay.
Check your plan so you understand how you will be billed. For patients who have hit their deductible, the charges may be minimal. But if you’re hitting a new deductible—this happens when pregnancies extend into two calendar years—be prepared for those new costs.
Also be aware that just because your hospital is in-network doesn’t mean every doctor who cares for you in the hospital will be in-network, too. Doctors bill separately from the hospital, and, while you cannot control every MD who manages your care (especially in an emergency situation), you can try to line up in-network doctors—especially anesthesiologists and/or neonatologists—before the delivery date. Talk to your OB/GYN about your preferences for doctors (and ask for your doctor’s in-network recommendations); you also can keep a list and take it with you to the hospital. Again, in an emergency situation, you may have little control, but you can try to prepare.
Beyond delivery, though, you also may notice costs for the new member of your family. The baby will have routine care, but childbirth complications or other issues may mean time in the neonatal intensive care unit (NICU). After the baby is born, you will need to add your new family member to your insurance. Typically, there is a grace period for adding a new baby to a healthcare plan, but it’s best to call the insurance company or your company’s HR department ASAP. While your insurance plan may cover baby’s nursery care in the hospital, more major costs (like the NICU) might mean separate costs for baby…and you may hit yet another deductible.
Paying for it All
So what do you do when the prenatal bills stack up and you’re budget is failing? If you find your medical bills to be too overwhelming, you should inquire about setting up a payment plan with your doctor or hospital. If you cannot afford to make those minimum payments, talk to your hospital’s billing department about financial assistance. Many hospitals—and medical laboratories like Quest—offer financial assistance based on federal poverty guidelines. If you’re in serious financial arrears, then you should investigate all options.
However, planning for prenatal costs is a part of becoming a parent and growing your family. A baby is a major financial responsibility, and that responsibility begins once that test turns positive. Plan ahead, start saving, and begin to adjust your budget to accommodate the growing number of bills associated with pregnancy. Because, unfortunately, that baby bump also means a major bump in the budget.