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Average Childbirth Costs & How to Pay With Health Insurance

Average Childbirth Costs & How to Pay With Health Insurance

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When you’re pregnant, you may spend a lot of money on baby gear, and some on prenatal care, but your biggest bills will likely arrive shortly after the baby does — for labor, delivery and the medical care you and your newborn get when you give birth.

The average cost of childbirth is $13,024 for a vaginal delivery without insurance. But with a Silver health insurance plan, the average cost of pregnancy care and delivery is $6,940.

Here we'll cover the average cost of childbirth — from both sticker price to allowable amounts under health insurance plans. We'll also show what types of services are included in the costs and explain how health insurance plans cover deliveries.

Cost of childbirth

In the U.S., the average cost of a vaginal birth is $13,024, including standard predelivery and postdelivery expenses such as facility fees and doctor fees.

A cesarean section (C-section) is much more expensive, costing an average of $22,646 including standard predelivery and postdelivery expenses.

Procedure
Average cost
Vaginal delivery$13,024
C-section$22,646

This cost to deliver a baby, totaling more than $10,000, is based on what the hospital charges. If you have health insurance, how much you'd pay for childbirth will be determined by the plan's benefits. This includes the insurance plan's deductible and copayments, which can affect how much you'd pay for the doctor's services and the hospital room, for example.

The average cost of a healthy pregnancy and childbirth totals $6,940 with health insurance.

Note that these average childbirth costs assume there are no complications. But even with a typical birth, the amount a hospital charges can vary widely between facilities and locations. What the hospital charges for a vaginal delivery can fluctuate by more than $30,000 between states, and the cost of a C-section fluctuates by more than $50,000.

The cost of childbirth also changes if you're considering alternative delivery methods. Some pregnant women are opting for an approach to childbirth that’s different from the common medical version: less clinical and, hopefully, less expensive. You could use a midwife for maternity care, deliver at a birthing center or even have your baby at home. Costs will generally be lower in these settings, but you won’t have access to as much high-tech medical care if something goes wrong. Women report their share of the costs at a birthing center or for a home birth with a midwife to be in the ballpark of $3,000. Insurance plans vary widely in how they cover midwives and birthing centers.

Cost of birth in hospital

Nearly 99% of births in the U.S. take place in hospitals, making childbirth the most common reason for hospitalization. If you give birth in a hospital, you’ll spend at least one night there, or more if you’ve had a cesarean section (C-section). And you’ll typically need the services of nurses, anesthesiologists and an obstetrician or midwife. You may have procedures like fetal monitoring and postnatal care for you and your newborn. The costs for all these elements of a hospital birth add up.

Here is a breakdown of how the cost of a routine delivery in a hospital may look, as per a sample insurance plan on HealthCare.gov:

Routine hospital delivery charges
Cost

Mother’s hospital charges

$2,700

Routine obstetric care

$2,100

Baby hospital charges

$900

Anesthesia

$900

Laboratory tests

$500

Prescriptions

$200

Radiology

$200

Vaccines, other preventive

$40

Total

$7,540

How health insurance covers childbirth

Health insurers must cover maternity care and childbirth. This is one of the 10 essential health benefits required by the Affordable Care Act. Only grandfathered individual plans and short-term health insurance plans are exempt from this requirement. All other plans, including those on any state exchange or on the federal marketplace; those offered by employers; and those offered for the first time after 2013, must cover these 10 essential benefits.

Health insurance plans can, and most do, require pregnant women to pay for a portion of their costs for labor and delivery. But the Affordable Care Act makes it a bit easier to understand exactly how this may work because it requires insurers to create a standardized Summary of Benefits (SBC) for each plan they offer. One coverage example standardized across each plan's SBC is having a baby with a normal delivery.

One unpleasant financial surprise for many new parents: Your newborn may start running up their own medical bills from the moment they are born. Insurance plans for families can charge a deductible and out-of-pocket costs for each covered individual, including your new little bundle of dollar signs, up to a predetermined maximum.

Also, insurance plans vary widely in how they cover midwives and birthing centers, and specifically which ones are in-network providers, so consult your insurer before you make this choice for your maternity care.

How much you’ll pay to have a baby — with health insurance

The amount you will pay out of pocket for the costs of childbirth will depend largely on whether or not you have health insurance and, if you do, on the cost-sharing structure (deductibles, copays and coinsurance) of the plan you choose.

If you do have health insurance, you may have to pay your deductible toward your inpatient care when you deliver your baby. You could also have copays or coinsurance toward things like medications, physician services or radiology.

If you have health insurance, the total cost of pregnancy care and childbirth can range from $460 to $8,224 based on the plan's benefits.

Let’s use an example to illustrate total out-of-pocket costs for a mom-to-be with health insurance coverage.

Sample patient costs with deductibles and coinsurance

The chart below shows how much it costs to have a baby with different insurance plans for someone living in Arlington, Va. Included are the costs of the health insurance plan, pregnancy care and childbirth. Medical costs are based on HealthCare.gov's calculation for the "cost for a healthy pregnancy and normal delivery."

When having a baby, paying more for a better health insurance plan often leads to lower overall costs.

With a typical pregnancy, choosing a Platinum plan could save you about $6,039 during the policy year, even though the plan costs $144 more per month than a Bronze plan.

Plan tier
Insurance cost (monthly)
Medical cost (healthy pregnancy & normal delivery)
Total annual cost (insurance, pregnancy & delivery)
Bronze$356$8,224$12,496
Silver$455$6,940$12,400
Gold$431$3,812$8,984
Platinum$500$460$6,460

In the cases shown in the table, the medical costs for a typical pregnancy and childbirth do not reach the plan's out-of-pocket maximum, which caps the amount that the person would pay for medical care during the year.

However, in a bad-case scenario where there are complications or other medical conditions to treat, medical costs could reach the plan's out-of-pocket maximum. Even if this happens, the Platinum plan with its great benefits still leads to the lowest overall costs.

In a situation with childbirth complications, choosing a Platinum-tier plan could save you about $3,000 to $4,000 over the year.

Plan tier
Insurance cost (monthly)
Medical cost (childbirth complications reach out-of-pocket max.)
Total annual cost (insurance plan & out-of-pocket max.)
Bronze$356$8,348$12,620
Silver$455$8,655$14,115
Gold$431$7,805$12,977
Platinum$500$4,000$10,000

Questions to ask your health insurance provider

Call the number on the back of your card and ask things like:

Question: Are the costs for pregnancy and childbirth capped at the individual level, or will the total family deductible and out-of-pocket maximum apply?

In most cases, family insurance plans will have both a deductible and out-of-pocket max for each individual as well as for all family members on the plan. This is significant because the cost of labor and delivery for a new mother is so high.

With most health plans, the mother's costs will be capped at the individual level, with an out-of-pocket maximum as high as $8,700 for marketplace plans. However, if expensive health care is needed for the other family members, your household spending may also hit the family out-of-pocket maximum, which can't be higher than $17,400.

Understanding how your insurance plan's individual and family benefits work can help you to better prepare for medical bills. Even if the mother has reached her individual spending cap, your family and newborn could still have additional medical bills.

Question: Once I add my new baby to my plan, when will they start to incur charges toward their deductible, copays and coinsurance?

According to reports from women who’ve recently had a baby, some plans cover the newborn’s hospital care under the mother’s cost-sharing requirements until both are released from the hospital. Others consider the baby a new individual family member from the date of their birth, when their bills accrue to their own deductible and cost sharing. These might include their hospital stay, physician visits and lab tests.

Also, note that if you don’t already have a family plan, the addition of your baby can push you into one, with an accompanying rise in monthly premiums.

How your health insurer handles these issues can make a difference of thousands of dollars to your family budget.

Delivering a baby without health insurance coverage

If you don’t have health insurance, you’ll be responsible for all the costs for prenatal care and the birth of your child. However, many states make it easier for pregnant women to enroll in Medicaid or a state-sponsored health insurance program, through which all of their health care would be free or very low cost.

In California, for example, a pregnant single woman with no other children can get Medicaid even if she earns up to $27,435 per year.

If she were not pregnant, she would have to earn less than $17,775 to qualify.

Those who can’t get coverage through a public program or through an employer can buy a plan through the health insurance marketplace or directly from an insurance company. A marketplace plan will usually be the cheapest because there are discounts available for those who have a low to moderate income. However, there are timing restrictions on when you can sign up for a marketplace plan.

If you're pregnant and uninsured, you can only sign up for marketplace insurance:

If you use the special enrollment period after childbirth, the cost to deliver the baby won't be covered by the plan.

To avoid being uninsured when giving birth, you can also purchase a health insurance policy directly from an insurer rather than through the marketplace. The monthly costs for a plan may be high, but they won't be as high as paying full price to deliver the baby. Before enrolling, check the policy for any coverage exclusions about a current pregnancy.

Also, we typically recommend avoiding any short-term health insurance policies because these plans usually exclude pregnancy and childbirth.

If you don’t have health insurance during childbirth, you may be able to negotiate prices with the doctor and hospital. However, be aware that without insurance, your expenses for a complicated delivery or a seriously ill newborn could reach into the high tens, or even hundreds, of thousands of dollars.

In closing

It’s hard to get around the expenses of childbirth. But if you’re pregnant, or trying to conceive, take a hard look at your options for health insurance coverage. Consider both your premiums and all the out-of-pocket costs you are likely to have to pay for your maternity care, from prenatal visits to ultrasounds to common prenatal tests, as well as the costs of labor and delivery. (Don’t forget your newborn’s share!)

When you’re facing a lot of expectable medical care, it may make financial sense to choose a plan with higher premiums if you’ll save money on the back end with lower deductibles and out-of-pocket maximums.


Methodology

The average cost of childbirth without insurance is based on ValuePenguin's independent research on vaginal births versus cesarean deliveries using hospital transparency data from the largest hospital systems in 39 states.

The average cost of childbirth for those with health insurance is based on marketplace health insurance plans offered in Arlington, Va., with averages across the 53 plans offered by Bright Health, Cigna, Kaiser Permanente, Innovation Health and UnitedHealthcare.

Additional sources include the Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services (HHS), the California Department of Health Care Services (DHCS) and HealthCare.gov.

Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.