• If your partner does deliver early (by more than a couple of weeks) and your baby needs to spend time in intensive care, the bills—most of which you will hopefully never see—can go into the hundreds of thousands.
If Your Partner Needs a Cesarean Section
If your partner ends up having a C-section (which happens more than 30 percent of the time—up from 21 percent in 1993), all bets are off. Even though it’s routinely done, it’s still considered major surgery, and is expensive. The operation, which your OB/GYN will perform, is not included in his or her flat fee, and you’ll have to pay for at least two other doctors to assist, plus a nurse, who must be in attendance to care for the baby. In addition, a C-section entails a longer recovery period in the hospital—usually four to five days—as well as extra nursing care, pain medication, bandages, and other supplies. If the baby is in good health, you can probably take him home while your partner stays in the hospital, but chances are you’ll want the baby to stay with your partner, especially if she is breastfeeding. The baby’s additional time in the nursery costs more too.
“Listen, are you absolutely sure you want to have kids?”
An Important (and Possibly Profitable) Word of Advice
Make sure that you and your partner check your birth-related bills very carefully. Hospitals can make mistakes—in fact, a study by credit giant Equifax found that nine out of ten hospital bills contain errors, and they’re rarely in your favor. After we’d recovered from the shock of the C-section bills for the birth of our first child (which started off at about $17,000), we asked a doctor friend to go over them with us. He found that we’d been charged for a variety of things that hadn’t happened and overcharged for a lot of the things that had. For example, we’d been billed $25 for a tube of ointment that the hospital’s own pharmacy was selling for $1.25. We (actually, mostly our insurance company) ended up paying closer to $15,000. And for the second pregnancy, our nitpicking review of the bills cut about 20 percent off the total.
Look for double billings, services you never received (say, a private room when you were actually in a shared one, or brand-name drugs when you really got generics), and any kind of suspicious jargon. A wonderful exposé done by ABC News found that people had been billed hundreds of dollars for a “disposable mucus recovery system” (a 79-cent box of tissues) and “thermal therapy” (ice cubes in a bag). Also keep an eye out for procedures that never happened. I’ve heard stories about new parents being billed for their baby’s circumcision. That would have been fine, except that they had a girl.
While some of these things may seem silly, they can really add up—especially if you’re footing a big portion of the bill. In the Equifax study, the average error was more than $1,300. And according to a joint study done by Harvard’s Medical and Law Schools, “[n]early half of all Americans who file for bankruptcy do so because of medical expenses.” About 10 percent of those are childbirth related.
Even if all the bills are being paid by your insurance, reviewing those bills can still be profitable. Although most insurance companies have their own internal auditors, all they’ll be able to catch are charges that are above the “usual and customary” and/or procedures that simply aren’t covered. They won’t know about most of the things mentioned above and will be ecstatic if your review ends up saving them money. In fact, some insurers are so thrilled that they’ll actually give you a percentage (sometimes as much as half) of the money they save. Naturally, though, you’ll have to ask for your reward. So, read your policy carefully and, if you still have questions, talk to your agent or one of the company’s underwriters.
And while you’re reading your insurance policy, here are a few other things to look out for:
• How long before the birth does the insurer need to be notified about the pregnancy and estimated due date? Not complying with the carrier’s instructions could mean a reduction in the amount they’ll pay for pregnancy and birth-related expenses.
• When can the baby be added to the policy? Until the baby is born, all pregnancy- and birth-related expenses will be charged to your partner.
After the birth, however, your partner and the new baby get separate bills (all baby-related expenses, such as medication, pediatrician’s exams, diapers, blankets, and various other hospital charges, will be charged to the baby). Some carriers require you to add the baby to your (or your partner’s) policy as far in advance as thirty days before the birth; most give you until thirty days after. Again, failing to follow the insurer’s instructions could result in a reduction of coverage.
LOW-COST ALTERNATIVES
Obstetrical Clinics
If you live in a city where there is a large teaching hospital, your partner may be able to get prenatal care at its obstetrical clinic. If so, you’ll spend a lot less than you would for a private physician. The one drawback is that your baby will probably be delivered by an inexperienced—yet closely supervised—doctor or a medical student. This isn’t to say that you won’t be getting top-quality care. Clinics are often equipped with state-of-the-art facilities, and the young professionals who staff them are being taught all the latest methods by some of the best teachers in the country.
Your Rights to Free and Subsidized Medical Care
If worse comes to worst, hospital emergency rooms are required by federal law to give your partner an initial assessment—and any required emergency care—even if you can’t afford to pay. But that’s no substitute for the kind of ongoing prenatal care that will ensure a healthy pregnancy, healthy baby, and healthy mom.
So if you’re uninsured or underinsured—according to the American Pregnancy Association (americanpregnancy.org/), that’s the case for 13 percent of pregnant women—or just need some help paying for that prenatal care your partner needs, your first step should be to find out what Medicaid benefits she’s eligible for. (If you’re in this category, don’t feel bad. Nearly half of all births in the U.S. are financed by Medicaid.) Since benefits vary by state, you should also make contact with your state’s health department as well. You’ll be able to get most of your questions answered at the Medicaid website (medicaid.gov).
Salad Days
WHAT’S GOING ON WITH YOUR PARTNER
Physically
• Morning sickness (nausea, heartburn, vomiting)
• Food cravings or aversions
• Dizziness, irritability, headaches
• Fatigue
• Breast changes: tenderness, enlargement
Emotionally
• Thrilled, stunned, a little frightened, or even completely bummed out (not all pregnancies are planned) that she’s pregnant. Sometimes all of these at the same time.
• A heightened feeling of closeness to you
• Apprehension about the nine months ahead
• Mood
