In the United States, some family physicians can oversee pregnancy and even deliver babies with hospital permissions. More commonly, a woman who suspects she's pregnant makes an appointment with her obstetrician. The OB-GYN might administer a urine test, or an HCG blood test. Depending on your medical history, you may receive further testing - blood levels, blood pressure, weight, height, date of last menstrual period. Sometimes a mother may prefer to visit a midwife instead of an OB, and the midwife can administer the same tests as well! But before any such visit to a doctor, it's best to check what your insurance can or will cover.
The OB who delivered both of my children released an insurance guide to all expectant patients. It included average labor & delivery costs for both vaginal and C-section births and a note on how to check your insurance's coverage - some have pregnancy set aside in your insurance cost guide. But there are even more tips for getting insurance coverage clarity than just reading your payment plan!
Pick Up The Phone
Call your insurance company, private or public, and ask them to walk you through your available pregnancy coverage. Any information that they provide for you, be sure to ask for them to share in writing. This step might feel uncomfortable, but just look at it as research-gathering. You just want to get an idea of the scope of coverage your insurance offers!
While you've got an insurance representative on the phone, ask them if they can help confirm that your preferred OB or midwife - and the birthing facility you hope to use - are covered. Some insurance companies use an online directory, while others will help you look up doctors by location over the phone. Once you confirm that these care providers are covered by your plan....
Call Your Care Providers
An overarching and repeating trend in this advice: ask for written evidence after you speak with each person on the phone. Make notes of their names, what you discussed, the time of day, and relevant account information. At some point, usually between 34 and 40 weeks of pregnancy, your insurance will require you to pre-register with the hospital or birthing center you plan to use.
But many weeks before then, you can call the same labor & delivery unit, or birthing center, and ask for a pricing guide for their services. Double-check that they have a policy for billing concurrently with your hospital. You might even want to request that any doctor that treats you is covered by your insurance plan. I've seen my friend get bills from emergency surgery because the on-call general surgeon wasn't covered by her plan - even though the hospital she was being treated at was. When in doubt, ask, ask, ask. And ask for it in writing.
Start Saving ASAP
As soon as you learn that you're expecting, consider shifting your insurance plan to be favorable for a labor and delivery as preferred. Even with the best insurance, you will benefit from starting a baby fund for the nest nine months! It can be really hard not to spend all your time and energy nesting in anticipation of your new squish!
Some insurance plans allow HSA or FSA plans that can cover pregnancy costs, including prescriptions and prenantal vitamins. If you can anticipate the overall medical cost (say, your total out-of-pocket maximum), budget out your savings as best as possible to pay it off as quickly - an easily - as possible.
A tip from my brave friend with her beautiful daughter E - get all medical records together in one file folder. Make copies, add to the master list an edit frequently. If you add a new doctor or specialist to your healthcare team, give them a full copy of the medical records - or at least bring it to your appointments.
Staying organized can help you track and pay off medical bills, avoid missed appointment fees, and promote medical safety and coordination between caregiver and patient.
What other tips do you have for making sure your insurance will cover your prenatal medical oversight? Let's make a huge list as a resource! Tweet @pi3sguarpi3 with #PrenatalHealthcare