Just found out you’re having a baby? Congratulations!

So many things are going through your mind. Is it a boy or a girl? When am I due? What products, furniture and equipment do I need to buy? Should our baby be breastfed?

I know exactly how you feel. I’ve been through it twice. While these are all important questions, remember, babies are expensive – from diapers to daycare to a host of things you might not have thought of.  And one of the biggest questions you need to ask yourself is, “How much do I need to save for medical bills?”

I’ve been through two pregnancies and deliveries and had a different insurance plan each time. I had to do a lot of research to fully understand my benefits. I’ve also helped my friends understand their insurance plans during their pregnancy.

Working in healthcare, I’ve learned a lot about insurance and the things to look for.

From what I’ve learned, here are some important things to know that will help come you come up with a Centsible Pregnancy Plan.

Check your health insurance policy carefully. Either call, look at your online insurance account, or check with your HR department to find these answers:

What is my deductible?

It’s important to know what your deductible is, but it’s also important to know what comes out of the deductible. For instance, when you have an ultrasound will it be part of your deductible or will there be a copay?

What is my co-insurance after the deductible is met?

Do you have a co-insurance? This is the percent you will have to pay after the deductible is met until you reach your out-of-pocket-max.

What is my out-of-pocket max?

In my opinion, this is the most important question. Since pregnancy involves doctor visits, tests, hospital stay, etc. you may end up meeting your out-of-pocket max. This amount will give you an idea how much to save. You may or may not end up paying this full amount, but it is important to know.

The baby’s insurance:

So, you saved for the amount on your out-of-pocket max and you feel good, but then it hits you, “What about the baby’s insurance?” On most plans the baby will have his or her own deductible and out of pocket max. It’s hard to predict what the cost will be for this (depending on length of stay, if the baby goes to the NICU, additional tests, etc.), but you will need to save for your baby’s hospital bills as well.

Insurance Calendar Year:

Find out when your deductible resets. If it resets in January and you are due in February, you end up paying more. Why? Because you may have paid into your deductible for things like ultrasounds in November and December then it resets in January. Or, maybe it all happens in the same year and you only pay the deductible/out-of-pocket max once. Either way, you need to know to plan ahead.

OB Visits:

Typically you pay a co-pay for your first OB appointment but not for the remaining scheduled pregnancy visits (always check with your plan first- there may be exceptions to this). At one of your first appointments their financial coordinator may sit down with you and review your benefits. They may also ask for payment upfront. This upfront amount is usually the doctor’s fee for delivery. It does NOT include hospital fees and other medical fees. Go into this appointment prepared by having done some research on your plan.   

Paying Bills:

After delivery you finally come home and try to adjust to life with a newborn, and then here come all the medical bills. Read each bill carefully and check the EOB (Explanation of Benefits) through your insurance BEFORE you pay the bills. If something doesn’t look right call and ask questions.

Disclaimer: The information on this blog is for educational and informational purposes only. This information may not apply to every insurance plan. You must always check with your specific insurance for any advice. For any medical advice you must always consult a physician or other health care provider