Advice on Finance in Prenatal Care and Delivery

Hello A.,
I have a friend who worked at Clinica de la Mama. It is a place that does Ultrasound and prenatal care for a set price. You will see mostly the latino population here (becasue most are illegally in US and do not have health insurance) I'm sure they could help you.
The other option is to talk to the office manager of the OB/Gyn you have. I work in the medical field as a sonographer and I hear this all the time. They will work with you-they would rather work with you to get some $$ than none. They have to treat you if you go to the hospital in labor, and if you can't pay the hospital has to write it off-raising everyones premiums. (I see this all the time also). Try your dr. first and then if you cannot get it worked out, try Cobb Gynecology. If you feel uncomfortable talking to them, send them a registered letter worded in a very nice way asking to get a total price for your care. If they will do it they will call you back. Good Luck, R.

I can sypathize. We faced the same thing last year. Dr.s don't care, it will cost from $9000 - $12000 for a regular prenatal care and vaginal delivery. They'll take a payment plan but nothing is discounted. Unless you can find better Dr.s. We live in the Grand Strand area and there was NONE here.
We chose a differant route and I am SO glad we did. We had a home birth with a midwife. It was amazing, not to mention a quarter of the cost. When things go as nature intented it is so much better. If you get a chance watch "Business of being Born" This is Ricki Lake's documentary about childbirth.
Good luck, if you would like my midwife's # you can write back or, she is on here listed as a mom owned business.

-Just a comment too on having a midwife. Midwife's are set up for a healthy birth. They know when something is wrong most of times and don't do high risk births. Also you do have to see a licensed OB/GYN once in 1st trimester and once in third trimester and you still have all the tests and blood work as going to a reg. OB.

So you have tried the 'Pregnancy Medicaid' route? Just wanting to make sure. It's for people that make too much money for Medicaid, but are uninsured, but they do qualify for the pregnancy medicaid one. You are only covered during your pregnancy and 6 weeks thereafter.

Another route would be to have your child at home. I have many friends that do this and it's a wonderful experience for them.

Congratulations A.!!!! I know of couples in your situation that talked with the hospital as well to find out how they could reduce the cost of labor and delivery. The hospital will charge you $20 for an asprin!! So keeping that in mind see what all you can bring in yourself so that you don't have to use there supplies. They will let you bring in your own baby diapers/supplies.

Enjoy your pregnancy and I wish you and your hubby all the best!

Hi A.,
There are other ways to have pre-natal care and delivery. Have you considered a home birth? The midwives are highly trained. Homebirths are more comfortable, very safe, and cost much less. A wonderful movie to get is "The Business of Being Born". It answers many questions. Also, "Orgasmic Birth" is another great one.
I hope you find the prefect fit for you and your family!
Best of wishes!
S.
PS My daughter was born at home in water! Giving birth to her was the most empowering moment of my life!!! I am convinced the whole birth process prepared me, to be a better Mom than I would have otherwise. Please know I get this is a very personal, individual choice.

I delivered in 2006 and paid everything out of pocket. I don't know where you are located but I used Highlands Center for Women in Greenville and I believe it was 1865 in 2006 for prenatal care/vaginal delivery. I had to pay additional money for two ultrasounds (maybe 180 each). I deleivered at St. Francis and they reduce your hospital bill by a certain percentage (it might have been 25%) regardless of your income if you are self pay and then an additional 10% if you pay all at once instead of a payment plan. THey also have a financial aid type program that you can apply for but our income was too high. Request an itemized statement after you deliver and before you pay. Some items that surprised me were the supplemental nurser (a little plastic thing with a thin tube) that you attach to your nipple to help the baby nurse was $250. I needed it for 1 day. If you need something like that ask for low cost alternatives if possible (cup feeding). The sitz bath and hygenique system for perineal cleaning were about $200. It's nice but lots of hospitals still use a $2 squirt bottle. I was also charged for two rounds of pitocin that I did not receive. Mesh briefs that they give you are also not free. So really look into what costs you can cut. The other thing that I did not realize with my first child was that the bulb syringe, thermometer, 2 receiving blankets and a few other things were mine to take home. The lady from dietary who delivered my food told me that! THe OB office also charged me for a test that an outside lab did also (at their request) and reimbursed me as it was their error. Basically, billing can be a mess so look over all bills carefully and keep everything. Hospitals and doctors are being hit hard by defaulting patients right now and they lose a lot by going to collection agencies so they will work with you. If you hear no ask to speak to someone higher up. Not proud of it but I also cried a little on the phone and my bill got knocked down another 10%. Remember it's also a tax deduction. Good luck!

My suggestion would be to go to the doctor and make an arrangement, often times you can arrange to pay what an insurance company would normally pay. I have heard this from several people. The advantage to the doctor and hospital is that they are getting their money up front and not waiting on an insurance company. Give them your insurance and ask what they would normally allow for the procedure, NOT WHAT THEY WILL BILL.

I am not quite sure where you live but try midwife groups in the area. They are often cheaper than hospitals and have wonderful one on one care.

Hi A.,
My husband and I ran into the same problem. But we found out that most OB practices will give you a "self-pay" discount. I called around to many practices to compare prices and quality of care before we settled on one. The hospital will also give a generous "self-pay" discount. We delivered at Northside and they gave a 30 or 40% discount, as did our OB practice. After adding up the expenses, it would have cost the same as paying the higher premium with our insurance over the course of a year. They will also usually let you break up the payments a bit if you need. Just don't be afraid to ask about the self-pay discount, and if you get a bill that doesn't reflect it, just call and they should credit you and bill you for the proper amount. That's what I did and really (miraculously) we had no problems. Good luck!

I know how you feel. My middle pregnancy was not covered by insurance, I cant remember why, but we paid cash too. I spoke with my docotr at my first appointment, told him the situation and he was very compassionate. The nurse figured up the fees for each visit, possible labs and the delivery. We made monthly payments. Talk to your doctor. If he doesnt seem to want to help, you may have to shop around.

If you do not qualify for the Pregnancy Medicaid program for sure and really do have to pay cash, doctors and hospitals alike will usually take less for cash payments, lump sum or not. Figure out what is affordable for you before you make the offer. If you get a no, go to a higher up, to a manager of the office or hospital. Generally, simple clerks who front the office are not in any position to make a deal, though there are exceptions. Usually, the doctor himself will not speak with you about it either, so go to the office managers and present your situation. They should be able to help. As for having the baby at home, there good things and not so good things about that. Women who have gone through it successfully will tell you it's the way to go, but you do have to weigh the safety issues for you and for the baby. At a hospital, there is an entire team of people and there are resources for emergency situations at hand that simply do not exist at a home birth. That said, complications are rare, so you must just weigh the risks involved and do what is comfortable for you personally. congratulations, by the way, on being pregnant!

I was in a similar situation, a "mom in the middle" and even though we had insurance ended up with $16,000 worth of hospital/doctor/ home care bills because I ended up on bed rest for three months before my daughter was born. Our daugther is worth every penny, but it was alot of unexpected costs that we're still paying slowly on. I hope one day there will be a good and uncomplicated solution for moms in our situations.

Some hospitals with patients who's insurance doesn't cover maternity costs will offer a flat-fee for the birth and delivery of your baby, but the catch is that you can only stay in the hospital for 24 hours after the birth, and you'll have to find out what extra charges you may have if you end up having a c-section.

You might want to also do some research about Maternity Card. I have not personally used it, (but heard about it in case we need it for our next child).

Hope this helps!

hi A.-- congrats on the pregnancy. It's too bad you're in such a rough spot with the insurance, but since it sounds like you HAVE insurance, but the coverage just isn't helpful in this instance, I would fight tooth and nail to at least get the insurance rates for everything that you have to pay. The cash price is usually MUCH higher than what the insurance companies pay. When my son was born my insurance covered much, but not all of the procedures (although we had to pay 20% of even the things that they did cover). I noticed that on the bills the hospital would bill the insurance company for something, the insurance would knock the price down another 10% or so (this was even off of the already-lower insurance company price compared to the cash cost) and then would say that they were paying 80% or 0% of the discounted price. So even the things that we had to pay out of pocket were already reduced because the bill had been sent to the insurance company first.
With all of that in mind, I would see if you can have your insurance billed for you prenatal care and hospital stay if you have to or choose to go that route and then the hospital will bill the insurance rate, the insurance company will knock it down a little more, then they'll reject the claim and you'll have to pay the reduced rate in full (it will also mean that you'll pay everything at once a month or two after the birth, giving you more time to save for it). I don't know if that can really work, but it's worth building a repport with either the hospital finance person or your insurance customer care person to find out if that is an option.
Good Luck!

apply for medicaid even if you think you don't qualify. when you become pregnant you are considered to have one more person in the family and you income level goes up. all they can say is you don't qualify so you have nothing to lose by applying.

Hi A., I had the same issue when I was pregnant. My OB/GYN accepted me as a cash patient and I had to pay $200 for every prenatal visit (less if I needed to, like once I paid $100). The total amount due was $2000 and that covered all of my prenatal visits and testing, delivery, and the 6 week check up afterwards. She was great and I will recommend her. Dr. Tracy Lemon ###-###-####. She is located in downtown Atlanta. If you need any more information please contact me. Good luck and Congratulations!

Hi A.-

We have a 5 month old and used Labors of Love- Midwife Linda Weaver (there are 2). She charges $3200 flat rate for all prenatal care + delivery. If something goes wrong towards the end and you end up needing to go to the hospital, she'll accompany you and then you end up paying more like $2000 for prenatal and her "doula-type care" in the hospital. We had this happen- my water broke and after 51 hours, never went in to labor, so I had to get induced. The people on here are right- the hospitals not only don't care that this is coming out of your pocket, but there are a lot of unknown costs, and a lot of procedures they'll push on you that might not be absolutely necessary (i.e., giving you pitocin because your labor isn't progressing as quickly as they'd like). We had insurance, but still ended up paying about $4k out of pocket. My pitocin drip alone was $8k.

So if you are open to having a natural birth (get educated about it- you won't regret it!) a midwife is the way to go. Linda also has a birthing center, so you can do it in home or at the center. While I was still pregnant, Linda told me of a woman of 5 children who had recently lost their health insurance. She had had hospital/ medicated births with all her previous children, but was financially desparate so she went to Linda. After all was said and done this woman said her deepest regret was having her other children in the hospital. Read this, and the best to you! http://www.scmidwife.com/midwifery-care/what-moms-say/28-...

Check with your local physician's directory to find the OBGYN who will work out pre-payment plans with you - and which hospital has pre-payment plans. Cash payments are amazingly less than insurance costs. Having the bills paid is a relief when the baby arrives. Good luck with your new family.

I second the medicaid route for folks with no insurance you may want to check into that and I know some doctors will take payments on their fess for services that include delivery at the hospital and I had a niece that had to go this route, the hospital usually has something called uncompensated services where the hospital as donations and federal money I think that goes to pays those bills for folks that have no insurance and of course you show what you make but remember if you are off work I don't know but if you have no income during that time you may very well qualify. My niece did she worked at a QT and her husband didn't make but 10 bucks an hour and she got no pay while she was off, she also had some serious situations that came up for her health so her bill was paid since she had no income but even before that she qualified. My best wishes to you.

Hi,
I had a child in April,08. We have medical insurance but did not have pregnancy coverage. We knew we did not have coverage before we got pregnant. We used Greenville OBGYN w/our first child (was covered by insurance) and used the same for our daughter in April. You can call the Drs and they will give you a price and you can also call the hospital and they will give you an estimated price. Both prices were almost exact with us. I had a c-section and also had to spend 1 night in the hospital prior to child birth. I also had major complications with my c-section afterwards. OBGYN never charged me additional fees after child birth (even though I was going to the OBGYN 2 to 3 times a week for several weeks after my c-section. We ended up paying around $25,000+ after it was all said and done. Hope this helps. Good luck!

A midwife and birth at home is much less expensive than a hospital birth. The only thing is that you won't have the pain meds available. But you also won't have a OB pushing things like pitocin, epidurals, etc, which will raise the cost of your stay. YOu're also at a lower risk for a C-section, which would send your bill through the roof. IF you're not comfortable at home, there's also the option of a birthing center. They're usually right near a hospital if needed, but again they allow for natural birth. Having a baby there is also a less expensive option than hospital birth.

Please consider calling the county health dept. Georgia does offer coverage for prenatal and you might qualify even though you think you don't. It is worth the call seeing that it could save you $2000+. Here is what I got off the web. The levels of coverage change often and you might qualify.

Pregnant Women

Apply for Medicaid if you think you are pregnant. You may be eligible whether or not you are married. If you are on Medicaid when your child is born, both you and your child will be covered. You may be covered for another 60 days after your child’s birth. Your child may be covered for up to one year.

If you think you are pregnant, contact your county health department, primary health care center, or hospital. Call the Georgia Division of Public Health at ###-###-#### to find out where to apply in your county. If you are pregnant and eligible, you can get a Medicaid certification form on the same day that you apply. You can get prenatal care for yourself and your baby immediately.

Right from the Start Medicaid for Pregnant Women (RSM Adults)

Pregnant women with family income at or below 200 percent of the federal poverty level.

Family Size Income Limits
1 $1,734 per month ($20,808 per year)
2 $2,334 per month ($28,008 per year)
3 $2,934 per month ($35, 208 per year)
4 $3,534 per month ($42, 408 per year)

Each additional person: $600 per month ($7,200 per year)

Hi A.,

WHile I don't personally have an experience with this issue- I have heard that whenever you receive a medical bill and have no coverage for that service, you should contact the provider and tell them you want to pay in full but at a reduced rate and fight with them to discount it 40 or 50%...I heard that this would work b/c they really would rather have a lump sum payment then either never see their money or receive a small amount each month for many months..This might help you b/c I know you receive several different bills from all the seperate doctors who provide treatment during your delivery...good luck!

Congratulations A.!

I know how stressful it can be not having insurance and expecting a baby. Make absolutely sure you don't qualify. We didn't think we did with our second and in my 7th month we found out that we were eligible for Medicaid. If you definitely can't get financial help, this is the route we were going to go. For $3500 you get everything (the prenatal and the birth)...

We have had 1 C-section with our first and a natural V-BAC with our 2nd. Having a midwife, doula, and childbirth education really made all the difference!

The best advice I can give you this:
1. Find a midwife. One who may serve your area and whom looks like she provides amazing services is http://www.birthingway.com/

2. Hire a birth doula or recruit a friend who has had babies and knows what kind of support to provide during labor to help you and your husband. http://www.alldoulas.com/forums/showthread.php?t=6262

3. Take childbirth education classes between 6-8 months pregnant. http://www.brightbirth.com/default.aspx

All the Best, A.,

R.
www.noblemother.com