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Wednesday, January 7, 2009

Prenatal Financing

Having relocated from a country that had universal health care (and provided it free to all under 16), the USA system can at times be very alien to Bella. In the UK all pregnancy's are overseen by a midwife and unless there are serious medical concerns, they too will assist you during labor and delivery. There will be no doctor, no planned c-sections or inductions to fit neatly into your calenders (unless serious medical complications occur). Furthermore, women are given the option of home births, water births in hospitals and availability to birth centers. Better yet, all of this is provided free of charge.

Bella's first child was born in the UK, consequently she did not look forward to the cost of having the baby here in the US. With only one income and a deductible of $3500 (GBP 2350) plus a co-pay of $7500 (GBP 5000) to meet before the insurance took over, it was vital to consider how and where to have the prenatal care and delivery. Luckily, for the budget, Bella was extremely determined to have a drug-free pregnancy with minimal OB-GYN interference. Sadly, there are not many alternatives to a hospital delivery (an issue for another day, on another blog). Also, insurance companies seem highly reluctant to cover the cost of alternative arrangements. A quick call to the insurance company, ruled out home-births, but did however cover some birth centers in the local area.

The costs of home-births and independent birth center (run by midwives), are considerably less than those of OB-GYN visits and hospital births. A requested c-section and office visits alone can come close to $10,000 (GBP 6,750), an uncomplicated vaginal delivery near to $8000 (GBP 5,400) (Agency for Health care Research and Quality, 2003, based on 2-3 day hospital stay). Had Bella gone this route she would have paid $7500 (GBP 5000) out of pocket, even with insurance. However, she was able to use the services of a birth centre for $3100 (GBP 2,090) after Insurance adjustment, without insurance it would have been $6000 (GBP 4,060) (our first choice was a home-birth costing $2650 (GBP 1,790). We had accumulated $2800 (GBP 1,890) in a roll-over health fund. The end result being $354 (GBP 240) out of pocket. This included all the office visits(10), tests, an ultrasound, labor, delivery, a home visit by a nurse, and a 2 week and 6 week postpartum office visit for baby(including newborn screening) and mother.

Bella would like to say that even though the financial savings were a bonus, the birth experience that occurred from her choosing a "less" expensive alternative, was safe and unforgettable. She would like to thank all the staff at
Nativiti, in the Woodlands especially the midwives, Melanie and Katherine. Also a special thanks to Lorri in the Finance department, for her endless patience with Bella. You will all be a forever memory to Bella and her husband.

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