Health Insurance For Pregnancy 101
Shopping for health insurance can seem as complex as doing your taxes and it becomes even more complicated if youre pregnant. So it first helps to understand the various health insurance terms youre likely to hear:
- Premiums: The amount of money youll pay your insurance company monthly for coverage.
- Out-of-pocket cost-sharing: What you pay personally to your practitioner for medical visits and procedures as part of your health insurance plan.
- Co-pay: The amount of money you pay for each in-network doctors visit , which usually ranges from $25 to $50 .
- In-network co-insurance: The percentage youll pay toward your medical bills if you have a bigger procedure at an in-network doctor or hospital .
- Deductible: The amount you pay before your health plan starts paying some share of the expenses. If your deductible is $3,000, youll pay for co-insurance out-of-pocket until you hit $3,000; at that point your health insurance starts paying for some of the expenses up to your out-of-pocket max, when theyll start paying for everything.
- Out-of-pocket max: The most youll pay for health care in a year. This amount does not count your monthly premiums but does include copays and coinsurance you continue to pay after you hit the deductible.;
Since pregnancy is a high-cost health expense even for women with health insurance, youll want to focus especially on the cost of premiums and the co-insurance to keep your overall costs as low as possible.
How Often Do You Need Prenatal Visits We Have Answers
Consistent prenatal care is important for both your health and your child’s. By consistently attending appointments, baby’s growth is closely monitored, and you have many opportunities to ask questions.
While some high-risk pregnancies require additional visits or tests, the following is a typical prenatal care schedule for a routine pregnancy.
The Cost Of Routine Screening Tests During Pregnancy
The health care law requires certain specific screening tests for pregnant women to be covered by insurance plans with no cost sharing. These will generally be done as part of your regularly scheduled prenatal visits, often through bloodwork or urine tests. The free routine screening tests covered by your health insurance plan should include but are not limited to:
- Anemia screening
- Bacteriuria urinary tract or other infection screening
- Rh incompatibility screening and follow-up testing for women at higher risk
- Hepatitis B screening at your first prenatal visit
- Gestational diabetes screening when you’re 24 to 28 weeks pregnant or at other times if you are at high risk of developing this condition
- Syphilis screening
You can also get fully covered the screenings and services that are available to all women, such as tests for HPV, cervical cancer, HIV, gonorrhea and chlamydia, as well as counseling for things like domestic violence and tobacco use.
Screening tests that aren’t mandated by the Affordable Care Act may lead to out-of-pocket payments from you, based on your insurance plan’s cost-sharing structure.
Professional Fees Start At Php10000
Hospital birthing packages don’t always include doctor’s fees, which may vary. Make sure you clear it with your doctor. Typically, obstetrician-gynecologist professional fees are the highest. You also have to pay your newborn’s pediatrician and your anesthesiologist.
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What Does A Positive Pregnancy Test Look Like
A positive test result will show a control line that was present before you took the test and a second line will appear after the urine passes through the window.
Some pregnancy tests have two individual windows, where lines need to show in each window.
Other pregnancy tests are designed to have a cross to show a positive result, so they can vary just read the instructions to find out what to look for.
The positive result line does not have to be as dark as the control line. But if you have a second line appear during the time frame specified on the packet, then you are pregnant.
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The Cost Of Routine Prenatal Visits Vs Diagnostic Visits
At your prenatal visits, your doctor will monitor your health and that of your baby. They will probably check your urine, your blood pressure, your weight and the fetal heart rate. As your pregnancy progresses, your doctor will also measure your abdomen and feel for the baby’s position. If you have health insurance, all of this routine prenatal care should be covered by your health insurance plan, with no charge to you.
If the obstetrician detects anything worrisome during the exam, or if you bring up a complaint that requires additional investigation, like unusual pain or bleeding, the billing code for your visit may change from routine to diagnostic because the doctor needs to figure out the problem. They may have to order some extra tests. This diagnostic prenatal care is generally not required to be covered by insurance with no cost sharing. You may be responsible for copays, coinsurance or payments toward your deductible, depending on the structure of your health insurance plan.
What Is Prenatal Care And Why Is It Important
Prenatal care is medical care you get during pregnancy. At each visit, your health care provider checks on you and your growing baby. Call your provider and go for your first prenatal care checkup as soon as you know youre pregnant. And go to all your prenatal care checkups, even if youre feeling fine.
Getting early and regular prenatal care can help you have a healthy pregnancy and a full-term baby. Full term means your baby is born between 39 weeks and 40 weeks, 6 days . Being born full term gives your baby the right amount of time he needs in the womb to grow and develop.;
Dont be afraid to talk to your provider about personal things. Your provider needs to know all about you so she can give you and your baby the best care. She asks lots of questions about you, your partner and your families. Your medical information and anything you tell her are confidential. This means she cant share them with anyone without your permission. So dont be afraid to tell her about things that may be uncomfortable or embarrassing, like if your partner hurts or scares you or if you smoke, drink alcohol, use street drugs or abuse prescription drugs.
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What Are The Extra Costs
If there are any complications resulting in extra testing, the total cost will increase.
If you would like additional ultrasounds, such as a 4d ultrasound, this will more than likely not be covered by insurance because it is not a necessity.; A 4d ultrasound can cost anywhere from $100 to $300 depending on what features are included in the experience.
Most doctors suggest that pregnant women take some sort of multi-vitamin.; This is usually covered by insurance except for a small copay.
The baby delivery will be considered an additional cost outside of the care.
Complications during a pregnancy can sometimes lead to extensive tests or prolonged hospital stays.; If this is the case, the cost can greatly vary depending on what has been done.
Newborn Screening Is At Php950 Or Free Via Philhealth
Newborn screening test;is covered by PhilHealth. However, the Newborn Care Package only allots P550 for the basic newborn screening, which screens for six conditions. The expanded newborn screening, which tests for 28 disorders, approximately costs P1,500, so parents will have to pay the remaining P950 out of pocket.;
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Tips For You This Week
Delivery day is getting close, so it’s time to;pack your hospital bag if you haven’t already.
Along with necessities, you may want to stash these feel-good items inside: lip balm since your lips may become very dry, even before you start breathing heavily during labor; bands or scrunchies to keep your hair back; a brush for tangles ; moisturizer; warm socks and slippers; mints; flip-flops and a warm robe.
They just might make your labor, delivery and overall stay more comfortable. Remember, don’t bring or wear anything you really love, like your favorite PJs or that fancy negligee, since it may get lost or ruined. And check if you need to pack your hospital bag differently in light of COVID-19.
It may not be just pregnancy weight. If you notice sudden facial swelling, talk to your doctor.
Along with changes in vision and headaches, swelling can be a sign of preeclampsia, a disorder that generally develops late in pregnancy, after week 20. Its characterized by a sudden onset of high blood pressure, severe swelling of the hands and face, and signs that some organs may not be working normally, including protein in the urine.
In case you haven’t noticed, the heat’s on when you’re expecting, especially as you get bigger and bigger. But water keeps the body’s cooling system running smoothly, even when your inner thermostat is on high, by dispersing excess heat in the form of sweat.
When To Take Pregnancy Tests
Pregnancy tests are designed to detect levels of hCG produced by your body if you are pregnant.
Your body may be producing human chorionic gonadotropin before a missed period, however its ideal to take a home pregnancy test on the first day of your missed period.
If you take a home pregnancy test before a missed period, you may indeed receive a positive result. But if you take a test before your period is due, youre more likely to end up with an inaccurate result.
Pregnancy tests may produce a negative result if your hCG levels are not yet high enough to detect a pregnancy.
On the other hand, it may show a positive result and not develop into a true pregnancy, due to the incidence of spontaneous miscarriage. These can occur before a missed period, and normally you would be none the wiser.
Are You Getting BellyBellys Pregnancy;Week By Week Updates?
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Hospital Birthing Fees Start At Php30000 Up To As High As P200000 Or More
The cost of giving birth depends on how and where you deliver your baby. A vaginal delivery costs cheaper than a C-section. The type of room you stay in after birth also factors in your hospital bill. If you choose to use the birthing suite or a water birthing suite, they cost higher, too.;
Birthing homes and lying-in centers are also possible locations, and cost much cheaper . Giving birth in them is not advisable for all pregnant women, however; it depends on your pregnancy risks and the doctor’s recommendation. If you opt to give birth in non-hospital locations, choose one that is equipped to handle emergencies or is near hospitals in case you need surgery.;
While the cost of giving birth has continually shot up, the good news is that you don’t necessarily have to pay for nursery room charges unless needed. All newborns are required by law to be roomed-in with their moms right after birth. It will cost you more, though, if you deliver prematurely, during which your baby may need to stay in the neonatal intensive care unit .
What Happens During My First Prenatal Care Appointment
Your first prenatal care visit is usually the longest one. Youll talk with your doctor about your medical history, the other parents medical history, and your family’s medical history.
Your doctor will give you a complete check-up, usually with a physical exam and blood and urine tests to make sure youre healthy. This can include:
measuring your height, weight, blood pressure, breathing, and pulse
a breast exam
testing for sexually transmitted infections
screening for diabetes, anemia, hepatitis B, and rubella
Your doctor might also talk with you about your diet and lifestyle, and prenatal vitamins. The most important vitamin you can take is folic acid, which ideally you would start taking before youre even pregnant. Your doctor can give you advice about any changes you can make to have the healthiest pregnancy possible.
Some types of medicine are dangerous to use during your pregnancy. Tell your doctor about every medicine, supplement, or drug youre using, and always check with your doctor before starting any new ones.
What If There Are No Lines On The Pregnancy Test
Its unlikely this will happen, but if it does, disregard the test.
The test may be faulty, or the result of not enough urine on the absorbent pad.
Other causes are too much urine on the absorbent pad, or perhaps the test was not held correctly in the stream of urine.
Repeat the pregnancy test, carefully following the instructions as in the above question on how to use the test.
Gestational Diabetes And Anemia: Between 26 To 28 Weeks
Diet and exercise can reduce your risk of gestational diabetes. However, some women still develop gestational diabetes for reasons that doctors do not fully understand. If you develop gestational diabetes, your doctor may recommend treatments ranging from diet adjustments to insulin injections. See this helpful Mayo Clinic guide for more information.
Anemia, or a lack of healthy red blood cells, often develops during pregnancy as your blood volume increases. This deficiency can usually be remedied with iron supplements or vitamins. See this American Pregnancy Association guide for more information.
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Get A Handle On Your Insurance
If youre unsure how your health insurance works, nows the time to research your benefits. You could take an entire course in understanding your policy, and still likely have questions. Consider this a cram session.;Your top two study areas include:
- Out-of-pocket costs: Copays, coinsurance, and deductibles
- Making sure your doctors are all in your provider network
Contact your health insurance company, with policy number in hand, and ask these key questions, making sure to write down whom you talked to and the date:
- Are prenatal care, labor and delivery covered benefits under my policy?
- Do I need a referral from my primary care doctor to see an OB-GYN or other specialists?
- Will I need pre-authorization for any prenatal care?
- What prenatal tests are covered ?
- What common prenatal, labor and delivery needs are not covered by my policy?
- Which hospitals in my area are in my insurance policys network?
- What do I need to do to ensure that my newborn is covered from the moment of delivery?
- How long of a hospital stay is covered after delivery?
- Does my policy cover a private room or suite, or will I have to share a room?
- If youre interested in nontraditional deliveries, like a home birth with a midwife, for instance, ask about coverage for these.
Throughout your pregnancy and into your babys well-child visits, err on the side of caution. If at any time you are unsure about your coverage and want to be doubly safe, call your insurance company to get confirmation in advance.
How To Choose A Prenatal Care Provider:
Similar to a midwife, a doula is more like a coach.; They will help with physical and emotional support during the labor.; A doula will often work with a midwife during the labor process.; If using a doula, make sure that you check with your insurance company to see if youre covered.
A certified midwife is great for women who are considered to be at low-risk.; Educated in nursing, a midwife can practice at hospitals and a birthing center.; Many prefer to deliver babies in the patients home.
Family doctors can provide care during a pregnancy but it may not be as detailed as an OB.; They can do just about everything, except for cesarean deliveries.
Medical doctors who specialize in delivering babies.; They will also have special training with surgeries such as a cesarean section.; Women who think that they are at the highest risk during a pregnancy should consider this specialty.
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When Is The Best Time To Take A Pregnancy Test
So youve had a missed period, and its time to take the test but when?
The pregnancy hormone hCG is usually at its highest levels early in the morning, when your urine is concentrated after a sleep. Especially if youre early in your pregnancy, this is when its the best time to take a pregnancy test.
Excessive fluid intake before taking the pregnancy test can actually dilute hCG. This can make the result hard to read.
Find Cheap Health Insurance Quotes In Your Area
Women typically have seven to 12 prenatal visits over the course of a normal pregnancy. If any complications arise, they may have even more.
The amount your obstetrician charges for each visit could range from about $90 to more than $500. Additional services such as pregnancy ultrasounds and laboratory tests are typically billed separately and usually cost upwards of $100 each. And special tests like amniocentesis can cost more than $2,500.
Depending on whether you have health insurance, and whether the prenatal care is considered routine or diagnostic, your actual out-of-pocket cost will be different. There are some costs that pregnant women still have to pay out of pocket.
For example, any visit that goes beyond the routine and becomes diagnostic can be subject to cost sharing under the terms of your insurance plan. Also, your insurer may expect you to chip in for some care that might seem routine, like bloodwork, obstetric ultrasounds or not-routine-for-everyone prenatal testing.
Those who don’t have health insurance must pay the entire cost of their prenatal care, but there’s some good news for those who do have insurance. The Affordable Care Act requires all qualified health insurance plans to cover routine prenatal care with no cost sharing. That means no copays or coinsurance, and the visits are fully covered even if you have a deductible you haven’t yet reached.
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