New research has found that the cost of giving birth the same way as someone else can vary by as much as 600 percent, even when you’re in the same city. Experts discuss why this is and what you can do to avoid overpaying.
You may assume that the cost of giving birth would be pretty similar to what your friends shell out for process, especially if you live in the same city. But revealing new research has found that’s not true. A new study of medical claims data from healthcare information company Castlight Health discovered that delivery costs across the country for women with insurance can range from $6,000 to more than $40,000. Of course, there’s a difference in cost between a vaginal delivery and a C-section, but researchers also found that there was a huge difference in cost for women who had the same procedure done—even in the same city.
For example, women in New York City who had a routine vaginal delivery faced costs ranging from $4,022 to $17,646. A C-section in San Francisco ranged anywhere from $8,399 to $41,191. But Los Angeles had the biggest price discrepancy: A routine vaginal delivery in that city ranged from $4,223 to $27,326.
While the findings sound staggering to the average person, healthcare experts unfortunately aren’t shocked. “The dramatic variances in the cost of childbirth in the U.S. are about as surprising as the sun coming up in the morning,” Sarah O’Leary, founder of Exhale Healthcare Advocates, a national consumer health-care advocacy group, tells SELF. “Choosing a hospital on one side of Main Street versus the other can be the difference between minimal charges past one’s deductible or a diagnosis of thousands of dollars of avoidable post-delivery debt.” Even the team of doctors and staff you choose within the same hospital can make a big difference in the price of the delivery, she says.
Many healthcare providers are also sneaking in overly-inflated prices for things, like charging $300 for the $20 blanket in the delivery room. That excess price can then get passed on to patients. “The insurer might honor the contracted rate of $20, but a greedy provider might try to get the $280 balance from the new family,” O’Leary says.
Healthcare expert Caitlin Donovan, spokeswoman for the National Patient Advocate Foundation, tells SELF that these unnecessary sky-high pricing happens “because it can.” “We don’t have any real system of transparency, nor do we regulate how hospitals arrive at their rates,” she explains. “Since most people are insured and don’t see anything but their copay, there’s only now starting to be a groundswell of protest as insurance companies are pushing off more of the costs onto the patients themselves.”
It’s scary that you can get a medical procedure done, not know how much it costs, and then receive a whopping bill later with little explanation as to why it costs what it does. “There’s no other sector that works like that,” Kristin Torres Mowat, senior vice president of Plan Development and Data Operations at Castlight Health, tells SELF. “Individuals have the right to know how much they’re going to pay.”
So, what can you do about this? Experts recommend being proactive before you give birth and asking a lot of questions. O’Leary says it’s a good idea to call your insurance provider and have them explain to you in detail what they cover. Then, have them either email or mail you those details, so you can use them as backup if the cost to you ends up being much higher down the road. “Don’t settle for a summary of benefits, because it really doesn’t tell you what you need to know,” she says.
Also, Donovan suggests calling the hospital where you plan to give birth and asking if they’re in-network for you (asking if they “take your insurance” isn’t enough, since they might but still charge you a ton because they’re out-of-network). You’ll also want to make sure their Neonatal Intensive Care Unit (NICU) is in-network, because it can be contracted out to a provider. If your baby has to stay there, it can end up costing you thousands of extra dollars. “Finally, check on the anesthesiologist, because they are often out-of-network and will lead to higher out-of-pocket costs,” Donovan says. (O’Leary recommends getting it in writing in advance that all who are involved in your case are in your health insurer’s network.)
If you get a bill after you give birth that seems off, don’t just pay it—you can challenge the cost. “Ask questions of your provider and insurer about bills that you don’t understand,” says Mowat. “Healthcare bills are very confusing and it’s hard to understand what things are. It may take a lot of phone calls, but don’t just hand over your money.” Donovan recommends calling the hospital to get an itemized bill, then speaking with your insurer and asking them what they need for the service to be covered. You may be able to get a charged greatly minimized or even reversed.
If you find that you have to pay a bill that still seems inflated, ask if you can pay a lower price. “With some hospitals, you can negotiate and offer to pay right then and there and they’ll reduce the amount you’ll owe,” Mowat says. “I’ve seen cases where people have been able to pay a lower amount because the hospitals have such outstanding collectibles.”
Lastly, keep this in mind: “Paying more for your healthcare providers doesn’t translate into better quality of care in most instances,” O’Leary says. If you’re researching options and trying to make a choice, she says in addition to doing all of the above, it’s good idea to talk to your friends who have given birth in your area to see what they thought of their quality of care and overall cost.