How to pay for prenatal care and delivery

Start looking at your options as soon as you know you're pregnant. Early prenatal care is important for you and your baby, and a lot of coverage options take time to set up.

Medicaid for pregnancy

Medicaid is the biggest payer for births in the country. Every state covers pregnant people with incomes well above the limits for other adults. In many states, a family of three can earn more than $50,000 a year and still qualify. Some states set limits much higher.

• What it covers: Prenatal visits, lab work, ultrasounds, labor and delivery, and postpartum care. Costs to you are usually very low or nothing.
• How long it lasts: Pregnancy Medicaid now continues for a full 12 months after your baby is born in most states.
• How to apply: Apply through your state Medicaid agency or HealthCare.gov. You can apply any time during pregnancy, not just during open enrollment. Many states also offer "presumptive eligibility," which lets you get prenatal care right away while your application is processed.
• Your baby: A baby born to a mother on Medicaid is automatically covered for their first year.

Marketplace health insurance

Don’t have your own insurance and worried that you earn too much for Medicaid? If you A plan from HealthCare.gov or your state's marketplace is another option. All marketplace plans cover pregnancy and childbirth.

The biggest problem you’ll face is timing enrollment to match your pregnancy. Most states don’t let you enroll just because you’re pregnant. Instead, you have to wait for the open enrollment period. If you're already pregnant and uninsured, check Medicaid first, and whether your state is an exception. The birth of your baby does open a special enrollment window.

If you have insurance through work

Most employer plans cover pregnancy and delivery, but you'll still have some costs. Look up:

• Your deductible: What you pay before insurance starts covering most costs.
• Your out-of-pocket maximum: The most you'll pay for covered care in a year.
• Whether your doctors and hospital are in network.

Delivery bills can easily hit your out-of-pocket maximum. If your due date is near the end of the year, costs could fall into two plan years with two deductibles.

How to lower your costs

• Use a health savings account (HSA) or flexible spending account (FSA). These let you pay medical bills with pre-tax money. Put extra into your FSA if you’re enrolling while you’re pregnant.
• Ask for an estimate. Hospitals and birthing centers can give you a cost estimate. If you're uninsured or paying yourself, you're entitled to a good faith estimate.
• Ask about financial assistance. Nonprofit hospitals have to have financial assistance programs, sometimes called charity care, for patients with lower incomes.
• Set up a payment plan. Most hospitals and doctors offer interest-free payment plans. Ask before putting a big bill on a credit card.
• Look into community health centers. These offer prenatal care on a sliding fee scale based on your income.
• Check your bills. Ask for an itemized bill and look for errors or duplicate charges before you pay.