Due to being self-employed and the insanely high cost of traditional health insurance, our family has been on a “medishare” plan now for a few years. For families without chronic illnesses who are mostly healthy, it’s a great option to consider. A year ago, we learned my wife was pregnant, and this would be the first baby we would have while utilizing the medishare program. I was immediately curious about what kind of costs we would encounter for the care associated with pregnancy as well as the actual birth. In this article, I’ll outline exactly how much it cost us to have a baby when paying using cash.
Before we get into the pregnancy costs and birth costs, let’s quickly review what it means to be on a medishare program. In these programs, individuals and families essentially commit to share each other’s medical expenses. Based on age and size of family, typically you will commit to a certain amount of money each month (this is similar to your premium in traditional health insurance). This is the amount of someone else’s bills you will pay each month. This can be as low as $100-something if you’re a young individual or something in the $500-800 range for larger families. There are many variables and plans and it truly varies depending on the program. You can learn more about these programs here.
When you encounter a medical expense, you get to share it to the community. Typically you pay cash upfront for all services, then you receive money from other members in order to fully reimburse you for the eligible costs.
Interestingly, because we are 100% reimbursed for all medical expenses over a certain threshold, we essentially had a net-zero expense on all pregnancy and birth costs. yes, we paid thousands upfront in cash, but we received every dime back from other members who “shared” the expense. What is fascinating is that even with my previous traditional health insurance, I had to come out of pocket several thousands of dollars previously for when my wife was pregnant with our previously born children – especially for the hospital birth – even with full health insurance.
So, overall, the experience was outstanding. But let’s get back to the point of the article here. How much does it cost to have a baby when paying cash? I’ll break it all down…
Maternity & birth costs
Prenatal Care & Doctor’s bill for birth
My wife’s OB doctor was willing to establish a set amount for all prenatal appointments throughout the pregnancy as well as the costs for the doctor to deliver the baby. Note that the birth costs are broken down into hospital facility charges, anesthesia charges, pediatrician and OB doctor. This was just the birth cost for the OB. If we paid upfront, the OB doctor agreed to $3800 which covered all prenatal appointments and the doctor’s role in the delivery. However, this did not cover ultrasounds and lab costs for bloodwork that was done throughout the pregnancy.
Throughout the pregnancy, the OB doctor would prescribe ultrasounds both as routine and then sometimes if they saw something they didn’t like. There were a number of ultrasounds. Even though most of these were done at the OB doctor office, we had to pay for these on top of the original $3800. These were typically $150 each. We had 6 of these throughout the pregnancy. We also had one special ultrasound at a specialist that was due to my wife being classified as high risk for a few things. This was a $600 cost.
Normal ultrasounds: 6 x $150 = $900
Specialist ultrasound: $600
Lab costs for bloodwork
When blood was drawn for various tests throughout the pregnancy, it was sent to labs and we were billed separately. These costs varied each time.
Delivery & Hospital Stay
We knew the hospital would be a big charge, so we went in ahead of time and registered and asked about discounts for paying cash upfront. The hospital had a “prepay” plan in which you can pay upfront. If you didn’t do this, the bills would be quite higher. They had an option to pay $5,000 upfront which covers a typical, issue-free birth. If something happens and more services like a C-section are required, costs would vary, but the $5,000 covered the basic costs.
Now it’s worth noting that after doing this, I still received bills afterward for about $40,000 in charges as if I didn’t prepay. I had to go back to the hospital in person and show them the prepay agreement with receipt of the $5,000 payment and they promptly got rid of the $40,000 bills. Don’t be shocked if something like this happens. These places are so used to going through the typical insurance route that they are likely going to make some mistakes when you’re paying cash like this. Make sure you keep all records so you can ensure you can prove you don’t owe money when you don’t. When they got rid of the $40,000 in bills, I had them print out a statement that said I was free and clear for all charges related to MOM AND BABY (make sure it states both) with respect to the delivery and stay on the particular dates.
Ok, the hospital facility charges is just one component of what you’ll pay for when having a delivery at the hospital. You will be billed separately by the anesthesiologist if you use anesthesia. You will also be billed separately by the pediatrician. We also had to pay for a $300 circumcision charge which was tacked on by the hospital (and was outlined as an additional service on our prepay agreement).
Note that the pediatrician bill I received was $1,765. Since I’m paying cash (and am without traditional insurance), it always makes sense to call and ask for a cash pay discount. Remember, they are often used to working with uninsured people who can’t pay hardly anything. I was able to get an immediate discount of over $500 which took the bill down to $1,235.50.
Hospital facility charge prepaid: $5,000
Hospital circumcision charge: $300
Anesthesia bill: $2,258
Summary & Total Costs
If we total everything up, here’s what we’re looking at:
OB (Prenatal visits & delivery): $3,800
Delivery (hospital, anesthesia & pediatrician): $8,793.50
So there you have it. It cost about $15,000 for us to have our baby in a major Florida city with full prenatal care, normal delivery in a major hospital with anesthesia. We paid cash upfront for most of it, although bills from labs and from hospital anesthesia groups and pediatricians were sent aftwared. For anything that we prepaid, we were able to usually get a “cash discount.” For the hospital related bills that came later, we were able to negotiate discounts from the stated balance and get those paid immediately. For lab charges, we just paid those without negotiation since they were never crazy.
As stated earlier, since we’re a member of the medishare program, we were able to get all of the $15,000 we paid in cash back to us via the member sharing method. While you have to manage your cash and credit card usage since there is a delay between paying bills and being reimbursed, the system worked great. We had a net zero cost for having the baby! Pretty awesome. Hopefully this guide for how much it costs to have a baby while paying cash is helpful.