Hospital vs. Homebirth Cost Comparison

Often, when assessing the cost of midwifery services, couples make the comment "we have insurance, so a hospital birth will be less expensive".  This is simply not true in most cases.  Armed with this information, you can now accurately calculate how much JUST THE HOSPITAL will bill you.  There will also be a bill from your primary care doctor, the anesthesiologist if you have a spinal or epidural, the pediatrician that examines the baby and the staff that provides your baby's immediate postpartum care [Vit K injection, eye ointment, Hep B injection, newborn exam]. 

Consider the following:

Copay:  Usually $25, $30 or $35 depending on the plan you choose.  Lab work and x-ray done in your doctor's office are not included in your copay.

Co-Insurance: This is the percentage of your bill you are responsible for after you have met your deductible and before you have reached your Maximum out of Pocket. 80/20 Co-insurance is the most common co-insurance. Many companies offer 70-30 or 60/40 coinsurance to lower your premium. The most important part of coinsurance is the STOP GAP. This is the amount you pay before you reach your maximum out of pocket. The stop gap is not equal with all companies; but it is easy to calculate. An 80/20 to $10,000 plan has a $2,000 stop gap [10,000 x 0.2 = 2,000].  An 80/20 to $15,000 has a stop gap of $3,000 [15,000 x 0.2 = 3,000]. What is the Stop Gap of the plan you are enrolled with?

Maximum Out of Pocket:  This is the total of your deductible and coinsurance that you must meet before the company pays 100% of your bills. Your deductible $500 plus coinsurance $2000 equals your annual maximum out of pocket of $2500. Your Maximum Out of Pocket may be more important than your deductible. Realize, too, that once the baby is born, he/she becomes a separate insured person - with a separate maximum out of pocket and copay. 

So, unless you have exceptional insurance, you will probably be paying a hefty sum to have your baby in a hospital.  Comparatively, although the fees from your Ohio homebirth might not be reimbursable, they will likely be less than your deductible, copay and stop gap combined. While I cannot speak for every homebirth midwife, all the midwives I know charge a single fee for prenatal, labor and postpartum care for both mom and baby. 

Now that insurance coverage has been explained, let's see how much it will cost you to have your baby in a Northeast Ohio hospital.  The Nation's Health, a publication of the American Public Health Association, reported the results of a 2004 March of Dimes Foundation study that found the average cost of having a baby in the United States, for "women insured through large employer private plans," was more than $8,000. The study examined health claims from more than 10 million employees and their spouses and dependents.  The study found the average cost for vaginal delivery was more than $7,700, and for C-section was nearly $11,000.

 

**All hospital fee quotes are taken directly from the hospital's own website referenced on 6/1/2010.  Hospitals change their fees often. PLEASE realize that the most accurate information is obtained by calling the hospital you plan to deliver at close to your due date and asking for a price list.**  Also, these numbers do not include charges for anesthesia, drugs[Pitocin, oxygen, antibiotics], or supplies [IV, suture and lidocaine to repair episiotomy] required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician. Based on a number of web searches, the range of cost for an epidural is between $1000 and $2200.  None of the local hospitals publish the cost of anesthesia.