There are a lot of bills to wade through after you have a baby, especially if the birth took place in a hospital. But one new dad noticed something unusual with a hospital bill his family received: His newborn son seemed to have been billed for his own delivery.
Redditor QuicksandGotMyShoe shared a post about his family’s experience that’s now gone viral. “My wife gave birth three months ago and, when going through the bills, we noticed that our baby was billed for its own delivery,” he wrote. “Conveniently (for the insurance company), this meant that it applies towards my son's deductible ($3,500) instead of my wife's which had been fully met at that point due to an earlier hospital stay.” QuicksandGotMyShoe said the family’s insurance “covers in-network hospitalizations fully after the deductible has been met."
QuicksandGotMyShoe later followed up with some good (and not-so-good) news: That the baby was not charged for its own delivery—and that the charges are valid. After speaking with a hospital representative, QuicksandGotMyShoe said he was told "most of what my son was charged was 'newborn charges' ($1,200/day, $2,400 total), the circumcision ($1,800) and 'other charges.'"
The Redditor added that, while he's still appealing some of the charges to see if they can be moved to his wife's insurance, but says that, overall, the charges are "legit"—but it still raises an important question: How exactly does insurance and billing work when it comes to giving birth?
So what do babies (and moms) get billed for during birth?
Health insurance coverage can be confusing under the best of circumstances, and it’s hard to know the details of this particular situation and the family’s coverage. (Health reached out to QuicksandGotMyShoe for comment, but didn’t hear back.) But, when it comes to having a baby, health insurance can be even more maddening.
“When babies are born, there are two components to the bills,” says Katalin Goencz, CIC, co-president of Alliance of Claim Assistance Professionals. One is the delivery, which is billed to the mother; The other is baby care, which is billed to the insurance on file under the newborn, she says.
As far as deductibles go, which are also confusing, some insurance policies have a per person deductible (i.e. the amount you pay for covered health care before your insurance plan starts to pay). “So, if the baby is born there is a new person on the policy and per person deductible kicks in,” Goencz explains.
Many policies also have a larger family deductible in addition to the personal deductible of each member, says Adria Gross, president of MedWise Insurance Advocacy and author of Solved! Curing Your Medical Insurance Problems. If the family deductible wasn’t met yet, the baby’s birth wouldn’t be covered, she says, adding that "it's a normal thing with health insurance."
In general, you usually have 30 days after you give birth to add your new baby to your healthcare benefits, says Abbie Leibowitz, M.D., founder, chief medical officer. and president emeritus of HealthAdvocate. If you do that, your child’s birth should be covered—again, provided your deductible has been met.
What can you do to make sure you’re not paying unusual bills after you give birth?
When you’re pregnant, make sure your doctor and hospital are in your network, Gross says. And, if your health insurance changed during your pregnancy, you’ll want to check your coverage again.
If you’re planning on having pain management during labor or a C-section, know that anesthesiologists are often out of network. Check your plan in advance to see what your in– and out–of–network coverage entails and, if you’re not sure, Gross recommends calling the hospital where you plan to give birth to ask in advance which insurance companies their anesthesiologists accept. If you have a scheduled induction, call and ask who will be the anesthesiologist who will work with you and make sure they’re in your network, she says. If they’re not covered, ask upfront what the cost will be. “If they tell you in advance what the amount will be, that’s what it should be,” Gross says.
It’s easy to just assume a bill is correct and pay it to avoid a hassle, but insurance mix-ups can and do happen. “Never pay a medical bill without questioning it,” Leibowitz says. You can contact your insurance provider directly or, if that doesn’t seem to help, there are patient advocacy organizations that can take this on for you.
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