First Time Mom Help With Hospital Bills (in the US)

As a first time mom, I remember the overwhelm associated with all of the financials. Not only are you worried about buying all the baby things, but you’re also supposed to look towards the future. The future and well being of this tiny human depends on you and the choices you make for them. I don’t know about you, but as a young 23 year old I did NOT feel grown up enough for that kind of responsibility. My brain kinda shuts off when it comes to finances, so I definitely was one of those first time moms who needed help with figuring out my hospital bills.

I’m not sure there’s a quick and painless way to figure out finances (short of making someone else do it for you), but I believe lists can help. So I’ve put one below – a sort of checklist of things you need to go through as you’re working through understanding those hospital bills. I tend to be thorough, so I’ve included some extra financial considerations you need to address once you’re a parent.

Table of Contents

First Time Parent Finance Checklist

Preparing for the Hospital Stay

Research and understand insurance coverage

Contact the insurance provider for details
Verify coverage for prenatal care, delivery, and postnatal care
Research and decide what kind of delivery you’d like to have taking finances into consideration (birthing center, hospital, home birth)
Explore government assistance programs (optional)
Investigate Medicaid or other state-specific programs to determine eligibility and application process (optional)

Communicating with Healthcare Providers

Discuss financial concerns with healthcare providers
Ask about payment plans or discounts
Inquire about potential financial assistance programs offered by the hospital/birthing center
Request a detailed estimate, seeking clarification on itemized charges if needed

Budgeting and Financial Planning

Estimate out-of-pocket costs based on insurance coverage
Consider additional expenses like medications, postnatal care, etc.
Create a budget for anticipated medical expenses
Set up a savings plan, allocating a portion of income for healthcare expenses
Explore Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) (SUPER valuable for us)

Post-Delivery Financial Steps

Promptly review and reconcile hospital bills
Ensure accuracy and address any discrepancies (because there’s usually at least one)
Make sure you get payment confirmation number for every payment made
Explore postnatal financial assistance options (especially ones for new mothers – these are often location based)
Seek support from community organizations or non-profits

Long-Term Financial Planning

Explore life insurance and disability insurance
Evaluate the financial impact of expanding the family in the future
Build/maintain an emergency fund and dictate what constitutes an emergency
Create a budget and revisit it every 6 months (or so)

Insurance Coverage

First, I want to mention that if you’re NOT currently insured but you or your partner’s place of work offer insurance – you may be in luck (at least at the time of birth). Remember with health insurance a “qualifying life event” can make you eligible for a special enrollment period. Definitely check with your (or your partners) employer and/or the marketplace to see if/when you could qualify. Here’s more information about a QLE (qualifying life event) as it pertains to health insurance.

Back to it. Researching and understanding insurance coverage is a crucial step for first-time moms preparing for childbirth and the associated hospital bills. The process will feel daunting, but I promise it gets easier.

Related: Third Trimester Checklist

To begin, contact your insurance provider well in advance of the expected due date. Keep in mind that coverage may slightly change at the beginning of a calendar year, so make sure you double check your information if a new year rolls over. Obtain a copy of your insurance policy and review the sections that pertain to maternity care, prenatal visits, delivery, and postnatal care. Pay close attention to details such as deductibles, co-payments, and co-insurance rates, as these will directly impact your out-of-pocket expenses.

Here’s a list of things you’ll need to clarify with your insurance company

Ask About Maternity Coverage: Explicitly ask about maternity coverage within your insurance plan. Inquire about the extent of coverage for prenatal visits, which may include routine check-ups, ultrasounds, and screenings. Be sure to understand any co-payments, deductibles, or co-insurance that may apply to these services.
Clarify Coverage for Delivery: Discuss the coverage for the actual delivery, whether it’s a vaginal birth or a Cesarean section. Understand the costs associated with hospital stays, anesthesia, and any other related services. Additionally, confirm that the hospital/birthing center is in network (or understand your out of pocket cost if not).
Explore Postnatal Care Provisions: Extend the conversation to postnatal care, encompassing services after childbirth. This may include follow-up appointments, medications, and any necessary postpartum treatments.
Check for Additional Benefits: Inquire about any additional benefits or support programs offered by your insurance provider for expectant mothers. Some plans may include resources such as lactation consulting (which even if you don’t think you need it, I promise it’s a great resource), well-baby check-ups, or postpartum mental health services. Keep in mind that if you don’t have coverage for something like a postpartum mental health visit, you may be covered for regular mental health visits that DON’T fall under maternal care.
Review Policy Documents: Request and thoroughly review your insurance policy documents. Policies can be complex, but they contain detailed information about coverage limitations, exclusions, and any specific conditions that may apply to maternity care. Understanding the policy language will empower you to make informed decisions.
Keep a Record of Communication: Document the details of your conversation with the insurance representative. Note down the names of the individuals you spoke with, the date of the conversation, and a summary of any important information.

Sometimes there are little “perks” that they’ll forget to mention unless you ask. When my second child was born, we learned that our insurance actually covered a free meal for my partner on the night of my daughter’s birth. We hadn’t known about this with my first child and so missed out on it. Not a big deal, but it was nice to have the second time around (don’t we all appreciate free stuff?)

Related: Newborn Baby Item Checklist

In addition to contacting the insurance provider directly, online portals and mobile apps often offer accessible and detailed information about your coverage (which is great if you hate talking on the phone). Typically you can log in to your insurance account to review policy documents and claims history.

The last thing I’ll say is..while your medical provider can be a great advocate and spokesperson between you and your insurance, ALWAYS verify for yourself on whether this or that is covered. We had a provider who swore up and down that they took our insurance on multiple occasions. Rather than check for ourselves, we trusted this and ended up getting footed with thousands of dollars in medical expenses that would have been free under a covered provider.

In summary, researching and understanding insurance coverage involves proactive communication with your insurance provider, a thorough review of policy documents, and exploration of online resources. By taking these steps, first-time moms can gain clarity on their coverage, anticipate potential expenses, and better prepare for the financial aspects of welcoming a new member to the family.

Additional Hospital Stay Financial Help for First Time Moms

Finding government or state assistance programs like Medicaid can help individuals seeking financial support for healthcare, including prenatal and maternity care. I’ve found that the downside to these kind of services is that there can be a bit of a wait between the time of application and actual assistance in your hands. It’s stressful not knowing if you’ll be accepted, and there’s often a lot of hoops to jump through for any kind of aid.

At first, constrain your search to government programs, but after you can look at other local programs that may not be associated with the government. The reason I suggest looking at government services first is there’s less of a chance that you’ll end up investing time into a scam.

Here’s a look at what I get when I look at what’s available in my state.

Here’s a breakdown of what you’ll want to do if insurance and/or paying out of pocket is not realistic for you.

Research State-Specific Government Programs: Each state may have its own set of programs designed to support individuals and families with healthcare expenses. Visit your state’s official government website and/or other official websites to gather information on available programs. Be careful to double-check ANY website visited – use a free service like Scam Advisor to verify its authenticity.
Explore Medicaid Eligibility: Medicaid is a federally funded, state-administered program that provides health coverage to eligible low-income individuals and families. Determine whether you qualify for Medicaid based on income, family size, and other criteria. Medicaid often covers a range of pregnancy/birth services, making it a valuable resource for expectant mothers.
Contact Local Social Services Offices: Reach out to local social services offices in your community. These offices often have information about various assistance programs, including Medicaid and other state-specific initiatives. Social workers can provide guidance on the application process and help you understand the available resources.
Attend Community Events and Workshops: Many communities organize events or workshops that focus on healthcare and social services. Attend these gatherings to connect with representatives from government agencies, non-profit organizations, and community groups. They can provide valuable information about assistance programs and guide you through the application process.
Utilize Online Resources: Take advantage of online resources provided by government agencies. Many states offer online portals where you can check eligibility, download application forms, and get information about the required documentation. Familiarize yourself with these resources to streamline the application process.
Seek Assistance from Healthcare Providers: Reach out to your healthcare providers, including prenatal care providers and hospitals. Staff members may have information about local assistance programs and can guide you on accessing financial support for maternity care. See what kind of payment plans are offered, and compare these to other facilities you could utilize.
Check with Non-Profit Organizations: Some non-profit organizations focus on providing assistance to individuals and families in need. Explore organizations that specialize in maternal and child health, as they may offer support or direct you to relevant government programs.
Check Online Forums: Utilize sites like Quora, Reddit, and even Facebook to find communities of other women in your state. Ask for advice on checking resources and application processes, as there are sometimes nuggets of information they have that could make or break your ability to get help.

By following these steps, a new moms can navigate the process of finding government assistance programs, investigate Medicaid eligibility, and access the financial support needed. I know it feels like a lot (it IS a lot), but once it’s done, it’s done. You got this.

Related: Baby Shower Theme Ideas

HSA’s and FSA’s

A flex spending account was one of our “secret” weapons. I was in a month-long daze after my first daughter was born, and we hadn’t set up much of a budget or plan. What we did have was a flex spending account, which I remember curbed my panic on multiple occasions when we were in medical need of something, but were a little short on funds. I think everyone should have one of these, even if you contribute minimally to it.

Anyway, I’ll provide a brief explanation on both of these.

What is a HSA and/or FSA?

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) provide individuals with tax-advantaged ways to save money – specifically for medical expenses. Both accounts allow individuals to contribute pre-tax dollars, reducing their taxable income, and the funds can be used for qualified medical expenses. However, there are differences in eligibility, contribution limits, and rollover rules.

Health Savings Accounts (HSAs):

Eligibility: Individuals must be enrolled in a high-deductible health plan (HDHP) to qualify for an HSA.
Contributions: Contributions are tax-deductible, and both the account holder and employer can contribute, up to annual limits set by the IRS.
Rollover: HSA funds can be rolled over from year to year, and the account remains with the individual even if they change employers or health plans.
Withdrawals: Withdrawals are tax-free when used for qualified medical expenses. After age 65, funds can be withdrawn for non-medical expenses without penalty (though income tax may apply).

Flexible Spending Accounts (FSAs):

Eligibility: Most employees are eligible for an FSA, regardless of the type of health insurance plan they have.
Contributions: Contributions are made through salary deductions, and both employees and employers can contribute, within annual limits set by the employer and IRS.
Rollover: FSAs typically have a “use it or lose it” rule, meaning that funds not used by the end of the plan year are forfeited. However, some plans allow a carryover of a limited amount or offer a grace period.
Withdrawals: Withdrawals are tax-free when used for qualified medical expenses.

How to Explore These Options:

Check Employer Offerings: Many employers offer HSAs or FSAs as part of their benefits package. Review your employer’s benefits documentation to see if these options are available (and remember, a pregnancy is considered a “life event”, meaning you can add something like this on even if you aren’t in open enrollment).
Evaluate Contribution Limits: Understand the annual contribution limits for each account, considering both your financial capacity and the potential medical expenses you may incur.
Learn About Rollover Rules: If applicable, review the rollover rules for each account. HSAs generally allow funds to roll over, while FSAs usually have use-it-or-lose-it rules (with some exceptions).
Research Qualified Expenses: Familiarize yourself with the list of qualified medical expenses for each account and decide which seems to pertain more to your needs
Consult Human Resources or Financial Advisor: If you have questions or need assistance, consult your employer’s human resources department or a financial advisor for guidance on choosing the right account for your situation.

By exploring and understanding the features of HSAs and FSAs, individuals can make informed decisions to optimize their tax savings and effectively manage their healthcare-related expenses.

Postnatal Financial Assistance Options

Finding postnatal financial assistance options and programs for new mothers involves exploring various resources that provide support during the critical period following childbirth. Many of these steps/resources will be similar to your prenatal search for financial help, but there are a few differences.

Here’s a guide on how to identify and access these assistance options. Some of these things will be redundant, but they are relevant so I included them.

Contact Healthcare Providers: Reach out to your healthcare providers, including obstetricians, pediatricians, and local clinics. Inquire about any postnatal financial assistance programs they may be aware of or if they have resources to help new mothers navigate potential financial challenges.
Speak with Social Workers: Hospitals and healthcare facilities usually have a social worker on staff who can provide information about financial assistance programs. Social workers are well-versed in connecting individuals with resources that support new mothers and families during the postnatal period.
Explore Government Assistance Programs: Investigate government assistance programs at both the federal and state levels. Programs like Women, Infants, and Children (WIC) (here’s more info from the USDA on this program). Keep in mind WIC is state specific. Temporary Assistance for Needy Families (TANF) is another option (also state specific). Here is a resource from the Office of Family Assistance with more information.
Research Non-Profit Organizations: Numerous non-profit organizations focus on maternal and child health. Explore charities and foundations dedicated to supporting new mothers. These organizations may provide financial assistance, counseling services, or access to essential resources.
Connect Online in Local Community Groups I’ve found my local Buy Nothing Facebook group to be of great use when we’ve been in need of something like diapers. There are often low cost buy/sell or trade groups for moms as well – these have also been of great use for us.
Utilize Online Resources: Search online for national and local organizations that specialize in postnatal financial assistance. Websites like Benefits.gov or Postpartum Support International can be valuable resources in identifying available programs and services.
Find Parenting Support Groups: I have tended to prefer the online local informal parenting groups on Facebook. I’ve also found these to provide valuable information on illnesses in my area, doctor recommendations, and new playground suggestions.
Check with Employers: Inquire with your employer about any postnatal support programs they may offer. Some companies provide benefits such as parental leave, flexible work arrangements, or assistance programs for new parents. At the time of my eldest daughter’s birth, my company gave me 3 months of paid leave, and my husband’s gave him one month of paid leave.
Consult Financial Advisors or Counselors: Seek guidance from financial advisors or counselors who specialize in family financial planning. They can provide advice on budgeting, financial assistance programs, and available resources for new mothers.