Skip to main content

Planning or expecting a baby? Ask your insurer these questions now

By James LaCorte | February 17, 2019 | Insurance Education, Community Health

Feature Blog Image

The cost of having a baby can be over $20,000. To put it into perspective that’s about one year of tuition from a public university.

While we recognize health insurance and medical care is expensive, not having insurance can be devastating. Health insurance reduces the financial burden because of the insurer’s bargaining power with medical providers. In addition to these lower charges, after a member’s deductibles and co-pays are met, the insurer picks up most of the remaining charges. Here’s a detailed example.

Your medical care routine during pregnancy

During your pregnancy, there are doctors’ visits where you will need to pay deductibles, co-pays and out of pocket costs. It can get a little overwhelming. To help make sense of it all, we asked one of our Medical Directors, Kelly Hill, MD, to weigh in.   

First Trimester – MONTHS 1-3

During your first trimester, common procedures may include monthly prenatal visits, lab work, ultrasounds, and any additional testing as needed (genetic testing, invasive testing for high-risk pregnancies). 

Second Trimester – MONTHS 4-6

During your second trimester, you will continue with monthly prenatal visits and may have additional lab work including glucose screening (to check for gestational diabetes) and blood screening (to check for genetic defects). You may also be scheduled for further testing or consultations. Additional ultrasound tests may also be performed to make sure your baby is developing normally throughout the pregnancy.

Third Trimester – MONTHS 7-9

By the third trimester, expect regular OB visits, which may be scheduled every two weeks, then weekly at the final stages of your pregnancy. Labor and delivery needs and costs vary based on the type of delivery or if any special care is needed.

Ready To Get Started? Download on Apple or Google Play

Now that I’ve shared what to expect during each trimester it may bring up more questions around what insurance covers and how to get the most out of your coverage.    

I spoke to our Customer Service Team to find the top questions members should ask when they learn about their pregnancy. There is a PDF available for pregnant moms to download.  The PDF also includes space for you to write down additional questions for your doctor and an infographic on what to expect during your pregnancy.

Questions to ask your insurer   

  • When and how do I report to my insurer I am pregnant?
  • How do I know what it will cost me?

    Click to download the checklist
  • How do I make sure my doctor, hospital and all related services are in-network?
  • Do I pay a deductible each doctor visit and in the hospital?
  • If my doctor prescribes tests, will these be covered? What do I need to do?
  • Is there a limit to my policy coverage?
  • Which procedures need pre-approval?
  • If I have complications are those covered?
  • Is an in-home nurse or midwife covered when doing a home birth?
  • How many ultrasounds are covered? Are 3D ultrasounds covered?
  • Is a cesarean delivery covered? Do I need prior approval?
  • Is tubal ligation covered?
  • If I take an ambulance to the hospital because I am in labor, is this covered?
  • Are breast pumps, supplies, and replacement parts covered? How do I order one? Does it have to be a specific kind?
  • If I have questions about pregnancy coverage who can I call?

We’re there when you need us

Our Customer Service Professionals are trained to make sure you understand your benefits, how to use them and help you through this exciting time in your life. For assistance call the number on the back of your insurance card.

You can also download the My Pregnancy app that offers:

  • A guide, tips, and FAQ about pregnancy, including a pregnancy survey.
  • Identifies potential pregnancy risks and connects customers to live nurse help 24/7.
  • Provides helpful Blue Cross NC resources and trusted information on pregnancy milestones and health.
  • Additional links to insurance policy tips, breast pump resources, and lactation counseling services.

Preparing for a baby is one of the most amazing experiences a mom, spouse, and siblings will have. Take it from me, all the books in the world cannot prepare you for parenthood, but Blue Cross NC is committed to you and your baby and will be there every step of the way.