Pregnant and without health insurance? Help is available

Mary Lou Jay

Pregnancy is supposed to be a joyful time. But if you're expecting and without health insurance coverage, the worry over the bills you're facing for prenatal care and delivery may outweigh the excitement of planning for your baby's arrival.

You have reason to be concerned. A study published in 2007 by the March of Dimes Foundation found that the average expenditures for maternity care were $7,737 for vaginal delivery and $10,958 for a Cesarean section. The American Pregnancy Association has similar figures ($6,000 to $8,000 for delivery costs) but reports that the costs can go much higher for high-risk pregnancies.

Thanks to the Pregnancy Discrimination Act of 1978, group health insurance plans sponsored by employers with 15 or more workers must include coverage for pregnancy and delivery-related expenses. But women working for small companies are not covered by that mandate (although their companies may choose to offer maternity coverage).

In addition, most women who purchase individual health care insurance policies don't have prenatal or delivery coverage. The National Women's Law Center, which has studied inequalities in health insurance, says that only 13 percent of individual health care plans covered maternity expenses in 2009.

With all of these exclusions, 13 percent of U.S. women who get pregnant each year are without insurance coverage for maternity costs, according to the American Pregnancy Association. That will change in 2014, when certain provisions of the federal health care reform law kick in and insurance companies will be required to include those benefits as part of their health insurance packages.

In the meantime, however, there is some help available today for women who are pregnant and without insurance., a website developed by the U.S. Department of Health and Human Services, suggests that pregnant women who need assistance call 1-800-311-BABY (1-800-311-2229) or 1-800-504-7081 (for assistance in Spanish). The number connects you with the health department in your state, which will have information about local resources, such as your state's Medicaid program, for which you might quality.

Although it's not insurance, there's also a program called AmeriPlan that offers participants discounts of 10 percent to 50 percent on pregnancy-related doctor bills, lab fees and even hospitalization expenses. The plan requires a sign-up fee and a monthly membership card. Unlike traditional insurance, AmeriPlan will cover women who are pregnant when they sign up for the plan.

The American Pregnancy Association also suggests that pregnant women should contact their local hospitals before the baby's birth to see whether they can work out some sort of financial arrangements, such as a sliding scale fee or discount. Another alternative for women without health insurance who are having normal pregnancies are free-standing birthing clinics, which traditionally charge about half of what a hospital would cost.