By Molly M. Ginty, Redbook, July, 2004
Believe it or not, parents paid from $325 to $63,274 for these bundles of joy. Find out why – and what you can do to minimize the price of becoming a mom.
No doubt about it: When a couple decides to bring a child into their lives, thousands of questions flood their minds: Will it be a boy or a girl? What will we name it? How dramatically will this change our lives? But one question that might not immediately spring to mind for many couples is this: How much will having this baby set us back financially?
The answer to that question is…it depends, since these days there’s an array of different ways couples can become parents. Take, for example, the four babies pictured above. Only one of them was born the way most parents expect it’ll happen (by the mom getting pregnant through sex with her husband). The other three infants became members of their families in less conventional ways – through in vitro fertilization (IVF), adoption, and gestational surrogacy. The expenses all these parents incurred in these four situations varied widely, from a mere $325 to a jaw-dropping, budget-busting $63,274.
How to prepare for the expense? “Parents should consider the costs of having a child long before they’re even pregnant,” says Janis Biermann, vice president of education and health promotion for the March of Dimes. “Otherwise they could very well get blindsided by unexpected fees that could put them in a tough situation financially.” Familiarizing yourself early on with what your expenses will be also gives you the time to learn all the tricks out there to lower your costs – for example, by shopping around for the health insurer with the best maternity coverage or by signing up for grants that go towards helping couples adopt and undergo IVF.
So read on to find out how much having a child could cost you, as well as the best ways to cut your expenses so the big day is as stress-free as possible.
Auguste Fung Schmidt,
Mother: Alice Fung
This baby cost: $325
Why: She had a pregnancy and delivered without complications, and she had health insurance.
Like 39 percent of women ages 18 to 46, Alice gets health insurance through her employer (26 percent get it through their spouse’s). “So the costs for me and my husband, John, were manageable,” says Alice. This is typical for insured moms-to-be, says Alina Salganicoff, vice president and director of Women’s Health Policy for the Kaiser Family Foundation. What’s more, insurers usually cover medically necessary procedures that develop from complications as well.
How to lower the costs of having a baby if you have health insurance
Shop for the right insurance
If your employer offers a number of health insurers, make sure to compare the plans to find the one with the best maternity coverage. If you’re already on one plan and want to switch to another, you’ll only get to do so during their open enrollment period, which usually occurs once per year.
Make sure your full care is covered
While health insurers generally cover all medically necessary procedures, that doesn’t mean they’ll pay any price. Most will cover “usual, customary, and reasonable fees,” so if your doctor charges higher rates than your insurer deems reasonable, you’ll get stuck paying more than your typical $10 co-pay. To limit your out-of-pocket expenses, use an in-network doctor, or if you go out of network, get a sense of what they charge for parental visits and delivery and find out how much of it your insurer will cover.
Buy your own insurance
Six percent of women purchase health care independently, often because they’re self-employed or wok part-time. If you’re considering this option – say, going part-time once you’re pregnant – do some comparison shopping for the best choice for moms-to-be at the National Association of Health Underwriters (nahu.org). Enter your zip code, and they’ll provide phone numbers for agents in your area who can discuss the pros and cons of insurers available to you. Also make sure to get insurance before you’re actually pregnant. “Apply for insurance after you’re pregnant and in most states insurers are allowed to deny you coverage, since insurers consider pregnancy a pre-existing condition,” warns Karen Pollitz, project director at the Georgetown University Health Policy Institute. The opposite is true if you sign up for insurance through your employer, who has to cover maternity care even if you’re hired after you’re already expecting.
Mother: Julie Rickansrud
This baby cost: $13,000
Why: She adopted
When Julie and her husband, Kyle, decided to adopt, they faced steep fees: Clients generally pay about $15,000 to the agency who finds them a pregnant woman willing to adopt out her child and several thousand in lawyers’ fees and to social workers who evaluate a couple’s physical and psychological fitness to be parents. The Rickansruds also faced stiff competition: although no accurate count is possible, experts guess that each year, about 230,000 families attempt to adopt through agencies, but only 50,000 infants are available.
Luckily, one pregnant woman who saw the Rickansruds’ application became convinced they’d be great parents. Months later, the Rickansruds met Hannah. “The minute I walked in the hospital room, the birth mother picked Hannah up and put her in my arms,” says Julie. “Hannah promptly spit up on me. I felt like she’d just christened me as her mom!”
How to lower the costs of adoption
See if your employer will pitch in
About a third of U.S. companies offer adoption benefits; some reimburse employees $2,000 to $10,000 for their expenses.
Get help from the IRS
If your income is under $192,390, you’re eligible for an adoption tax credit of up to $10,160, which is subtracted form the amount you owe the IRS. Visit irs.gov/pub/irs-pdf/p968.pdf.
Apply for grants
A handful of philanthropic organizations (giftofadoption.org, shaohannahshope.org) offer financial assistance to families looking to adopt.
Pick a reputable agency
Make sure it has a state license and is a member of the National Council for Adoption (ncfa-usa.org). And since about 5 to 10 percent of birth mothers back out of the adoption, see if your agency offers financial credit toward a second placement if the first one doesn’t work out, says Allan Hazlett, an adoption attorney and former president of the American Academy of Adoption Attorneys.
Consider foster kids
Adopting a child who’s in foster care (government-run agencies that look after kids whose parents can no longer do so) can be less expensive than private adoption and sometimes even free. Foster kids are usually older (5 to 16 years), but “many of them are healthy kids who are simply in need of loving homes,” says Gloria Hochman, a spokesperson for the National Adoption Center.
Mother: Nancy DePersis
This baby cost: $20,000
Why: She used IVF
After struggling to get pregnant for one year, Nancy DePersis and her husband, Orlando, discovered they were one of the 2.1 million couples in the U.S. (around 10% of the population) who suffer from infertility. Although doctors couldn’t peg the reason, they did determine that Nancy’s eggs and Orlando’s sperm were healthy. So the DePersises decided to try in vitro fertilization, in which the woman’s eggs are harvested from her body, fertilized with her partner’s or a donor’s sperm, and then implanted back in her uterus.
The procedure is costly – and only about one-forth of attempts result in pregnancy. Due to multiple attempts that are often needed, couples typically spend anywhere from $25,000 to $75,000 for a child. What’s more, this fee is rarely covered by insurance. “Most insurers only reimburse you for medically necessary treatments, explains Salganicoff. “And they don’t define having a child as a medical necessity.”
The DePersises’ first IVF attempt was unsuccessful. “It was difficult and depressing, but I reassured myself that I was young, with a good doctor, and that it often takes more than one try,” says Nancy. Months later, she was elated to find out that their second round of IVF worked: She was pregnant. Nine months later, when Nancy gave birth to Matteo, she realized that her long wait and the high price were well worth it. “I’d do it all over again without hesitation,” she says.
How to lower the costs of in vitro fertilization
Get partial insurance coverage
One-third of companies offer some coverage for IVF through their health plans; coverage is mandated in 12 states (Arkansas, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, California, New York, Rhode Island, Texas, and Ohio). This usually covers 15 to 25 percent of the costs of fertilizing the egg and implanting the embryo in the womb. For more info, visit the InterNational Council on Infertility Information Dissemination (inciid.org).
Find a top notch specialist
For the best odds of conceiving, make sure your doctor belongs to the Society for Assisted Reproductive Technology (sart.org). “your doctor should have three years of training and two years of practical experience in reproductive technology,” says David Adamson, M.D., a board member of the American Society for Reproductive Medicine. “His success rate should meet or beat the national average: live births for 25 percent of patients under 35, and 20 percent of patients ages 35 to 40.” Also look for a specialist who will refund part of your medical costs if treatment is unsuccessful, says Christo Zouves, M.D., medical director of the Zouves Fertility Center.
Save on IVF
Advanced Reproductive Care (arcfertility.com) offers financial assistance to people undergoing infertility treatment.
Mother: Gail Hanny
This baby cost: $63,274
Why: She used a gestational surrogate
Gestational surrogacy – in which an embryo resulting from IVF is implanted in the womb of a woman hired to carry the baby to term – can cost anywhere from $45,000 to $70,000. And for good reason. “Surrogacy is extremely expensive because the medical technology and legal paperwork involved are extremely elaborate,” explains Melissa Brisman, a reproductive lawyer.
In addition to the medical fees for the IVF treatment, you’ll pay $8,500 to $9,000 to the agency that finds you a surrogate, $6,000 to $17,000 in lawyers’ fees, and $22,000 to $25,000 for the surrogate (a surrogate’s medical costs are usually covered by her own health insurance). Think surrogates make a killing for what they do? Not really, insists Shirley Zagar, a director of the Organization of Parents Through Surrogacy (OPTS), a nonprofit for surrogates and the couples who use them. “Stretch her payment over nine months and you’ll find out she’s getting $2.25 an hour.”
Perhaps due to these expenses, only 1,000 babies are born by surrogacy every year, according to OPTS. Gail and her husband, Mark, decided on this route because Gail had had a hysterectomy due to complications during the birth of her first daughter, Lauren. Once their agency found a surrogate, a doctor took an embryo previously made from Gail’s egg and Mark’s sperm and implanted it in her womb. Nine moths later, Megan was born. Although their agency was a bit more expensive than others, “We chose them because other ones would have put us on a waiting list for a full year,” says Gail. “This one spared us the heartache of having to wait any longer, which was important to us.”
How to lower the cost of gestational surrogacy
Have a loved one serve as your surrogate
While it’s not a common practice (fewer than 5 percent of couples find a friend or relative to be their surrogate), it’s a way to avoid both the agency’s and the surrogate’s fees. Even in these cases, all of the parties (including spouses) should be seen together by a psychologist with experience in surrogacy screening.
Hire a reputable agency
The majority (65 percent) of parents find their surrogates through an agency (find one at opts.com). And while around 30 percent of couples try to find a match on their own – usually through the newspaper or the Internet – this can be risky, warns Zagar of OPTS. “Agencies conduct medical, psychological, and criminal background checks on surrogates to make sure they’re fit for the job,” she explains.
Find a qualified surrogate
Whether you’ve found your surrogate on your own or through an agency, make sure she has her own health insurance with maternity coverage. It’s preferable for the surrogate to have had at least one successful pregnancy, which allows doctors to assess her fertility history. Worried your surrogate might change her mind and want to keep the baby? Keep this comforting thought in mind: “Of the 22,000 births to surrogates that have occurred since 1975, there were only 28 legal disputes,” points out Zagar. “That means that less than one-tenth of one percent of arrangements run into legal problems.” To find out more about gestational surrogacy (in which an embryo created from the parents’ egg and sperm is implanted in the womb of the surrogate) and traditional surrogacy (in which the surrogate also serves as the egg donor), go to EverythingSurrogacy.com or opts.com.
Pregnant and uninsured? Where to go…
Moms-to-be who can’t pay for health insurance may be eligible for Medicaid (call 877-267-2323 or log on to cms.hhs.gov/medicaid/). Believe it or not, Medicaid pays for one-third of all births in the U.S. You can also get financial help from your local State Children’s Health Insurance Program (cms.hhs.gov/schip/).
In general, these programs are only available to families who are not far above the poverty level. What if you don’t qualify? One alternative to high-priced hospitals is a community health clinic. Check the Blue Pages for your local Department of Public Health for a referral.