Prenatal Care Cost

How Much Does Prenatal Care Cost?

With Insurance: Out of Pocket Costs Average $260

Without Insurance: Out of Pocket Costs Average $2,000

Prenatal care involves a series of doctor or midwife visits throughout the pregnancy to check the health of the patient and her fetus and make sure the pregnancy is progressing normally. Prenatal care allows a health professional to spot common problems with the potential to become dangerous if left untreated. Prenatal visits are recommended every month during the first six months of pregnancy; every two weeks during months seven and eight; and every week during month nine. The U.S. Department of Health & Human Services has an FAQ on prenatal care.

Typical costs:

The average total cost for prenatal care throughout a typical pregnancy is about $2,000, according to the Kaiser Family Foundation. This figure includes about 12 doctors' visits at $100 to $200 each, as well as routine blood tests, urinalysis and at least one ultrasound -- usually done at about 20 weeks. The March of Dimes offers an overview of routine prenatal tests.
Prenatal care usually is covered by health insurance. Even if you join a group health insurance plan after you already are pregnant, prenatal care still will be covered; according to the U.S. Department of Labor, the federal government prohibits group health insurance plans from treating pregnancy as a pre-existing condition, or, if they offer maternity coverage, from refusing to cover prenatal care or childbirth. However, individual health insurance plans can legally treat pregnancy as a pre-existing condition, baby delivery probably will not be covered if you join one while pregnant. If you are insured, it is very important to check with the insurance company about their requirements; some companies require you to "pre-authorize" coverage for your baby.
For patients with insurance, out-of-pocket costs for prenatal care, which usually consist of copays or coinsurance for office visits and laboratory work, can range from less than $200 to several thousand dollars or more, if the deductible is high or the pregnancy has complications. According to the Kaiser Family Foundation, private insurance pays about 87 percent of the costs for prenatal care -- so, in that case, the out-of-pocket costs on a typical $2,000 bill would total $260.

What should be included:

The first prenatal visit usually takes place about 8 weeks after the last menstrual period, and lasts longer than subsequent visits. During the visit, the doctor or midwife will: calculate your due date based on your last period; take your medical history; perform a physical exam and possibly an ultrasound; do a Pap test and check for sexually transmitted diseases; take a urine sample to check for urinary tract infections; and draw blood for a number of laboratory tests. The U.S. government now also recommends that all pregnant women be screened for HIV at their first prenatal visit, so the doctor probably will offer a test. The doctor probably also will want to discuss diet and exercise, miscarriage precautions and other safety issues.
BabyCenter.com offers a guide to the first prenatal visit.
On subsequent prenatal visits, the doctor or midwife will: check your weight and blood pressure; look at the baby's position and listen to its heartbeat; take urine for a urinalysis; and possibly order other tests. BabyCenter.com has a guide to second trimester prenatal visits and third trimester prenatal visits as well as an overview of prenatal tests.

Additional costs:

Because mouth health affects overall health, it is recommended that patients have a dental checkup early in the pregnancy.
All pregnant women or women trying to conceive should take a prenatal vitamin containing folic acid; the average cost is about $0.30 per day -- or about $9 per month. For more information, see CostHelper.com's article on prenatal vitamins.
Extra ultrasounds -- doctors sometimes order one early in the pregnancy to try to determine the due date or late in the pregnancy to check the position and health of the baby -- usually cost about $200 each. For more information, see the CostHelper.com article on ultrasounds.
Women with a chronic illness or who experience pregnancy complications will have to see a doctor more frequently. Diagnostic tests -- to check for possible problems or genetic abnormalities -- cost extra, and are most commonly recommended for patients 35 and older or those who have a family history of certain conditions or genetic abnormalities. The U.S. Department of Health & Human Services has an overview of the most commonly ordered tests, which can cost $1,000 or more extra, depending on which tests are needed.

Discounts:

TheAmerican Pregnancy Association offers an overview of free and discounted prenatal care options for uninsured or underinsured pregnant women.
Some providers will negotiate a discounted package rate for prenatal care, or prenatal care combined with delivery, for a patient paying out-of-pocket.

Shopping for prenatal care:

An obstetrician/gynecologist should be board-certified by the American College of Obstetricians and Gynecologists. Or, the American College of Nurse-Midwives offers a certified midwife locator. And the American Board of Family Medicine offers a board-certified family physician locator. A maternal-fetal medicine specialist is an obstetrician/gynecologist who has two to three years of additional education and clinical experience with high-risk pregnancies; the Society for Maternal-Fetal Medicine has an overview on this type of specialist, and a physician locator.
Tip: When you find a prospective provider, make sure you feel comfortable with them and ask questions such as which hospital they are affiliated with; whether you always will be seen by the same provider; who covers when the provider is unavailable; and how after-hours calls and emergencies are handled. The March of Dimes has a guide to choosing a prenatal care provider.

Material on this page is for informational purposes only and should not be construed as medical advice. For medical decisions, always consult your physician for the right course for your infant or child.

Article updated September 2008