PennCare Hospital Bill

What is the cost of childbirth? One community member reported paying $2,418.38 for antepartum care, vaginal delivery and postpartum care, and $899.80 for the hospital part of the experience.

I asked for more details

1. This was the entire bill for antepartum, delivery and postpartum care? Also, did they ask for installments before, or was it all one bill after?

2. Do you have an explanation of benefits or bill you could share with us? Please feel free to black out any identifying details.

3. You say you have a high deductible — was this money all from your deductible? How big is the deductible?

4. Did the baby get a bill?

5. I see the epidural bill as well — was that anesthesiologist out of network?

P.S. How did you find us?

She replied by sending a bill and an explanation

The first charge, $5,300, was for antepartum care, delivery and postpartum care. The bill conflates payment and adjustment, assigning them a total of $2,862.62, with patient responsibility of $2,418.38.

The total hospital bill was $44,037, of which the insurer paid $8.098.20 and wrote down by $35,039. The patient was left with $899.80 for the hospital part. The baby got a separate bill.

She wrote:

How I found you: I remember reading (online) in the Inquirer about this project when it was first launched, and I thought it was a great idea! (Thank you for doing it!) When I received this bill for my second child’s birth, it reminded me of the project, so I googled it (using the search term ‘Philadelphia Inquirer health costs’ or something like that).

1. I think this was the entire bill for my antepartum, delivery and postpartum care — professional services (see #5 below). (I haven’t received another one.) It was all one bill afterwards.

2. I will attach a copy of the bill.

3. I asked my husband to explain this for me, because I know that ultimately this plan is cheapest for us, but I couldn’t remember the details. Here is his answer:
Our plan has a $3000 deductible per person, capped at $6000 for the family. Over the deductible, we pay 10% (‘co-insurance’), up to a total out of pocket max of $4500 per person and $9000 max for the family. With both kids, the kids themselves have gotten bills where the negotiated rate is more than $3000, so we’ve paid the full $6000 family deductible those years (and total out of pocket costs this year will be around $7200 I think).

All those numbers are for in-network services – the out-of-network numbers would be higher. But I think everything billed to us for both pregnancies was in network.

As far as why this plan is best… basically because my company subsidizes the high-deductible plan to make it strictly cheaper for us overall. We net pay ~$2000 per year for our coverage. If we got a low-deductible plan, depending on which one we chose, our annual cost of premiums would be $8600 (plus I’d guess about $5000 out of pocket costs) or $11500 (plus I’d guess about $3500 out of pocket costs).

4. The baby did get a bill, which came from CHOP, since their pediatricians are the ones rounding at Pennsylvania Hospital. I’ll have to find that one for you.

5. As far as I know, the anesthesiologist was in network. That was the first line of multiple charges that were part of the same bill as above, but billed under hospital services rather than professional services. This will all be on the copy of the bill that I’ll attach.

I asked to see the baby’s bill

She followed up by sending the baby’s bill. Their daughter was also charged: $1,602 from the neonatologist, of which the plan discounted $877, leaving them with a payment of $705 (since their baby had not met her deductible). The plan paid nothing on this charge.

Their baby was also charged $6,471 for hospital services, of which the insurer wrote off $3,721, making the member rate $2,750, of which the plan paid $674.44. The couple paid $2,000.62 for their deductible and $74.94 in co-insurance for a total of $2,075.56.

That made the baby’s total out of pocket cost $2,780.56.

Related: What does childbirth cost?


Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...