How To Have a Low-Cost Childbirth in Colorado

As of 2023, the national average cost of pregnancy, childbirth, and postpartum care exceeds $18,865, with Cesarean sections reaching an average cost of $26,280.

Even with insurance, many women and couples grapple with substantial out-of-pocket costs, including high premiums, hidden expenses, and limited provider choices.

The good news is, if you are pregnant or planning to become a mother soon, there are a number of things you can do to help limit your costs.

These include:

Taking assistance of various government assistance programs:

• Medicaid
• Low-cost birth centers and midwives
• Switching from traditional health insurance products to a lower-cost health sharing plan

Let’s take a closer look at each of these options.

Government Assistance Programs

Government assistance programs can serve as a lifeline for those facing financial constraints.

In Colorado, Medicaid, CHIP, WIC, and TANF provide comprehensive prenatal and perinatal care, nutrition support, and financial assistance for low-income families. Local resources, such as county health departments and community health centers, offer additional support.

1. Health First Colorado (Medicaid)

Overview: Medicaid is a joint federal and state program that provides health coverage to low-income individuals, including pregnant women.

Health First Colorado is the Rocky Mountain State’s version of Medicaid. The program is designed to ensure that those with limited financial means have access to essential healthcare services.

• Prenatal and Perinatal Care: Medicaid covers comprehensive prenatal and perinatal care, offering services such as prenatal check-ups, screenings, and childbirth expenses. This coverage aims to support expectant mothers throughout the pregnancy and postpartum period.
• Nutrition Support: While Medicaid itself may not directly provide nutrition support, it covers medical services, which may include nutritional counseling and guidance from healthcare professionals to promote a healthy pregnancy.
• Financial Assistance: Medicaid operates on an income-driven eligibility basis, meaning individuals and families with lower incomes are eligible for coverage. The program helps alleviate the financial burden associated with medical expenses, including maternity care.

Click here to apply for Health First Colorado.

2. The Colorado Presumptive Eligibility (PE) Program

This program gives some individuals immediate, temporary Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+) medical coverage.

PE covers children under 19 and pregnant people, individuals eligible for the Breast and Cervical Cancer Program (BCCP), and individuals eligible for the limited Family Planning Limited Benefit.

The member must complete an application and appear eligible to get the temporary health care benefits while their application is being processed by Health First Colorado.

Click here for more information on the Colorado PE program.

3. Child Health Plan Plus (CHP+)

Overview: Child’s Health Plan Plus is the Colorado version of CHIP (Children’s Health Insurance Plan).

It’s designed for people who have too much income to qualify for Medicaid outright, but who cannot afford private insurance on their own.

In Colorado, the CHP+ program includes pregnant women as well as children.

This coverage includes prenatal check-ups, screenings, and other essential services for pregnant women.

Here is a sample list of copay requirements for CHP+ members. This list is not exhaustive.

CHP+ Copays, 2023

Source: Colorado Child Health Plan Plus.

4. Colorado WIC Women, Infants, and Children (WIC) Program:

Overview: WIC is a federal assistance program that focuses on providing nutrition support to pregnant women, new mothers, and young children (up to age five) who are at nutritional risk.

WIC aims to improve pregnancy outcomes and the health of infants and young children.

Prenatal and Perinatal Care: While WIC itself does not provide medical care, it offers nutrition education, counseling, and support to pregnant women to ensure they receive the necessary nutrients for a healthy pregnancy.

Nutrition Support: WIC provides supplemental food, nutrition education, and counseling.

Pregnant women participating in WIC receive specific food packages tailored to meet their nutritional needs during pregnancy.

Click here to learn more about WIC assistance in Colorado.

5. Colorado Works (TANF):

Overview. Colorado Works is Colorado’s version of Temporary Assistance to Needy Families.

That’s a federally-funded assistance program that provides financial assistance to low-income families.

It is designed to help families achieve self-sufficiency by providing cash assistance and support services.

Prenatal and Perinatal Care. While Colorado Works itself may not directly cover medical care, the financial assistance it provides can help pregnant women and families meet their basic needs, including accessing healthcare services.

Financial Assistance. TANF provides financial assistance to eligible families, which can be used to cover various expenses, including housing, utilities, and other essential needs during pregnancy and beyond.

Who can apply? Colorado Works is available to families with children in the home.

In some cases, children not living with their parents can participate in Colorado Works. You can also apply for the program if:

• You are pregnant or taking care of a child under 18 years old.
• You live in Colorado.
• You are a citizen of the United States, a legal alien, a refugee, or a permanent resident.
• Your family income is less than $75,000 a year.

Click here for more information on Colorado Works.

6. Local Resources (County Health Departments and Community Health Centers):

County Health Departments: These departments often offer a range of public health services, including prenatal care and support for low-income individuals.

They may provide information on available resources and programs.

Community Health Centers: These centers are community-based healthcare providers that offer a range of services on a sliding fee scale, making healthcare more affordable for low-income individuals.

Some community health centers may specialize in maternal and child health.

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In summary, these government assistance programs play a crucial role in ensuring access to healthcare, nutrition support, and financial assistance for pregnant women and families facing financial constraints. They contribute to the overall well-being of expectant mothers and help promote healthy pregnancies and positive birth outcomes.

Birthing Centers and Midwives

For individuals with low-risk pregnancies, birthing centers and midwives provide a cost-effective alternative to traditional hospital births.

These options offer substantial cost savings compared to hospital settings, a more relaxed home-like atmosphere. and a more personalized approach to childbirth.

Birthing centers in Colorado include:

1. Beginnings Birth Center (Colorado Springs)
2. Bloomin; Babies (Colorado Springs)
3. Denver Center for Birth and Wellness
4. Seasons Birth Center (Thornton)
5. Colorado Birth and Wellness (Lowry)
   

Click here for more information on Colorado birth centers.

Maternity Bundled Payments Programs in Colorado

Specific programs like the Maternity Bundled Payments Program in Colorado may offer financial relief.

County Health Departments, Community Health Centers, and Hill-Burton Facilities in the state can be accessed for reduced-fee prenatal care or free/low-cost care.

Here’s a list of Hill-Burton facilities nationwide.

Budgeting and Saving

Proactively budgeting and saving for pregnancy-related expenses can provide a safety net.

Access to Care services, including temporary Medicaid (PEPW) for eligible pregnant women, may also be available in your area.

Shop around for the best value.

Thanks to recent changes in the law, it’s easier than ever for healthcare consumers to shop around hospitals and other providers to find the best value in health care services.

All hospitals in Colorado and across the country must now post their actual cash prices for common services on their Websites.

Click here to learn how to use the new Price Transparency Laws to find the best possible healthcare values in and around Colorado.

Health Sharing: A More Affordable Insurance Alternative

For many young people who don’t get a big subsidy under Obamacare, and who are reasonably healthy, switching out of traditional health insurance to a health sharing plan can make a lot of sense, and save on overall costs.

Health sharing plans aren’t insurance. Instead, they are voluntary associations of health-conscious, like-minded people who share similar values, and who agree to help share one another’s medical costs.

While they still enable individuals to spread the risk of unexpected medical bills across thousands of people reducing their own risk as individuals, health sharing plans are structured and regulated very differently from traditional health insurance policies.

They also cost much less.

Health sharing programs routinely save members around 50% each month compared to the unsubsidized cost of a traditional health insurance policy available via your state marketplace.

This typically equates to savings of thousands of dollars per year compared to traditional insurance plans, before accounting for subsidies.

There are no limited “open enrollment periods” with health sharing plans. You can join a health sharing plan at any time during the year.

Health sharing plans and pre-existing conditions

Before enrolling in a health sharing plan, you should pay careful attention to how that particular plan deals with pre-existing conditions.

Health sharing plans typically impose a waiting period before they will share the cost of treating a preexisting condition, or complications if it.

They also generally impose a waiting period on newly-enrolled members before they will share surgery costs, except for those necessary to treat injuries and accidents that could not have been foreseen at the time of enrollment.

If you are already pregnant, most health share ministries will treat that as a pre-existing condition (see below).

If you have a preexisting condition or you are already pregnant, you may be better off choosing a traditional health insurance plan – even if it has higher monthly costs than a health sharing plan in the short run.

Do Health Share Plans Include Maternity Costs?

Most health share plans do help share the cost of maternity and childbirth—but with some limitations.

For example health sharing plans typically don’t share maternity and childbirth costs for members who join when they’re already pregnant.

Also, some plans only make maternity sharing benefits available in their higher-tier plans.

There may be caps on the total amount, but these caps are generally well over typical costs for all but the most complex pregnancies.

Some health sharing plans are faith based, and will generally not share maternity costs for unmarried women, except in limited circumstances.

Generally, health share members must pay a few thousand dollars out of pocket before the plan will begin to share costs—a requirement similar to a health insurance deductible.

Speak to a ColoHealth Personal Benefits Manager, or consult your plan’s membership guideline’s document to make sure. 

Health Sharing Programs in Colorado

Health sharing—also called medical cost sharing—is enjoying a surge in popularity both here in Colorado and nationwide.

These affordable, innovative alternatives to traditional health insurance products offer several important benefits:

First, monthly contributions are much lower than traditional health insurance products before accounting for Obamacare subsidies. Up to 50% lower compared to unsubsidized Marketplace plans.

Health sharing also offers more flexible provider choices.

Unlike Marketplace HMOs, health sharing plans let you use the doctors and hospitals of your own choosing.

Top 5 Colorado Health Sharing Ministries for Maternity Benefits

Here’s a look at how the top 5 health share ministries available in Colorado compare when it comes to cost sharing for maternity-related expenses.

Altrua Maternity

• Offers Maternity Cost-Sharing: YES
• Eligible Memberships: Diamond and Emerald-Level Only
• Waiting Period: 90 days from membership start
• Member’s Out of Pocket Responsibility: $5,000
• Annual Sharing Limit: $12,000 in year one, $25,000 per year after that
• Preserves Eligibility to Make HSA Contributions: NO

netWell Maternity

• Offers Maternity Cost-Sharing: YES
• Eligible Memberships: Elite + option only
• Waiting Period: 6 months from membership start
• Member’s Out of Pocket Responsibility: None
• Annual Sharing Limit: $15,000
• Preserves Eligibility to Make HSA Contributions: NO

OneShare Health Maternity

• Eligible Memberships: Classic Crown, Complete Basic, Complete Enhanced, Complete Crown only
• Waiting Period: Conception must occur after plan effective date
• Member’s Out of Pocket Responsibility: $5,000
• Annual Sharing Limit: $5,000 for natural delivery, $8,000 for c-section, $50,000 for birth with health-threatening complications
• Preserves Eligibility to Make HSA Contributions: NO
• Offers Maternity Cost-Sharing: YES

Medi-Share

• Offers Maternity Cost-Sharing: YES
• Eligible Memberships: $3,000 AHP options and above
• Waiting Period: Conception must occur after membership start date. Conception must also occur within marriage.
• Member’s Out of Pocket Responsibility: Between $3,000 and $12,000 per household
• Single Pregnancy Sharing Limit: $125,000
• Preserves Eligibility to Make HSA Contributions: NO

HSA Secure / Zion Maternity

• Offers Maternity Cost-Sharing: YES
• Eligible Memberships: Secure, Care+
• Waiting Period: 60 days after start of membership
• Member’s Out of Pocket Responsibility: Double your plan’s standard Initial Unshared Amount (IUA) before maternity is included
• Annual Sharing Limit: None
• Preserves Eligibility to Make HSA Contributions: YES
• Note: The HSA Secure health share plan is only available to business owners or those with verifiable 1099 income from independent contracting or self-employment.

Self-Pay Options

For those not covered by insurance or assistance programs, self-pay options can provide relief.

Negotiating discounts, exploring payment plans, and utilizing healthcare discount services can make healthcare costs more manageable.

Use Health Savings Accounts (HSAs)

If you have money in a health savings account (HSA), you can use those funds for medically necessary prenatal, childbirth, postnatal and postpartum care.

Contributions are pre-tax, and any money you take out of your HSA to pay for qualified medical expenses is Tax Free.

That can save hundreds or even thousands of dollars in taxes, depending on your situation and tax bracket.

Click here to learn how to set up and use an HSA in Colorado.

Read More: Paying for Maternity Care When You Don’t Have Insurance

Is Pregnancy Considered a Pre-Existing Condition?

With health sharing, pregnancy can be subject to waiting periods before costs are eligible to be shared.

Many healthshare companies will not offer cost sharing on pregnancies that occurred during membership, and can have 60- or 90-day waiting periods after pregnancy begins.

Need help? Contact us!

The best way to save money on maternity costs is to have a solid strategy in place.

If you’re planning to become a parent of a new child, we can assist you in choosing and enrolling in a healthshare plan that fits your maternity needs, just contact your Personal Benefits Manager.

Congratulations and best of luck on this incredible journey!

Here are some more blogs for further reading: Switching from traditional health insurance to health sharing | Explore Medishare plans today! | Health Savings Accounts pay for alternative therapies