The miscarriage is devastating – and then the bill comes

It has an emotional and physical impact when you experience pregnancy loss – and it can also lead to an unexpected financial burden.

Even with Insurancesurgical treatment for a miscarriage can cost more than $4,300 on average, according to FAIR Health, a national independent nonprofit organization that uses health care claims data to provide cost estimates to consumers.

The amount you pay depends on your insurance plan.

What is a miscarriage?

Miscarriage is the most common form of pregnancy loss, according to the American College of Obstetricians and Gynecologists. A miscarriage occurs when there is a spontaneous loss of the embryo or fetus in the uterus during the first 20 weeks of pregnancy. Studies indicate that approximately 1 in 4 pregnancies end in miscarriage, with the majority occurring in the first trimester.

After a miscarriage, the body needs to get rid of the contents of the uterus. It can happen naturally and last for a few weeks. But it could also require taking medication or undergoing a minor surgery called dilation and curettage, or D&C, to ensure that any remaining tissue is removed.

The Cleveland Clinic provides more details on the signs and types of miscarriage. If you are pregnant and experience any of the symptoms described, contact your doctor.

Miscarriage and Cost of a D&C Procedure

The costs really increase when someone needs a D&C after a miscarriage. Data from FAIR Health shows the average cost of a D&C in the first trimester is $4,307 with insurance; a D&C used to treat a second-trimester miscarriage costs an average of $5,301. These costs include outpatient fees and doctors’ fees, which may be higher or lower depending on where you are being treated.

Your share of the bill would be determined by the coinsurance or co-payment policies, as well as your deductible and disbursement maximums.

For someone who is uninsured, data from FAIR Health shows the cost nearly doubles to $8,445 for a procedure in the first trimester and $9,742 in the second trimester.

State Medicaid programs also cover the treatment of miscarriages. Medicaid provides coverage for pregnant people who meet the eligibility requirements. Pregnancy-related care provided under Medicaid includes the services needed to care for the pregnant person and their unborn baby. This includes medical services that become necessary because the person was pregnant, such as a D&C. The national program pays for about 40% of births in the United States, according to KFF, a health research group.

A person who is eligible for Medicaid because they are pregnant remains eligible for at least 60 days after the pregnancy ends, allowing for continued care during the postpartum period, including after pregnancy loss. And under the American Rescue Plan Act of 2021, state Medicaid programs can extend the postpartum coverage period to 12 months. As of last month, 34 states have implemented or are planning to implement this extension.

Contact your state Medicaid office to determine what is covered where you live.

Miscarriage and drug costs

Surgery may not be necessary in all cases of miscarriage, with medication being a less invasive and cheaper option. The drug most likely to be prescribed is misoprostol. Studies show that adding a second drug – mifepristone, which is taken before misoprostol – may be more effective than taking misoprostol alone. This would make it less likely that someone who has had a miscarriage would require further medical intervention like a D&C.

Because pregnancy care is an essential health benefit under the Affordable Care Act, most insurance plans and Medicaid are required to cover medications used to treat a miscarriage. However, mifepristone and misoprostol are also used in abortions, which has impacted access in some states.

On average, treating a miscarriage with medication costs just under $700, whether you take one medication or both, according to a 2018 study published by the American Medical Association.

How the recent Roe v. Wade affects miscarriage

The quashing of Roe v. Wade by the United States Supreme Court allowed states to enact laws prohibiting or severely restricting abortion. These state laws can also impact those experiencing pregnancy loss, as treatment for a miscarriage often depends on the same medications and surgical procedures used to induce an abortion and remove tissue from the uterus.

The impact could be felt through insurance coverage as well as access to care.

A Texas abortion law enacted in 2021 allows civil lawsuits to be brought against anyone who helps terminate a pregnancy after six weeks, resulting in a fine of at least $10,000. As a result, there have been reports detailing stories of patients struggling to get care after a miscarriage because doctors or pharmacists try to avoid any semblance of assisting with an abortion.

Access issues could impact costs if patients are forced to pay for services themselves, either because they are denied coverage or because they are forced to seek care at facilities outside the network of their insurance scheme. Delays in administering medication after a miscarriage could also result in the need for additional medical attention.

Last July, the Biden administration warned pharmacists that they could not refuse to fill prescriptions for drugs used in abortions because those drugs have other approved uses.

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