baby doctor visits with insurance

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Your baby's checkup schedule: What to expect at doctor visits

There are a lot of doctor visits in your baby's first few years, and they're all important! Your baby's pediatrician will monitor their growth and development, stay on top of their vaccinations, and answer your questions and concerns.

It can seem like you're always headed to the doctor, even when all is well with your baby. But there's good reason for all those appointments.

"There's so much that happens in the first year of life that it's important that nothing gets missed!" explains Chandani DeZure, M.D., a neonatal and pediatric hospitalist at Lucile Packard Children's Hospital/Stanford University Opens a new window in Palo Alto, California and member of the BabyCenter Medical Advisory Board .

"Babies need to be developing and growing appropriately, eating well, and getting vaccinated to protect against diseases so they can thrive as they get older and be as healthy as possible. All this and more happens at regular well-baby checkups," says Dr. DeZure.

Checkups are also the perfect time to ask questions and raise concerns about your baby's sleep habits , crying , poop , breastfeeding , formula feeding , development milestones , and more.

Learn how to find a pediatrician for your baby .

What newborn doctor visits will my baby have?

In the first week, the doctor will want to check your newborn to make sure they're doing well. Then you'll have scheduled visits at 1 and 2 months.

A lot happens right after birth and while you're still at the hospital with your newborn . At birth, the medical team will assess your baby's health and assign an Apgar score – which evaluates your baby's heart rate, breathing, muscle tone, reflex response, and color.

They'll weigh your baby and measure your baby's length and head circumference . These numbers will be recorded on a growth chart , which will be used to keep track of your baby's growth at all future doctor's visits.

Your baby's progress along the growth chart is just one way to evaluate their health. "Growth charts are not intended to be used as a sole diagnostic instrument," explains the Centers for Disease Control and Prevention Opens a new window (CDC). "Instead, growth charts are tools that contribute to forming an overall health picture for the child being measured."

At the hospital, your baby will get antibiotic eye ointment (to prevent dangerous eye infections) and a vitamin K shot (to help their blood clot normally and protect them from a rare but dangerous bleeding disorder). They'll also receive their first hepatitis B shot .

Your pediatrician or a pediatric hospitalist will give your newborn a complete physical at the hospital within 24 hours of birth. They'll examine your baby head to toe, checking their skin tone, reflexes, alertness, heart, lungs, and skin (for rashes and jaundice ).

If you're having your baby circumcised , that will be done a day or two after birth.

Your baby will also receive screening tests while at the hospital. These include tests for hearing loss , congenital heart defects , and metabolic disorders (such as PKU and sickle cell disease ). Screening tests are usually done between 24 hours and 48 hours after birth.

Read more about what happens to your baby right after birth .

Your baby's checkup schedule

Some pediatricians' schedules vary slightly, but the American Academy of Pediatrics Opens a new window (AAP) recommends babies get checkups at birth, 3 to 5 days after birth, and then at 1, 2, 4, 6, 9, 12, 15, 18 and 24 months. (Once your baby is a toddler and child, they'll have routine checkups at 30 months, 3 years, and annually after that.)

If you've gotten behind, talk with your child's doctor about a catch-up schedule. "It's particularly important for parents to work with their child's doctor or nurse to make sure they get caught up on missed well-child visits and recommended vaccines," says the CDC Opens a new window . "Making sure that your child sees their doctor for well-child visits and recommended vaccines is one of the best things you can do to protect your child and community from serious diseases that are easily spread."

At each visit, your baby's doctor will:

• Do a complete physical examination, checking your baby's eyes and ears, heart and lungs, head, body, belly, genitals, and hips and legs
• Weigh your baby and take their measurements (length and head circumference). The doctor will chart these numbers on your baby's growth chart and let you know how they're progressing.
• Ask about your baby's eating habits and number of wet and poopy diapers
• Ask about your baby's sleeping habits
• Watch how your baby responds to movement. They'll ask you if you've noticed anything unusual about your baby's eyes or the way they look at things.
• Watch how your baby responds to sounds. The doctor will ask if your baby responds to your voice and other sounds by turning in the direction of the sound.
• Run any appropriate tests (screening and diagnostic), depending on your baby's needs
• Give needed vaccinations
• Chat about your baby's developmental skills, including gross motor skills and fine motor skills , social skills , and language skills
• Answer your questions and concerns

Follow the links below for more detailed information about what to expect at each visit, but here are some highlights:

1-month doctor appointment

At the 1-month checkup , the doctor will check your baby's soft spots (fontanels) and the shape of your baby's head. They'll also review the results of your baby's newborn screening tests.

Your baby may also get their second hepatitis B shot. The first was probably given at birth, and the second shot can be given at the 1- or 2-month visit.

The doctor may also ask about your baby's head control and cooing. They'll also ask how you're doing and ask you some screening questions for postpartum depression . (They'll continue to monitor you for postpartum depression through your baby's 6-month checkup.)

2-month doctor appointment

At the 2-month visit , your baby will receive their first shots of DTaP (diphtheria, tetanus, and pertussis), Hib (haemophilus influenzae type B), IPV ( polio ), and PCV (pneumococcal disease), along with an oral vaccine for RV ( rotavirus ). 

The doctor will check your baby's posture and may ask about their head control, ability to push up , and whether they're smiling voluntarily yet.

4-month doctor appointment

Your baby's 4-month checkup will include another oral dose of the rotavirus vaccine and a second DTaP vaccine. They'll also receive the second dose of the IPV, Hib, and PCV vaccines. (Some offices have combination vaccines, so your baby may receive less pokes than they would if each vaccine were given individually.)

The doctor will screen your baby for iron-deficiency anemia and lead poisoning (by asking you questions about breast milk or formula intake and environmental exposures) and test for these if necessary. They may ask what sounds your baby's making and whether they're reaching for and grabbing things . And they'll check your baby's gums and refer you to a dentist to establish  dental care whenever the first tooth erupts .

6-month doctor appointment

At the 6-month checkup , the doctor may talk with you about your baby's readiness to start solids and other developmental strides, such as rolling over and babbling.

The third hepatitis B, DTaP, Hib, PCV, and IPV vaccines are typically given at 6 months, along with an oral rotavirus vaccine. Your baby can also get their first COVID vaccine now and, if it's flu season, they'll also get a flu shot . Your baby will need a second dose of the flu shot 4 weeks later.

9-month doctor appointment

At their 9-month checkup , your baby will catch up on any missed vaccinations (including a flu shot if it's flu season).

The doctor will check for any new teeth and ask you if your baby is crawling or scooting around, if they know any words , and if they can pick up objects with their thumb and forefinger.

They may remind you of the importance of babyproofing your home now that your baby is mobile.

12-month doctor appointment

At your baby's 12-month checkup , your baby's doctor will order tests to rule out iron-deficiency anemia. Depending on risk factors, they may also offer tests for tuberculosis and lead exposure , if your baby is at risk. And they may ask you if your baby points at things , says words, and stands on their own .

Your baby will also get a handful of vaccines:

• COVID, if the timing is right based on when your baby got their first shot
• Flu, if it's flu season and your baby hasn't been immunized yet.
• MMR (measles, mumps, and rubella), which can be given between 12 and 15 months and again between 4 and 6 years
• Varicella (chickenpox), given between 12 and 15 months and again between 4 and 6 years
• Hepatitis A (HepA), which they can receive between 12 months and 23 months, with a second dose at least 6 months later)
• Hib vaccine. The fourth dose can be given now or anytime between 12 and 15 months.
• PCV. The fourth dose can be given between 12 and 15 months.

Some of these shots will be combined. And your baby's doctor may spread them out between this visit and your baby's 15-month visit.

15-month doctor appointment

Your child's doctor will give your baby a fourth dose of the DTaP vaccine (given between now and 18 months), and – if they haven't already had them – your baby may now get their Hib, PCV, MMR, hepA, and varicella immunizations.

Your child may also get a flu vaccine, if it's flu season, and/or a COVID vaccine, if appropriate.

The doctor may check your baby for new teeth and apply fluoride unless you have a dentist taking care of this. And they may check your child's blood pressure, hearing, and vision.

18-month doctor appointment

At the 18-month check-up , your child's doctor will make sure your toddler is caught up on any missed immunizations and give them another round of DTaP and hepatitis A vaccines. If your child has risk factors for anemia or lead poisoning, the doctor will screen for those.

And they'll ask about your toddler's sleeping, eating, potty-training readiness , walking , and ability to follow simple commands .

24 month doctor appointment

Your toddler's 2-year checkup is a good time to make up any missed immunizations and screen for anemia and/or lead poisoning if your child has risk factors. The doctor will probably ask your child to walk so they can check their gait and coordination.

Your child's doctor may ask about potty training and temper tantrums , and they may encourage you to take your child for a dental checkup if you haven't done so yet.

How can I prepare for my baby's doctor appointments?

Here are some tips:

Consider timing

If possible, schedule your visit at a time when your baby is usually happy (fed, and not on the verge of needing a nap ). If this time coincides with a time when the office isn't usually very busy, even better! This isn't always practical – doctor's offices don't always have appointment times that coincide with your preferences, and your baby may not be on enough of a schedule to make even an educated guess at the best time for them. But it's worth a try.

Dress (both of you) comfortably

Your baby will need to be undressed for their exam, so dress them in something that's easy off/easy on. (Practicality over cuteness today!) Make sure you're dressed for the appointment, too – in something comfortable and that you can easily nurse in, if you're breastfeeding . Bring a sweater for you and your child (or a blanket for your baby), in case the office is chilly (doctor's offices often are).

Pack thoughtfully

Before your appointment, make sure your diaper bag is stocked with everything you might need. This includes diapering supplies ( diapers , wipes , a change of clothes) and feeding supplies (a bottle if you're bottle feeding and snacks if your baby is eating solids), a blankie or other lovey , burp cloths , and a pacifier if your baby uses one. Bring your current insurance information and any other paperwork, too.

Jot things down

The doctor will ask you about your baby: the number of wet and soiled diapers they have each day, how many hours they sleep, and how much and often they eat. They'll ask about motor and language skills, too. When did your baby start rolling over, sitting up, and crawling? Are they babbling yet? It's a good idea to keep ongoing notes about these things, or jot them down before your visit.

Importantly, bring a list of questions you have. These visits are the perfect time to get them answered!

Make sure you tell the doctor about any concerns, too, no matter how small they seem. Do you wonder if your baby sometimes doesn't hear you or if they favor one side of their body when they crawl across the floor? Are you worried that your baby should be walking or talking by now or that they often wake up screaming ? 

Remember that you and the doctor are partners in managing your baby's health. Don't hesitate to give your perspective, and make sure your questions are addressed.

Learn more:

• Everything you need to know about baby poop
• How your baby's skull, skeleton, and bones develop after birth
• The importance of tummy time for your baby
• How to make shots less painful for your baby

Was this article helpful?

Vaccine schedule for babies and kids

Postpartum depression screening for new moms

Baby's doctor visits: The 1-month checkup

Your 1-month-old baby's growth and development

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

AAP. 2023. AAP schedule of well-child care visits. The American Academy of Pediatrics.  https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx Opens a new window  [Accessed June 2023]

AAP. 2023. All about the recommended immunization schedules. The American Academy of Pediatrics.  https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Recommended-Immunization-Schedules.aspx Opens a new window  [Accessed June 2023]

AAP. 2023. Recommended childhood and adolescent immunization schedule for 2023. The American Academy of Pediatrics.  https://www.healthychildren.org/English/news/Pages/recommended-childhood-and-adolescent-immunization-schedule-for-2023.aspx Opens a new window  [Accessed June 2023]

AAP. 2023.Vaccines Opens a new window your child needs by age 6. The American Academy of Pediatrics.  https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Your-Babys-First-Vaccines.aspx Opens a new window  [Accessed June 2023]

AAP. 2022. Why your newborn needs a vitamin K shot. The American Academy of Pediatrics.  https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Where-We-Stand-Administration-of-Vitamin-K.aspx Opens a new window  [Accessed June 2023]

AAP. 2022. Your child's checkups. The American Academy of Pediatrics.  https://www.healthychildren.org/English/ages-stages/Your-Childs-Checkups/Pages/default.aspx Opens a new window  [Accessed June 2023]

CDC. 2022. Growth charts. National Center for Health Statistics. Centers for Disease Control and Prevention.  https://www.cdc.gov/growthcharts/index.htm Opens a new window  [Accessed June 2023]

CDC. 2023. Stay up to date with COVID-19 vaccines. Centers for Disease Control and Prevention.  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html Opens a new window  [Accessed June 2023]

Nemours KidsHealth. 2022. Your child's checkup: 1 month.  https://kidshealth.org/en/parents/checkup-1mo.html Opens a new window  [Accessed June 2023]

Where to go next

Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

The 1-Month Well-Baby Visit

The physical checkup, developmental milestones, read this next, 1-month shots, questions to ask your doctor, screening for postpartum depression.

If you’re not sure whether you’ve had the screening, or if you are concerned that you or your partner has symptoms of PPD or another mood disorder, ask the pediatrician, an OB/GYN or another practitioner for help as soon as possible.

What to Expect the First Year , 3rd edition, Heidi Murkoff. WhatToExpect.com, When and How Babies Lift Their Heads Up , October 2021. Centers for Disease Control and Prevention, Vaccines for Your Children: Vaccine (Shot) for Hepatitis B , August 2019. American College of Obstetricians and Gynecologists, Screening for Perinatal Depression , October 2018. Pediatrics ,  Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice , January 2019.

About What to Expect

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Doctor Visits

Make the Most of Your Child’s Visit to the Doctor (Ages 1 to 4 Years)

Take Action

Young children need to see the doctor or nurse for a “well-child visit” 7 times between ages 1 and 4 years.

A well-child visit (also called a checkup) is when you take your child to the doctor to make sure they’re healthy and developing normally. This is different from visits for sickness or injury.

At a well-child visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You’ll also have a chance to ask questions about things like your child’s behavior, eating habits, and sleeping habits.

Learn what to expect so you can make the most of each visit.

Well-Child Visits

How often do i need to take my child for well-child visits.

Young children grow quickly, so they need to visit the doctor or nurse regularly to make sure they’re healthy and developing normally.

Children ages 1 to 4 years need to see the doctor or nurse when they’re:

• 12 months old (1 year)
• 15 months old (1 year and 3 months)
• 18 months old (1 year and 6 months)
• 24 months old (2 years)
• 30 months old (2 years and 6 months)
• 3 years old
• 4 years old

If you’re worried about your child’s health, don’t wait until the next scheduled visit — call the doctor or nurse right away.

Child Development

How do i know if my child is growing and developing on schedule.

Your child’s doctor or nurse can help you understand how your child is developing and learning to do new things — like walk and talk. These are sometimes called “developmental milestones.”

Every child grows and develops differently. For example, some children will take longer to start talking than others. Learn more about child development .

At each visit, the doctor or nurse will what new things your child is learning to do. They may also ask how you’re feeling and if you need any support.

Ages 12 to 18 Months

By age 12 months, most kids:.

• Stand by holding on to something
• Walk with help, like by holding on to the furniture
• Call a parent "mama," "dada," or some other special name
• Look for a toy they've seen you hide

Check out this complete list of milestones for kids age 12 months .

By age 15 months, most kids:

• Follow simple directions, like "Pick up the toy"
• Show you a toy they like
• Try to use things they see you use, like a cup or a book
• Take a few steps on their own

Check out this complete list of milestones for kids age 15 months.

By age 18 months, most kids:

• Make scribbles with crayons
• Look at a few pages in a book with you
• Try to say 3 or more words besides “mama” or “dada”
• Point to show someone what they want
• Walk on their own
• Try to use a spoon

Check out this complete list of milestones for kids age 18 months . 

Ages 24 to 30 Months

By age 24 months, most kids:.

• Notice when others are hurt or upset
• Point to at least 2 body parts, like their nose, when asked
• Try to use knobs or buttons on a toy
• Kick a ball

Check out this complete list of milestones for kids age 24 months . 

By age 30 months, most kids:

• Name items in a picture book, like a cat or dog
• Play next to or with other kids
• Jump off the ground with both feet
• Take some clothes off by themselves, like loose pants or an open jacket

Check out this complete list of milestones for kids age 30 months .

Ages 3 to 4 Years

By age 3 years, most kids:.

• Calm down within 10 minutes after you leave them, like at a child care drop-off
• Draw a circle after you show them how
• Ask “who,” “what,” “where,” or “why” questions, like “Where is Daddy?”

Check out this complete list of milestones for kids age 3 years . 

By age 4 years, most kids:

• Avoid danger — for example, they don’t jump from tall heights at the playground
• Pretend to be something else during play, like a teacher, superhero, or dog
• Draw a person with 3 or more body parts
• Catch a large ball most of the time

Check out this complete list of milestones for kids age 4 years . 

Take these steps to help you and your child get the most out of well-child visits.

Gather important information.

Take any medical records you have to the appointment, including a record of vaccines (shots) your child has received.

Make a list of any important changes in your child’s life since the last doctor’s visit, like a:

• New brother or sister
• Serious illness or death in the family
• Separation or divorce — or a parent spending time in jail or prison
• Change in childcare

Use this tool to  keep track of your child’s family health history . This information will help your doctor or nurse know if your child is at risk for certain health problems. 

Ask other caregivers about your child.

Before you visit the doctor, talk with others who care for your child, like a grandparent, daycare provider, or babysitter. They may be able to help you think of questions to ask the doctor or nurse.

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions you want to ask the doctor..

Before the well-child visit, write down a few questions you have. This visit is a great time to ask the doctor or nurse any questions about:

• A health condition your child has (like asthma or an allergy)
• Changes in sleeping or eating habits
• How to help kids in the family get along

Here are some questions you may want to ask:

• Is my child up to date on vaccines?
• How can I make sure my child is getting enough physical activity?
• Is my child at a healthy weight?
• How can I help my child try different foods?
• What are appropriate ways to discipline my child?
• How much screen time is okay for young children?

Take notes so you can remember the answers later.

Ask what to do if your child gets sick. 

• Make sure you know how to get in touch with a doctor or nurse when the office is closed.
• Ask how to reach the doctor on call — or if there's a nurse information service you can call at night or during the weekend. 

What to Expect

Know what to expect..

During each well-child visit, the doctor or nurse will ask you questions about your child, do a physical exam, and update your child's medical history. You'll also be able to ask your questions and discuss any problems you may be having.

The doctor or nurse will ask questions about your child.

The doctor or nurse may ask about:

• Behavior: Does your child have trouble following directions?
• Health: Does your child often have stomachaches or other kinds of pain?
• Activities: What types of pretend play does your child like? What toys or other things do they most like playing with?
• Eating habits: What does your child eat on a normal day?
• Family: Have there been any changes in your family since your last visit?
• Learning: What’s something new your child learned recently?

They may also ask questions about safety, like:

• Does your child always ride in a car seat in the back seat of the car? 
• Does anyone in your home have a gun? If so, is it unloaded and locked in a place where your child can’t get it?
• Is there a swimming pool or other water around your home? Is there a locked door or gate to keep your child from getting to the pool without an adult?
• What steps have you taken to childproof your home? Do you have gates on stairs and latches on cabinets?
• Does everyone who cares for your child know when and how to call Poison Control (1-800-222-1222)?

Your answers to questions like these will help the doctor or nurse make sure your child is healthy, safe, and developing normally. Be honest, even if you’re worried you’re doing something wrong — the doctor or nurse is there to help you.

Physical Exam

The doctor or nurse will also check your child’s body..

To check your child’s body, the doctor or nurse will:

• Measure your child’s height and weight
• Check your child’s blood pressure
• Check your child’s vision
• Check your child’s body parts (this is called a physical exam)
• Give your child any vaccines they need

Learn more about your child’s health care:

• Find out how to get your child’s shots on schedule
• Learn how to take care of your child’s vision

Content last updated July 10, 2024

Reviewer Information

This information on well-child visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by:

Sara Kinsman, MD, PhD Director, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration (HRSA)

You may also be interested in:

Help Your Child Stay at a Healthy Weight

Take Care of Your Child's Teeth

Healthy Snacks: Quick Tips for Parents

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What to Expect at Your Baby’s First Pediatrician Visit

Nervous about your baby's first pediatrician visit? Here's what to expect, from paperwork to meeting the doctor, plus tips for making the visit easier for you and your baby.

Your baby should have their first well-baby visit at the pediatrician's office three to five days after birth, according to the American Academy of Pediatrics (AAP). After that, you'll be going in for checkups every few months over the course of the first year.

Since your baby's first pediatrician visit might be the first time your newborn leaves home, it's natural to feel some trepidation. But remember that this visit is often empowering and informative for new parents. Read on to learn what to expect during your baby's first pediatrician visit, from exams to vaccinations, as well as tips for timing and preparation.

There Will Be Paperwork

Be prepared to fill out paperwork when you arrive. Remember to pack the following:

• Your ID and health insurance card
• Information about your newborn's discharge weight
• Any complications during pregnancy or birth
• Your family's medical history

Knowing that your older child has asthma or your parents have diabetes, for example, focuses your pediatrician's attention on likely problems, says Christopher Pohlod, DO , assistant professor of pediatrics at Michigan State University's College of Osteopathic Medicine.

The Nurse Will Do Some Exams

A nurse will probably handle the first part of your baby's exam. They'll do the following:

• Weigh your naked baby on a scale
• Extend their limbs to measure height and width
• Use a tape measure to determine the head circumference

According to the AAP, it's normal for babies to lose weight after birth (up to 10% of their body weight). But they'll generally gain it back within a couple of weeks.

You'll Get to Know the Doctor

The pediatrician will examine your baby, educate you about their health, and answer any questions. One of the biggest components of the first pediatrician visit is developing a relationship with your child's new doctor. They will be a source of information, support, and troubleshooting in the many years to come.

They'll Check Your Baby's Neck and Collarbone

At your baby's first pediatrician visit, a health care provider will feel along your baby's neckline to check for a broken collarbone during the physical exam. That's because some babies fracture their clavicle while squeezing through the birth canal.

If your pediatrician finds a small bump, that could mean a break is starting to heal. It will mend on its own in a few weeks. In the meantime, they may suggest pinning the baby's sleeve across their chest to stabilize the arm so the collarbone doesn't hurt.

They'll Check Your Baby's Head

A pediatrician will also palm your baby's head to check for a still-soft fontanel. They will do this at every well visit for the first one to two years.

Your baby's head should grow about 4 inches in the first year, and the two soft spots on their skull are designed to accommodate that rapid growth. But if the soft spots close up too quickly, it can lead to a condition called craniosynostosis, which is when the tight quarters can curb brain development, and your child may need surgery to fix it.

They'll Check Your Baby's Hips

The doctor will roll your baby's hips to check for signs of developmental hip dysplasia, a congenital malformation of the hip joint that affects 1 in every 1,000 babies. You can expect this exam starting at your baby's first pediatrician visit and every visit until your baby can walk.

"The exam looks completely barbaric," says Vinita Seru, MD , a pediatrician in Seattle. "I tell families what I'm doing so they don't think I'm trying to hurt the baby."

If your pediatrician feels a telltale click from the hips, they'll order an ultrasound. Luckily, when dysplasia is found early, treatment is simple: The baby wears a pelvic harness for a few months.

They'll Check Your Baby's Reflexes

To check for a Moro reflex, a health care provider startles your baby. For the first 3 or 4 months, whenever something startles your infant, they'll fling their arms out as if they're falling. It's an involuntary response that shows your baby is developing normally.

This exam starts at the first pediatrician visit and continues through the first four well-child visits. A health care provider might also check whether your little one grasps a finger or fans their toes after you touch their foot.

They'll Check Your Baby's Pulse

By pressing the skin along the side of the baby's groin, a health care provider checks for your baby's pulse in the femoral artery, which runs up from your baby's thigh. Your pediatrician wants to see if the pulse is weak or hard to detect on one or both sides as that may suggest a heart condition.

You can expect this exam at the first pediatrician visit and all baby well visits. Around 1 in 125 babies are diagnosed with a heart defect every year in the US. This check is a simple way to screen for problems, says Dr. Seru: "When a heart condition is caught early, it can increase the likelihood of a good recovery."

They'll Check Your Baby's Genitalia

Starting at the first pediatrician visit and every well-baby visit after that, a health care provider will check your baby's genitals to ensure everything looks normal.

In about 1 to 3% of babies with testicles, the testicles don't descend into the scrotum before birth. While the problem usually corrects itself by 3 to 4 months of age, your doctor will keep an eye on things to see if your baby needs surgical assistance in the future. They will also check for signs of infection if your baby has been circumcised .

In babies with vulvas, it's not uncommon to find labial adhesions. Although the labia should open up over time, adhesions can shrink the vaginal opening and make your baby more prone to urinary tract infections (UTIs) . "If we know that they're there when your baby has a high fever, we look for a UTI first," says Melissa Kendall, MD , a pediatrician in Orem, Utah.

They'll Ask About Your Baby’s Feeding Patterns

The doctor will want information about your baby's feeding patterns. You don't need to keep super-detailed records, but you should have a general idea of the following:

• How often your baby is eating
• How long they feed (if nursing)
• How much they consume (if bottle-feeding)

This is an excellent time to raise concerns or questions about latching, formula brands, and other feeding issues.

They'll Check Your Baby’s Digestive System

You should have a general idea of how often you change your baby's diapers each day. If your doctor knows the consistency, frequency, and color of your baby's poop , they can better assess their digestive system and nutrient absorption.

They'll Ask About Your Baby's Sleeping Patterns

A health care provider will also probably inquire about sleeping patterns at your first pediatrician visit. They'll also make sure you're following safe sleep practices to help reduce the risk of sudden infant death syndrome (SIDS).

They'll Review the Childhood Vaccination Schedule

Hospitals usually give babies their first dose of the hepatitis B vaccine shortly after birth, but if your baby was born at home or at a birth center, they might receive it at their first pediatrician visit.

Most vaccinations start when your baby is 2 months old, and a health care provider might review the vaccine schedule with you so you're prepared for the many vaccines your baby will receive in the months ahead.

There Will Be Time for Questions

You will cover a lot of ground during your baby's first pediatrician visit. Ask the doctor to slow down, repeat, or clarify information if needed. It's also wise to come prepared with any questions you have.

Here are some examples:

• Is this behavior normal?
• Is my baby eating enough?
• Should their stool look like that?
• When should I schedule the next appointment?
• What should I expect in the next few days and weeks?

When you have a written list of talking points, you won't worry about your mind going blank if your baby starts to fuss, says Dr. Pohlod.

You'll Schedule Your Next Appointment

The lineup of well-baby checkups during the first year includes at least a half dozen more pediatrician visits.

Recommended Baby Checkup Schedule

Here is a quick-glance list of what ages the AAP recommends that your child be seen for well-child pediatrician visits through their second year:

• 3 to 5 days old
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 24 months old

At first glance, the recommended number of checkups may seem like a lot. But trust the process: This schedule was designed to closely monitor your baby's growth and development to ensure their health and well-being.

The checkups, depending on the age of your baby, will include measurements, sensory screening, and developmental health, which include social, behavioral, and mental health. It will also include vaccinations, oral health, and advice for parents and caregivers.

Frequent appointments with your baby's health care provider are also the best way to get personalized expert answers to your questions about your baby. Ultimately, it's important to be comfortable with your doctor, and seeing them frequently in the first year helps you develop a relationship you may have for years to come.

When you schedule your next appointment, ask about the office's hours of operation, billing policies, and how after-hours communication works. Keep the doctor's phone number handy, and be informed of what to do and who to contact in an emergency or when you have a question.

Tips for Your Baby's First Pediatrician Visit

Leaving the house with a newborn isn't easy, and it can be especially stressful when you're on a timetable (like when you're trying to make it to a scheduled appointment). But your baby's first pediatrician visit doesn't have to be super stressful. Here are some tips for smooth sailing:

• Plan your time. Ask for an appointment during the least busy part of the day. You can also see if a health care provider has specific time slots dedicated to seeing newborns. Expect the visit to take about 25 minutes, but plan for waiting and setbacks as well.
• Bring a support person. Consider bringing your partner or another caregiver to your baby's first doctor appointment. Two people can more effectively care for the baby, remember the doctor's advice, and recall questions you plan to ask.
• Dress your baby with the exam in mind. Since the doctor will examine your baby's entire body, dress them in easy-on, easy-off clothing or even just a diaper and comfortable blanket if weather permits.
• Be prepared, but pack light. Definitely bring a change of clothes, extra diapers, wipes, pacifiers, feeding supplies, and other necessities, but try not to overpack. Ultimately, "warmth, cuddling, loving, and reassuring voices are more helpful than a stuffed animal" at a newborn exam, says Brian MacGillivray, MD, a family medicine specialist in San Antonio.
• Wait in the car, if you can. If you attend the appointment with another person, send them inside to fill out paperwork while you wait in the car with the baby. This limits your newborn's exposure to germs. Some offices even have systems in place that allow you to fill out the paperwork online, wait in your car, and receive a call or text when it's time to go in.
• Keep your distance from others. If you must sit in the waiting room, have your baby face the corner. According to  Mary Ellen Renna, MD , a pediatrician from Jericho, New York, the chances of catching sickness are lower if you maintain a 3-foot radius from others.

AAP Schedule of Well-Child Care Visits . American Academy of Pediatrics . 2023.

Weight Loss . The American Academy of Pediatrics . 2020.

Clavicular Fractures in Newborns: What Happens to One of the Commonly Injured Bones at Birth? . Cureus . 2021.

Facts About Craniosynostosis . Centers for Disease Control and Prevention . 2023.

Developmental Dislocation (Dysplasia) Of the Hip (DDH) . American Academy of Orthopaedic Surgeons . 2022.

Moro Reflex . StatPearls . 2023.

A five (5) chamber heart (Cor Triatriatum) in Infancy: A rare congenital heart defect .  Niger Med J . 2013.

Undescended Testicles: What Parents Need To Know . American Academy of Pediatrics . 2022.

Periodicity Schedule . American Academy of Pediatrics . 2023.

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Children's Health Insurance Program (CHIP)

Every child deserves to grow up healthy and happy. To help them get there, kids need regular checkups and medical care.

If your child doesn't have health insurance, there's help. The Children’s Health Insurance Program (CHIP) offers low-cost or no-cost coverage for infants, children and teens. It's designed to help children get the care they need as they develop.

Each state runs its own CHIP program, and Medicaid helps pay for it. Your state will have specific rules about who qualifies and what's covered.

Does my child qualify for CHIP?

CHIP is for children who can't get insurance elsewhere. Your child may qualify, even if you don't receive Medicaid.

Can I apply if I'm not the child's parent?

Grandparents, aunts, uncles – anyone can apply as long as they have legal custody. (Your state may use the term "legal guardian.") The good news is you can apply at any time. Note: If you apply once and your child isn't accepted, don't give up. Programs and rules may change, and your child could qualify later.

What does CHIP cover?

CHIP offers coverage for a wide range of services, including:

• Well-baby doctor visits
• Vaccinations
• Hospital and emergency care
• Prescription drugs
• Dental and vision care

What does CHIP cost?

For some plans, there will be no cost. For others, you may need to pay a small amount each month and when your child gets care. But there's a limit – no more than 5 percent of your annual income.

What type of plan am I eligible for?

Answer a few quick questions to see what type of plan may be a good fit for you.

Find Medicaid plans in your area

Medicaid or dual-eligible plan benefits can change depending on where you live. Search using your ZIP code to find the right plan to meet your health care needs.

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Preventive care benefits for children

Coverage for children’s preventive health services.

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

Refer to glossary for more details.

The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

• Alcohol, tobacco, and drug use assessments  for adolescents
• Autism screening for children at 18 and 24 months
• Behavioral assessments for children
• Bilirubin concentration screening for newborns
• Blood pressure screening for children
• Blood screening  for newborns
• Depression screening  for adolescents beginning routinely at age 12
• Developmental screening for children under age 3
• Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders
• Fluoride supplements  for children without fluoride in their water source
• Fluoride varnish  for all infants and children as soon as teeth are present
• Gonorrhea preventive medication for the eyes of all newborns
• Hearing screening for all  newborns ; and regular screenings for children and adolescents as recommended by their provider
• Height, weight and body mass index (BMI) measurements taken regularly for all children
• Hematocrit or hemoglobin screening for all children
• Hemoglobinopathies or sickle cell screening  for newborns
• Hepatitis B screening  for adolescents at higher risk
• HIV screening  for adolescents at higher risk
• Hypothyroidism screening  for newborns
• PrEP (pre-exposure prophylaxis) HIV prevention medication  for HIV-negative adolescents at high risk for getting HIV through sex or injection drug use
• Chickenpox (Varicella)
• Diphtheria, tetanus, and pertussis (DTaP)
• Haemophilus influenza type b
• Hepatitis A
• Hepatitis B
• Human Papillomavirus (HPV)
• Inactivated Poliovirus
• Influenza (flu shot)
• Meningococcal
• Pneumococcal

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• Obesity screening and counseling
• Oral health risk assessment  for young children from 6 months to 6 years
• Phenylketonuria (PKU) screening  for newborns
• Sexually transmitted infection (STI) prevention counseling and screening  for adolescents at higher risk
• Tuberculin testing for children at higher risk of tuberculosis
• Vision screening  for all children
• Well-baby and well-child visits

More on prevention

• Learn more about preventive care from the CDC.
• See preventive services covered for  adults  and  women .
• Learn more about what else Marketplace health insurance plans cover.

How Much Does a Well-Baby Doctor Visit Cost?

In order to ensure that your baby is growing properly, it is recommended that you schedule well-baby doctors visits on a regular basis.  In the first year, a baby should see the doctor for 7 well-visits: between 2-5 days after birth, and then at one, two, four, six, nine, and twelve months.  During the second year, the baby will usually visit every three months.

How much does a well-baby delivery visit cost?

Without insurance, the cost of a well-baby doctor’s visit is right around $100.  However, the majority of these visits are covered by insurance and the only thing you will need to pay is your copay, which could range from $5-$25 depending on your insurance provider.   A baby will need a visit during the first week of life, followed by a two-week visit, four-month visit, six-month visit, nine-month visit, and first-year visit.

Without insurance, the cost of immunizations for your baby’s first year will be, on average, a little over $600.  This won’t include the physician fee.  This cost is almost always covered by insurance, however, and some states even do it for free for those without insurance.

According to BMO Harris Bank, the average out-of-pocket medical expenses in the first year is about $1,297 .

Well-baby delivery visit overview

As noted on the charts above, well-baby visits will be done during the first week, first month, second month, fourth month, sixth month and ninth month.

Mayo clinic provides much information regarding what to expect at each of the child’s well-baby check-ups in the first year.

The doctor will take the baby’s measurements including his or her height, weight, and head circumference.  A doctor will use a chart to see how your child is growing compared to other children in the same range.

Your baby’s head will be checked for soft spots as well as external problems such as cradle cap.

The doctor will look in the baby’s ears, mouth, and eyes.

A stethoscope will be used to listen to the baby’s heart and lungs.

The doctor will press and feel the baby’s abdomen to make sure there are no problems with the organs.

The doctor will move the baby’s hips and legs around to see if there are any dislocations or bone problems.

The baby’s genitalia will be checked for a number of different things, such as a hernia.

Immunizations will also be given according to schedule.

During these visits, a pediatrician will ask if the baby is hitting milestones, is active and is eating well.

What are the extra costs?

Some doctor offices charge a “new patient” or “processing” fee for the first visit.

The visits discussed here are only well-baby visits.  If your child becomes ill, the cost will increase.

Tips to know:

When choosing a pediatrician, be sure to ask friends and family for a recommendation.  While the Yellow Pages can help with the search, you’re not going to be able to get a first-hand experience.  Neighbors, friends and family will be more than happy to assist those with recommending a good pediatrician.

Do a background check with your pediatrician to see if any wrongdoings have been done in the past.  The Federation of State Medical Boards (FSMB) can show you if there are serious disciplinary actions, or if there are any bad marks.

It doesn’t hurt to interview a handful of those that you’re interested in.  Before talking with one, make sure that your insurance company works with this doctor.

Take a look around the office.  How clean is the office?  Talk with the staff.  How is the staff?  Are they accommodating?  Do they feel annoyed when you ask them questions during off hour sessions?  Does the pediatrician make you feel stupid when you ask questions?  It’s always best to trust your gut.

Be sure to add your newborn to your health insurance policy within 30 days.

According to the Affordable Care Act, the health care reform law notes that well-baby visits must be covered.

Questions to ask:

How many doctor’s offices do you have?  If there is more than one, ask them why they have more than one.

What are the latest trends with diseases, nutrition and treatments?  What are you doing to help prevent these problems?

What is your experience with working with children?  How long have you been practicing medicine?

Do you have any references that I can talk to?

Is my baby up to date with immunizations?

What can I do to make sure my baby is sleeping healthy?

How much television can my baby watch?

How can I compare prices?

Most people find a doctor based on a friend or family member’s recommendation.

Some insurance companies have a list of recommended doctors from which to choose.

Websites such as pediatricians.com can help you find a pediatrician in your area.  Be hesitant when reading reviews online.  These reviews can commonly be rigged by insiders.

Advertising Disclosure: This content may include referral links. Please read our disclosure policy for more info.

Average Reported Cost: $122

How much did you spend?

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Well Child visit was $122 with no ins.

About Us | Contact Us | Privacy Policy | Amazon Affiliate Disclosure Copyright © 2022 | Proudly affiliated with the T2 Web Network, LLC The information contained on this website is intended as an educational aid only and is not intended as medical and/or legal advice.

• Without health insurance, a full year of the recommended seven well baby visits costs an average of $668 total -- or just over $95 per visit -- according to the American Academy of Pediatrics.
• Immunizations for the first year cost at least $620 extra and usually are covered by health insurance.
• Well baby visits are almost always covered by group health insurance -- in 97 percent of cases with PPOs and 99 percent of cases with HMOs -- according to a survey by the Kaiser Family Foundation[ 2 ] . However, some insurance policies require that the baby be added to the insurance plan within a certain time frame -- usually by one month after birth, so check with your provider.
• For patients covered by insurance, out-of-pocket costs, usually copays, typically range from $10 to $30 per visit, depending on the plan.
• During the first well baby visit, the doctor will weigh and measure the baby to check growth; check eyesight and hearing; check for common problems such as diaper rash or the flaky scalp known as "cradle cap"; and look at umbilical cord stump or wound and, if necessary, administer a hepatitis shot. Subsequent visits will include immunizations, measurement of the head to check brain growth, addressing concerns about child safety and common health issues such as colds, croup, ear infections and diarrhea.
• At well baby visits, the doctor usually will ask about the baby's sleeping, eating and bowel habits and development markers, such as whether the baby can hold its head up or quiets at the sound of the parent's voice. The answers allow the doctor to make sure the baby's development is progressing on schedule.
• BabyCenter.com[ 3 ] has detailed lists of what to expect at each well baby visit.
• It is not uncommon for a baby to become ill in the first year of life, so additional doctor visits might be necessary.
• The U.S. Department of Health & Human Services[ 4 ] offers information on low-cost or free health insurance for uninsured children in qualifying families. This insurance can be used for well baby visits.
• Most parents choose a doctor who is a pediatrician, which means they have graduated from medical school and had an additional three years' residency in pediatrics. It is recommended to find a pediatrician before the baby is born.
• To find a pediatrician, ask a friend or family member for a referral. Or, the American Academy of Pediatrics offers a pediatrician locator service by state.
• When you find a prospective pediatrician, check credentials to make sure the doctor is board-certified by the American Board of Pediatrics or the American Board of Family Medicine[ 5 ] .
• It also is a good idea to meet your prospective pediatrician face-to-face. Observe the waiting room and ask questions about background, areas of interest, how the doctor can be reached after-hours in an emergency, how many doctors are in the office, whether the child will be able to see the same doctor for well and sick visits and how long a typical appointment lasts. WebMD.com[ 6 ] offers a guide to selecting a pediatrician.
•   www.nlm.nih.gov/medlineplus/ency/article/001928.htm
•   kff.org/medicaid/report/struggling-with-financing-the-recession-and-national-healt...
•   www.babycenter.com/0_doctor-visits-for-your-babys-first-year_66.bc
•   www.insurekidsnow.gov/
•   /www.theabfm.org
•   www.webmd.com/baby/shopping-for-a-pediatrician

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How Much Does It Cost to Have a Baby? Expenses from Pregnancy to Delivery

As NerdWallet’s Senior Economist, Elizabeth Renter spends her time analyzing economic trends and data to help people make more informed decisions about their personal finances. Her work has been cited by The New York Times, The Washington Post, the "Today" show, CNBC and elsewhere. Prior to joining NerdWallet in 2014, she was a freelance journalist. She received a Masters of Science in Finance and Economics from West Texas A&M University, and focused her elective coursework on macroeconomics and analytics. When she’s not at work, Elizabeth enjoys college football, old houses, traveling to old cities and powerlifting. She is based in Durham, North Carolina.

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She lives in St. Paul, Minnesota.

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Having a baby is expensive — sometimes alarmingly so. Costs related to pregnancy, childbirth and postpartum care average nearly $19,000 for individuals covered by large group insurance plans, according to a July 2022 study by Peterson Center on Healthcare and KFF, a health policy nonprofit. Insurance covers most of the costs, with the average woman paying about $2,850 out of pocket.

Differences between actual prices as well as insurance coverage can span tens of thousands of dollars. Navigating the costs of nine months of pregnancy — and then the cost of raising a baby — can seem overwhelming, but knowing what to expect can help. Read this guide to understand your coverage as well as which expenses to expect and when.

Beware of major differences in cost and coverage

Any guide to medical bills and your share of the cost should come with several disclaimers.

Prices vary from city to city and even hospital to hospital. Researchers at the University of California, San Francisco found in 2014 that in the Golden State, the cost of an uncomplicated vaginal birth varied widely — from $3,296 to $37,227, depending on the hospital. Cesarean sections ranged from $8,312 to almost $71,000.

If you have health insurance , coverage differences are similarly dramatic. The Affordable Care Act requires most health plans to cover maternal and newborn care. But because ACA requirements remain broad, insurance coverage isn’t uniform.

Price and out-of-pocket cost estimates are handy but are estimates. The only way to know for certain what you’ll pay is to contact your medical providers and health insurance company. The more work you’re willing to do on the front end, the less likely you’ll get surprise bills.

Get a handle on your insurance

If you’re unsure how your health insurance works, now's the time to research your benefits. You could take an entire course in understanding your policy and still likely have questions. Consider this a cram session. Your top two study areas include:

Learning about out-of-pocket costs: copays, coinsurance and deductibles .

Making sure your doctors are in your provider network, if possible.

Contact your health insurance company — with policy number in hand — and ask the key questions below. Make sure to write down whom you talked to and the date.

Are prenatal care, labor and delivery covered benefits under my policy?

Do I need a referral from my primary care doctor to see an OB-GYN or other specialists?

Will I need pre-authorization for any prenatal care?

What prenatal tests are covered (ultrasounds, amniocentesis, genetic testing, etc.)?

What common prenatal, labor and delivery needs are not covered by my policy?

Which hospitals in my area are in my insurance policy’s network?

What do I need to do to ensure that my newborn is covered from the moment of delivery?

How long of a hospital stay is covered after delivery?

Does my policy cover a private room or suite, or will I have to share a room?

If you’re interested in nontraditional deliveries, like a home birth with a midwife, ask about coverage for these.

Throughout your pregnancy and into your baby’s well-child visits, err on the side of caution. If you are unsure about your coverage and want to be doubly safe, call your insurance company to get confirmation in advance.

Watch out: Depending on your medical providers’ billing practices and your due date, you could have to pay two deductibles if your prenatal care happens in one calendar year and your baby is delivered in the next.

Some providers package their charges to insurance companies in what’s called “global billing,” which can include all prenatal and delivery charges. Ask your OB-GYN whether they plan to use global billing so you’ll know where you stand.

» MORE: How do insurance deductibles work?

Uninsured? Seek help

If you don’t have health insurance, you’re looking at tens of thousands of dollars in care over the next nine months.

Despite requiring health insurance companies to offer well-woman and maternity care, the Affordable Care Act doesn’t consider pregnancy a “qualifying event.” You will have to wait until your child is born to sign up for a new plan under the ACA.

But ACA insurance plans aren’t your only option. If you meet income requirements, you could be eligible for Medicaid , which covers many maternity care costs.

If you’re forced to pay cash for maternity care, these steps can help:

Comparison and price shop for prenatal visits, tests and your labor and delivery.

Explain to your doctor and all medical providers that you are a cash-paying customer. They often offer discounts for uninsured peoples.

Negotiate lower balances and payment plans on your medical bills.

Ask the hospital about “charity care” programs that may be available.

Consider a maternity package, increasingly offered by hospitals as a way for new parents to get all of their maternity and childbirth expenses covered under one price.

Prepare for how much it costs to have a baby

For all medical care from pregnancy to birth to recovery, the Peterson and KFF study places the total at $18,865. This is an average based on insurance benefits claims data from 2018 through 2020. The data included enrollees in large employer private health plans. Researchers compared health spending between female enrollees who gave birth and those who didn’t.

The type of delivery can have a big impact on the total cost. Pregnancies that resulted in a vaginal delivery averaged $14,768, compared with $26,280 for those involving a cesarean section.

Insurance pays most of that. The study reported out-of-pocket expenses of $2,655, on average, for vaginal delivery. The average balance for a C-section was $3,214.

» MORE: How to handle your medical bills

Averages can help you prepare. But unless you pay upfront for a maternity package, there’s no single, knowable price tag on pregnancy and childbirth. Labor and delivery might loom in your mind as the most expensive part of the experience, but a routine pregnancy requires several standard appointments and tests. Special concerns about your health or your baby’s could mean more doctor visits and interventions, all potentially coming at an additional cost.

It’s important to note that the cost breakdown below begins with a positive pregnancy test. If you hope to become pregnant after going through in vitro fertilization or some other fertility treatment, this guide can help you prepare for one phase of your journey to parenthood. You also may want to learn more about IVF costs .

Similarly, if you're looking to adopt a newborn, medical care for your baby’s birth mother may be a significant part of your expenses. NerdWallet can help you prepare for the other costs of adopting a child as well.

First trimester

If you have an uncomplicated pregnancy, you’ll see your doctor for monthly checkups during the first trimester. Typically, these are subject to a copay.

These visits will involve checking your weight, blood pressure, fundal height measurement and fetal heart rate as soon as it’s audible. Additional lab work and tests will come throughout and could cost extra.

Prenatal vitamins: Your doctor may prescribe these, or you can find them over the counter at most drugstores. Under a prescription, they’ll be subject to your copay. Bought over the counter, a bottle containing a one-month supply will cost about $10 to $30.

Lab work: Blood will be drawn for a series of lab tests including screening for common birth defects, your blood type, Rh status, hemoglobin measurements, and immunity and exposure to certain kinds of infections. If you have insurance, it’s likely that much of this will be covered, though it could be subject to your deductible. Costs vary widely.

Early ultrasound: If everything appears healthy, your doctor may not recommend an ultrasound this soon. However, a first-trimester transvaginal ultrasound may be necessary to establish the location of the fetus, how far along you are, viability of the pregnancy and number of fetuses. For people without insurance, the average cost of an early ultrasound is $1,423, according to 2022 data from FAIR Health, a national, independent nonprofit that uses health care claims data to provide cost estimates to consumers. For those with insurance coverage, the average amount billed to the insurer is lower — $586 — because of agreements between the provider and the insurance company. The amount an insured person pays out of pocket depends on their plan’s cost-sharing rules.

Cell-free fetal DNA testing: After 10 weeks of pregnancy, your baby’s blood can be screened for genetic conditions. This testing is typically performed only for at-risk pregnancies, and costs can run upward of $4,000 for people without insurance, according to FAIR Health.

Chorionic villus sampling, or CVS: This test looks for many of the same genetic abnormalities as a cell-free fetal DNA test does but analyzes the tissue surrounding the baby, similar to an amniocentesis. The test looks for Down syndrome, cystic fibrosis, sickle cell anemia and other genetic abnormalities. Most insurance plans will cover CVS in high-risk pregnancies, though you could be responsible for out-of-pocket costs if it's subject to your deductible.

A medical bill often includes multiple charges for a single procedure. One charge covers the work of professionals who performed the procedure or interpreted test results. Another charge comes from the facility where the procedure was performed, covering the use of equipment and supplies. For this article, cost estimates combine these charges, which were each provided by FAIR Health.

Second trimester

Through the end of your second trimester (week 28), you’ll continue with monthly prenatal visits. In addition, you’ll likely need:

Glucose screening: Used to test for gestational diabetes, this bloodwork is typically done around weeks 24 to 28. If you’re not insured, you could pay about $240, according to FAIR Health.

Maternal blood screening: This blood test looks for four substances that could be evidence of possible birth defects. Costs vary widely by location and coverage.

Amniocentesis: An amniocentesis is the analysis of amniotic fluid surrounding your baby. It looks for genetic conditions like Down syndrome and is usually covered by insurance when medically necessary. The average cost to someone without insurance is $1,933, according to FAIR Health.

Ultrasound: The main ultrasound during a pregnancy occurs around 18 to 22 weeks, according to the American Congress of Obstetricians and Gynecologists. Your doctor will look for things such as the overall health and position of your baby and placenta, and your ovaries and cervix. It’s at this ultrasound that your doctor will be able to determine your baby’s sex — if the little one is willing to reveal that. This ultrasound is usually covered by insurance.

Third trimester

By your third trimester, basically every lab test that needs to be done has been done. Your monthly checkups will likely be every two weeks from weeks 28 to 36 and then weekly until the baby’s birth.

Birthing classes: These classes help you prepare for labor and delivery and are often covered by health insurance. If you’re a new parent, you might also be interested in classes that introduce you to breastfeeding or newborn care. Without insurance coverage, these classes can cost $50 to $200 each.

The largest expense you can expect during this last phase of pregnancy is the cost of labor and delivery.

Labor and delivery

Your itemized bill for labor and delivery will be immense, in ink and paper, if not cost. Hospitals in the U.S. often bill per service, and each hospitalization represents a series of small services and related fees.

It’s common to be billed for each doctor who attends to you and for each pill and IV fluid pouch as well as the use of your room, among many other things. Because these prices vary from hospital to hospital, the total cost of childbirth can be difficult to estimate.

On average, someone covered by insurance would see their insurer billed $6,230 for a vaginal delivery or $5,252 for delivery via cesarean section, according to FAIR Health. The cost to the person varies, depending on cost-sharing rules in their insurance plan.

For expectant parents without insurance, the average cost of giving birth ranges from about $10,000 for vaginal delivery to about $12,000 for a C-section.

If you have to be induced, need an unexpected C-section, receive an epidural or get a snack, the charges climb. Doulas, midwives and birthing tubs are typically considered optional and thus additional, too.

If you’re insured, determining how much you’ll pay will include knowing what’s covered and how much your share of the bill will be, including deductibles and coinsurance.

To try to lower childbirth charges:

Call the hospital’s billing office to get an estimate of total charges, and apply that to what you know about your policy specifics.

If possible, set aside enough money to cover any remaining deductible for the year, plus your coinsurance share of the expected charges and some cushion for unexpected denials and charges.

If you have access to a health savings account or flexible spending account through your employer, you can set aside these anticipated expenses using pretax dollars.

Consider a maternity package: It offers all the normally itemized features of a delivery for a flat fee. Many of these packages come with payment options and discounts for those paying cash, with some costing about $3,000 to $8,000.

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Concierge medicine means better access to doctors for patients who pay, but disrupts care for many

By John Rossheim

Updated on: June 21, 2024 / 3:12 PM EDT / KFF Health News

"You had to pay the fee, or the doctor wasn't going to see you anymore."

That was the takeaway for Terri Marroquin of Midland, Texas, when her longtime physician began charging a membership fee in 2019. She found out about the change when someone at the physician's front desk pointed to a posted notice.

At first, she stuck with the practice; in her area, she said, it is now tough to find a primary care doctor who doesn't charge an annual membership fee from $350 to $500.

But last year, Marroquin finally left to join a practice with no membership fee where she sees a physician assistant rather than a doctor. "I had had enough," she said. "The concierge fee kept going up, and the doctor's office kept getting nicer and nicer."

With the national shortage of primary care physicians reaching 17,637 in 2023 and projected to worsen, more Americans are paying for the privilege of seeing a doctor — on top of insurance premiums that cover most services a doctor might provide or order. Many people seeking a new doctor are calling a long list of primary care practices only to be told they're not taking new patients.

"Concierge medicine potentially leads to disproportionately richer people being able to pay for the scarce resource of physician time and crowding out people who have lower incomes and are sicker," said Adam Leive, lead author of a 2023 study on concierge medicine and researcher at University of California-Berkeley's Goldman School of Public Policy.

Leive's research showed no decrease in mortality for concierge patients compared with similar patients who saw non-concierge physicians, suggesting concierge care may not notably improve some health outcomes.

A 2005 study showed concierge physicians had smaller proportions of patients with diabetes than their non-concierge counterparts and provided care for fewer Black and Hispanic patients.

There's little reliable data available on the size of the concierge medicine market. But one market research firm projects that concierge medicine revenue will grow about 10.4% annually through 2030. About 5,000 to 7,000 physicians and practices provide concierge care in the United States, most of whom are primary care providers, according to Concierge Medicine Today . (Yes, the burgeoning field already has a trade publication.)

The concierge pitch is simple: More time with your doctor, in-person or remotely, promptly and at your convenience. With many primary care physicians caring for thousands of patients each in appointments of 15 minutes or less, some people who can afford the fee say they feel forced to pay it just to maintain adequate access to their doctor.

As primary care providers convert to concierge medicine, many patients could face the financial and health consequences of a potentially lengthy search for a new provider. With fewer physicians in non-concierge practices, the pool available to people who can't or won't pay is smaller. For them, it is harder to find a doctor.

Concierge care models vary widely, but all involve paying a periodic fee to be a patient of the practice.

These fees are generally not covered by insurance nor payable with a tax-advantaged flexible spending account or health savings account. Annual fees range from $199 for Amazon's One Medical (with a discount available for Prime members) to low four figures for companies like MDVIP and SignatureMD that partner with physicians, to $10,000 or more for top-branded practices like Massachusetts General Hospital's.

Many patients are exasperated with the prospect of pay-to-play primary care. For one thing, under the Affordable Care Act, insurers are required to cover a variety of preventive services without a patient paying out-of-pocket. "Your annual physical should be free," said Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation. "Why are you paying $2,000 for it?"

Liz Glatzer felt her doctor in Providence, Rhode Island, was competent but didn't have time to absorb her full health history. "I had [a] double mastectomy 25 years ago," she said. "At my first physical, the doctor ran through my meds and whatever else, and she said, 'Oh, you haven't had a mammogram.' I said, 'I don't have breasts to have mammography.'"

In 2023, after repeating that same exchange during her next two physicals, Glatzer signed up to pay $1,900 a year for MDVIP, a concierge staffing service that contracts with her new doctor, who is also a friend's husband. In her first couple of visits, Glatzer's new physician took hours to get to know her, she said.

For the growing numbers of Americans who can't or won't pay when their doctor switches to concierge care, finding new primary care can mean frustration, delayed or missed tests or treatments, and fragmented health care.

"I've met so many patients who couldn't afford the concierge services and needed to look for a new primary care physician," said Yalda Jabbarpour, director of the Robert Graham Center and a practicing family physician. Separating from a doctor who's transitioning to concierge care "breaks the continuity with the provider that we know is so important for good health outcomes," she said.

That disruption has consequences. "People don't get the preventive services that they should, and they use more expensive and inefficient avenues for care that could have otherwise been provided by their doctor," said Abbie Leibowitz, chief medical officer at Health Advocate , a company that helps patients find care and resolve insurance issues.

What happens to patients who find themselves at loose ends when a physician transitions to concierge practice?

Patients who lose their doctors often give up on having an ongoing relationship with a primary care clinician. They may rely solely on a pharmacy-based clinic or urgent care center or even a hospital emergency department for primary care.

Some concierge providers say they are responding to concerns about access and equity by allowing patients to opt out of concierge care but stay with the practice group at a lower tier of service. This might entail longer waits for shorter appointments, fewer visits with a physician, and more visits with midlevel providers, for example.

Deb Gordon of Cambridge, Massachusetts, said she is searching for a new primary care doctor after hers switched to concierge medicine — a challenge that involves finding someone in her network who has admitting privileges at her preferred hospitals and is accepting new patients. 

Gordon, who is co-director of the Alliance of Professional Health Advocates , which provides support services to patient advocates, said the practice that her doctor left has not assigned her a new provider, and her health plan said it was OK if she went without one. "I was shocked that they literally said, 'You can go to urgent care,'" she said.

Some patients find themselves turning to physician assistants and other midlevel providers. But those clinicians have much less training than physicians with board certification in family medicine or internal medicine and so may not be fully qualified to treat patients with complex health problems. "The expertise of physician assistants and nurse practitioners can really vary widely," said Russell Phillips, director of the Harvard Medical School Center for Primary Care .

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism.

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Human Subjects Office

Medical terms in lay language.

Please use these descriptions in place of medical jargon in consent documents, recruitment materials and other study documents. Note: These terms are not the only acceptable plain language alternatives for these vocabulary words.

This glossary of terms is derived from a list copyrighted by the University of Kentucky, Office of Research Integrity (1990).

For clinical research-specific definitions, see also the Clinical Research Glossary developed by the Multi-Regional Clinical Trials (MRCT) Center of Brigham and Women’s Hospital and Harvard  and the Clinical Data Interchange Standards Consortium (CDISC) .

Alternative Lay Language for Medical Terms for use in Informed Consent Documents

A   B   C   D   E   F   G   H   I  J  K   L   M   N   O   P   Q   R   S   T   U   V   W  X  Y  Z

ABDOMEN/ABDOMINAL body cavity below diaphragm that contains stomach, intestines, liver and other organs ABSORB take up fluids, take in ACIDOSIS condition when blood contains more acid than normal ACUITY clearness, keenness, esp. of vision and airways ACUTE new, recent, sudden, urgent ADENOPATHY swollen lymph nodes (glands) ADJUVANT helpful, assisting, aiding, supportive ADJUVANT TREATMENT added treatment (usually to a standard treatment) ANTIBIOTIC drug that kills bacteria and other germs ANTIMICROBIAL drug that kills bacteria and other germs ANTIRETROVIRAL drug that works against the growth of certain viruses ADVERSE EFFECT side effect, bad reaction, unwanted response ALLERGIC REACTION rash, hives, swelling, trouble breathing AMBULATE/AMBULATION/AMBULATORY walk, able to walk ANAPHYLAXIS serious, potentially life-threatening allergic reaction ANEMIA decreased red blood cells; low red cell blood count ANESTHETIC a drug or agent used to decrease the feeling of pain, or eliminate the feeling of pain by putting you to sleep ANGINA pain resulting from not enough blood flowing to the heart ANGINA PECTORIS pain resulting from not enough blood flowing to the heart ANOREXIA disorder in which person will not eat; lack of appetite ANTECUBITAL related to the inner side of the forearm ANTIBODY protein made in the body in response to foreign substance ANTICONVULSANT drug used to prevent seizures ANTILIPEMIC a drug that lowers fat levels in the blood ANTITUSSIVE a drug used to relieve coughing ARRHYTHMIA abnormal heartbeat; any change from the normal heartbeat ASPIRATION fluid entering the lungs, such as after vomiting ASSAY lab test ASSESS to learn about, measure, evaluate, look at ASTHMA lung disease associated with tightening of air passages, making breathing difficult ASYMPTOMATIC without symptoms AXILLA armpit

BENIGN not malignant, without serious consequences BID twice a day BINDING/BOUND carried by, to make stick together, transported BIOAVAILABILITY the extent to which a drug or other substance becomes available to the body BLOOD PROFILE series of blood tests BOLUS a large amount given all at once BONE MASS the amount of calcium and other minerals in a given amount of bone BRADYARRHYTHMIAS slow, irregular heartbeats BRADYCARDIA slow heartbeat BRONCHOSPASM breathing distress caused by narrowing of the airways

CARCINOGENIC cancer-causing CARCINOMA type of cancer CARDIAC related to the heart CARDIOVERSION return to normal heartbeat by electric shock CATHETER a tube for withdrawing or giving fluids CATHETER a tube placed near the spinal cord and used for anesthesia (indwelling epidural) during surgery CENTRAL NERVOUS SYSTEM (CNS) brain and spinal cord CEREBRAL TRAUMA damage to the brain CESSATION stopping CHD coronary heart disease CHEMOTHERAPY treatment of disease, usually cancer, by chemical agents CHRONIC continuing for a long time, ongoing CLINICAL pertaining to medical care CLINICAL TRIAL an experiment involving human subjects COMA unconscious state COMPLETE RESPONSE total disappearance of disease CONGENITAL present before birth CONJUNCTIVITIS redness and irritation of the thin membrane that covers the eye CONSOLIDATION PHASE treatment phase intended to make a remission permanent (follows induction phase) CONTROLLED TRIAL research study in which the experimental treatment or procedure is compared to a standard (control) treatment or procedure COOPERATIVE GROUP association of multiple institutions to perform clinical trials CORONARY related to the blood vessels that supply the heart, or to the heart itself CT SCAN (CAT) computerized series of x-rays (computerized tomography) CULTURE test for infection, or for organisms that could cause infection CUMULATIVE added together from the beginning CUTANEOUS relating to the skin CVA stroke (cerebrovascular accident)

DERMATOLOGIC pertaining to the skin DIASTOLIC lower number in a blood pressure reading DISTAL toward the end, away from the center of the body DIURETIC "water pill" or drug that causes increase in urination DOPPLER device using sound waves to diagnose or test DOUBLE BLIND study in which neither investigators nor subjects know what drug or treatment the subject is receiving DYSFUNCTION state of improper function DYSPLASIA abnormal cells

ECHOCARDIOGRAM sound wave test of the heart EDEMA excess fluid collecting in tissue EEG electric brain wave tracing (electroencephalogram) EFFICACY effectiveness ELECTROCARDIOGRAM electrical tracing of the heartbeat (ECG or EKG) ELECTROLYTE IMBALANCE an imbalance of minerals in the blood EMESIS vomiting EMPIRIC based on experience ENDOSCOPIC EXAMINATION viewing an  internal part of the body with a lighted tube  ENTERAL by way of the intestines EPIDURAL outside the spinal cord ERADICATE get rid of (such as disease) Page 2 of 7 EVALUATED, ASSESSED examined for a medical condition EXPEDITED REVIEW rapid review of a protocol by the IRB Chair without full committee approval, permitted with certain low-risk research studies EXTERNAL outside the body EXTRAVASATE to leak outside of a planned area, such as out of a blood vessel

FDA U.S. Food and Drug Administration, the branch of federal government that approves new drugs FIBROUS having many fibers, such as scar tissue FIBRILLATION irregular beat of the heart or other muscle

GENERAL ANESTHESIA pain prevention by giving drugs to cause loss of consciousness, as during surgery GESTATIONAL pertaining to pregnancy

HEMATOCRIT amount of red blood cells in the blood HEMATOMA a bruise, a black and blue mark HEMODYNAMIC MEASURING blood flow HEMOLYSIS breakdown in red blood cells HEPARIN LOCK needle placed in the arm with blood thinner to keep the blood from clotting HEPATOMA cancer or tumor of the liver HERITABLE DISEASE can be transmitted to one’s offspring, resulting in damage to future children HISTOPATHOLOGIC pertaining to the disease status of body tissues or cells HOLTER MONITOR a portable machine for recording heart beats HYPERCALCEMIA high blood calcium level HYPERKALEMIA high blood potassium level HYPERNATREMIA high blood sodium level HYPERTENSION high blood pressure HYPOCALCEMIA low blood calcium level HYPOKALEMIA low blood potassium level HYPONATREMIA low blood sodium level HYPOTENSION low blood pressure HYPOXEMIA a decrease of oxygen in the blood HYPOXIA a decrease of oxygen reaching body tissues HYSTERECTOMY surgical removal of the uterus, ovaries (female sex glands), or both uterus and ovaries

IATROGENIC caused by a physician or by treatment IDE investigational device exemption, the license to test an unapproved new medical device IDIOPATHIC of unknown cause IMMUNITY defense against, protection from IMMUNOGLOBIN a protein that makes antibodies IMMUNOSUPPRESSIVE drug which works against the body's immune (protective) response, often used in transplantation and diseases caused by immune system malfunction IMMUNOTHERAPY giving of drugs to help the body's immune (protective) system; usually used to destroy cancer cells IMPAIRED FUNCTION abnormal function IMPLANTED placed in the body IND investigational new drug, the license to test an unapproved new drug INDUCTION PHASE beginning phase or stage of a treatment INDURATION hardening INDWELLING remaining in a given location, such as a catheter INFARCT death of tissue due to lack of blood supply INFECTIOUS DISEASE transmitted from one person to the next INFLAMMATION swelling that is generally painful, red, and warm INFUSION slow injection of a substance into the body, usually into the blood by means of a catheter INGESTION eating; taking by mouth INTERFERON drug which acts against viruses; antiviral agent INTERMITTENT occurring (regularly or irregularly) between two time points; repeatedly stopping, then starting again INTERNAL within the body INTERIOR inside of the body INTRAMUSCULAR into the muscle; within the muscle INTRAPERITONEAL into the abdominal cavity INTRATHECAL into the spinal fluid INTRAVENOUS (IV) through the vein INTRAVESICAL in the bladder INTUBATE the placement of a tube into the airway INVASIVE PROCEDURE puncturing, opening, or cutting the skin INVESTIGATIONAL NEW DRUG (IND) a new drug that has not been approved by the FDA INVESTIGATIONAL METHOD a treatment method which has not been proven to be beneficial or has not been accepted as standard care ISCHEMIA decreased oxygen in a tissue (usually because of decreased blood flow)

LAPAROTOMY surgical procedure in which an incision is made in the abdominal wall to enable a doctor to look at the organs inside LESION wound or injury; a diseased patch of skin LETHARGY sleepiness, tiredness LEUKOPENIA low white blood cell count LIPID fat LIPID CONTENT fat content in the blood LIPID PROFILE (PANEL) fat and cholesterol levels in the blood LOCAL ANESTHESIA creation of insensitivity to pain in a small, local area of the body, usually by injection of numbing drugs LOCALIZED restricted to one area, limited to one area LUMEN the cavity of an organ or tube (e.g., blood vessel) LYMPHANGIOGRAPHY an x-ray of the lymph nodes or tissues after injecting dye into lymph vessels (e.g., in feet) LYMPHOCYTE a type of white blood cell important in immunity (protection) against infection LYMPHOMA a cancer of the lymph nodes (or tissues)

MALAISE a vague feeling of bodily discomfort, feeling badly MALFUNCTION condition in which something is not functioning properly MALIGNANCY cancer or other progressively enlarging and spreading tumor, usually fatal if not successfully treated MEDULLABLASTOMA a type of brain tumor MEGALOBLASTOSIS change in red blood cells METABOLIZE process of breaking down substances in the cells to obtain energy METASTASIS spread of cancer cells from one part of the body to another METRONIDAZOLE drug used to treat infections caused by parasites (invading organisms that take up living in the body) or other causes of anaerobic infection (not requiring oxygen to survive) MI myocardial infarction, heart attack MINIMAL slight MINIMIZE reduce as much as possible Page 4 of 7 MONITOR check on; keep track of; watch carefully MOBILITY ease of movement MORBIDITY undesired result or complication MORTALITY death MOTILITY the ability to move MRI magnetic resonance imaging, diagnostic pictures of the inside of the body, created using magnetic rather than x-ray energy MUCOSA, MUCOUS MEMBRANE moist lining of digestive, respiratory, reproductive, and urinary tracts MYALGIA muscle aches MYOCARDIAL pertaining to the heart muscle MYOCARDIAL INFARCTION heart attack

NASOGASTRIC TUBE placed in the nose, reaching to the stomach NCI the National Cancer Institute NECROSIS death of tissue NEOPLASIA/NEOPLASM tumor, may be benign or malignant NEUROBLASTOMA a cancer of nerve tissue NEUROLOGICAL pertaining to the nervous system NEUTROPENIA decrease in the main part of the white blood cells NIH the National Institutes of Health NONINVASIVE not breaking, cutting, or entering the skin NOSOCOMIAL acquired in the hospital

OCCLUSION closing; blockage; obstruction ONCOLOGY the study of tumors or cancer OPHTHALMIC pertaining to the eye OPTIMAL best, most favorable or desirable ORAL ADMINISTRATION by mouth ORTHOPEDIC pertaining to the bones OSTEOPETROSIS rare bone disorder characterized by dense bone OSTEOPOROSIS softening of the bones OVARIES female sex glands

PARENTERAL given by injection PATENCY condition of being open PATHOGENESIS development of a disease or unhealthy condition PERCUTANEOUS through the skin PERIPHERAL not central PER OS (PO) by mouth PHARMACOKINETICS the study of the way the body absorbs, distributes, and gets rid of a drug PHASE I first phase of study of a new drug in humans to determine action, safety, and proper dosing PHASE II second phase of study of a new drug in humans, intended to gather information about safety and effectiveness of the drug for certain uses PHASE III large-scale studies to confirm and expand information on safety and effectiveness of new drug for certain uses, and to study common side effects PHASE IV studies done after the drug is approved by the FDA, especially to compare it to standard care or to try it for new uses PHLEBITIS irritation or inflammation of the vein PLACEBO an inactive substance; a pill/liquid that contains no medicine PLACEBO EFFECT improvement seen with giving subjects a placebo, though it contains no active drug/treatment PLATELETS small particles in the blood that help with clotting POTENTIAL possible POTENTIATE increase or multiply the effect of a drug or toxin (poison) by giving another drug or toxin at the same time (sometimes an unintentional result) POTENTIATOR an agent that helps another agent work better PRENATAL before birth PROPHYLAXIS a drug given to prevent disease or infection PER OS (PO) by mouth PRN as needed PROGNOSIS outlook, probable outcomes PRONE lying on the stomach PROSPECTIVE STUDY following patients forward in time PROSTHESIS artificial part, most often limbs, such as arms or legs PROTOCOL plan of study PROXIMAL closer to the center of the body, away from the end PULMONARY pertaining to the lungs

QD every day; daily QID four times a day

RADIATION THERAPY x-ray or cobalt treatment RANDOM by chance (like the flip of a coin) RANDOMIZATION chance selection RBC red blood cell RECOMBINANT formation of new combinations of genes RECONSTITUTION putting back together the original parts or elements RECUR happen again REFRACTORY not responding to treatment REGENERATION re-growth of a structure or of lost tissue REGIMEN pattern of giving treatment RELAPSE the return of a disease REMISSION disappearance of evidence of cancer or other disease RENAL pertaining to the kidneys REPLICABLE possible to duplicate RESECT remove or cut out surgically RETROSPECTIVE STUDY looking back over past experience

SARCOMA a type of cancer SEDATIVE a drug to calm or make less anxious SEMINOMA a type of testicular cancer (found in the male sex glands) SEQUENTIALLY in a row, in order SOMNOLENCE sleepiness SPIROMETER an instrument to measure the amount of air taken into and exhaled from the lungs STAGING an evaluation of the extent of the disease STANDARD OF CARE a treatment plan that the majority of the medical community would accept as appropriate STENOSIS narrowing of a duct, tube, or one of the blood vessels in the heart STOMATITIS mouth sores, inflammation of the mouth STRATIFY arrange in groups for analysis of results (e.g., stratify by age, sex, etc.) STUPOR stunned state in which it is difficult to get a response or the attention of the subject SUBCLAVIAN under the collarbone SUBCUTANEOUS under the skin SUPINE lying on the back SUPPORTIVE CARE general medical care aimed at symptoms, not intended to improve or cure underlying disease SYMPTOMATIC having symptoms SYNDROME a condition characterized by a set of symptoms SYSTOLIC top number in blood pressure; pressure during active contraction of the heart

TERATOGENIC capable of causing malformations in a fetus (developing baby still inside the mother’s body) TESTES/TESTICLES male sex glands THROMBOSIS clotting THROMBUS blood clot TID three times a day TITRATION a method for deciding on the strength of a drug or solution; gradually increasing the dose T-LYMPHOCYTES type of white blood cells TOPICAL on the surface TOPICAL ANESTHETIC applied to a certain area of the skin and reducing pain only in the area to which applied TOXICITY side effects or undesirable effects of a drug or treatment TRANSDERMAL through the skin TRANSIENTLY temporarily TRAUMA injury; wound TREADMILL walking machine used to test heart function

UPTAKE absorbing and taking in of a substance by living tissue

VALVULOPLASTY plastic repair of a valve, especially a heart valve VARICES enlarged veins VASOSPASM narrowing of the blood vessels VECTOR a carrier that can transmit disease-causing microorganisms (germs and viruses) VENIPUNCTURE needle stick, blood draw, entering the skin with a needle VERTICAL TRANSMISSION spread of disease

WBC white blood cell

Take a Mid-Year Review of Your Health Insurance Coverage

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Many Americans spend thousands of dollars each year on health care, even if they have good insurance. But there are ways to reduce the amount you spend on everything from elective procedures to prescription drugs.

Start by reviewing how much you have left to meet your deductible. The average amount that employees have to pay before most health insurance coverage kicks in has increased by 10% over the past five years and 53% over the past 10 years, according to KFF (formerly the Kaiser Family Foundation). 

The average deductible for workers with single coverage was $1,735 in 2023, and 31% had a general annual deductible of $2,000 or more. If you’ve reached your deductible or are close to it, schedule appointments and elective procedures by the end of the year, before a new deductible kicks in for 2025.

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Even if your insurance company offers some level of coverage if you go out of the plan’s network, you’ll have lower co-payments on a lower negotiated rate if you choose in-network providers. You can save even more by comparing how much in-network providers charge for specific procedures. 

Employers and insurers are offering better tools to help you decide where to get care when you need it, says Regina Ihrke, managing director of health and benefits at WTW, a benefits consulting firm. Some employer health plans also offer one-on-one concierge services to help employees navigate their care options; by phone, a representative will walk you through your choices from providers covered by your insurance.

“Transparency tools have been around since about 2010, and now every carrier has them to at least show you what the range of the costs would be for certain procedures,” Ihrke says. The new generation of tools include quality measures in addition to cost data, she says. “The cheapest options may actually cost you more in the end because you may get misdiagnosed or have more readmissions.”

For example, Healthcare Bluebook , which is offered through some plans, lets you search by procedure to see the fair price in your area and look up cost and quality information for nearby doctors who perform the procedure. You’ll also see whether the provider falls in the top third, middle third or bottom third of quality ratings.

Other ways to make the most of employer and insurance benefits:

Take advantage of preventive care services. Even if you have a high-deductible health insurance plan, you likely qualify for many preventive care services, such as mammograms and colorectal cancer screenings, without having to pay the deductible or co-payments. 

Depending on your age, you may also be eligible to get vaccines for the flu, shingles and other diseases without having to pay the deductible or co-payments. Also, some services and medications for chronic conditions may not be subject to the deductible. Take advantage of these tests, screenings and programs without any cost to you.

Cash in on wellness benefits. Many employers offer additional benefits to keep their employees healthy. You may, for example, get a discounted gym membership, a reduced insurance premium or extra contributions to your health savings account if you take a health risk assessment and complete certain activities, Ihrke says. 

About 10% of employers offer lifestyle savings accounts, in which employees are given up to $1,000 to use for a variety of physical, mental or financial wellness expenses, such as a gym membership, a mindfulness resiliency app, nutrition counseling, financial wellness courses or student loan assistance. If you have access to these programs, make sure to use them by the end of the year.

Clear out your flexible spending account. An FSA allows you to set aside tax-free money from your paycheck to cover deductibles, co-payments and other out-of-pocket costs. And to use an FSA , you don’t need to enroll in a high-deductible health plan, as you do with a health savings account. 

But unlike HSAs, FSAs generally require you to use the money by December 31 of the plan year (or March 15 of the following year, if the plan offers a grace period); otherwise, you forfeit the unused balance. A study by the Employee Benefit Research Institute found that half of FSA contributors forfeited funds to their employers in 2022, with an average forfeiture of $441.

The Coronavirus Aid, Relief and Economic Security (CARES) Act of 2020 made it possible for FSA (and HSA) users to buy over-the-counter medications such as aspirin or acetaminophen without a prescription, says Rachel Rouleau, chief compliance officer at Health-E Commerce, parent brand to FSA Store and HSA Store, which sell products that qualify for FSA and HSA reimbursement. You can also use FSA money for ibuprofen, cough syrups, and allergy pills and sprays.

Other items that you can buy with FSA money include glasses, contact lenses, prescription sunglasses, broad-spectrum sunscreens, certain lip balms and sun protection moisturizers with an SPF of 15 or higher, first aid kits, acne medications, menstrual care products, hearing aids, acupuncture devices, health monitors, and deep-tissue pain relief devices. 

“The list of eligible FSA expenses has expanded in recent years to include a wide variety of clinical services, an extensive list of everyday essentials and several surprisingly eligible products,” Rouleau says. See a list of eligible expenses at https://fsastore.com/fsa-eligibility-list .

Pay less for prescription drugs

The Inflation Reduction Act also eliminated deductibles and co-payments for all recommended adult vaccines. And starting in 2025, Medicare Part D will have a $2,000 spending cap on out-of-pocket drug costs.

Websites such as GoodRx.com , SingleCare.com and Amazon Pharmacy can help you save money on prescription drugs, and more employers are incorporating cost-saving tools — such as Rx Savings Solutions and Scripta — into their pharmacy benefits. “It further directs members to additional cost savings,” says Chantell Sell, senior director in the pharmacy practice at WTW. Using these resources can help you find the lowest-cost pharmacy to buy the drug, coupons to reduce the cost or similar drugs that may cost less under your insurance.

“This can help people save quite a bit of money because prescription drug prices can vary by up to $100 between pharmacies — even between pharmacies in the same neighborhood,” says Charlene Rhinehart , a certified public accountant and personal finance editor at GoodRx. Using a coupon can help if you’re paying cash, and sometimes it can reduce the cost to less than you’d pay by going through your insurance plan instead, says Rhinehart. Other ways to lower your prescription drug costs:

Explore generic and alternative drugs. If you’re prescribed a drug that isn’t covered by your health insurance or that has high co-payments, ask your doctor whether there’s another drug that can serve a similar purpose but costs less under your plan. You may save a lot of money by switching to a generic drug. And even if no generic medication is available, there may be a “therapeutic alternative” — another name-brand drug that has similar effects — with better coverage from your insurance and lower co-payments for you.

“If your medication isn’t on the formulary, then in some cases there are generic versions or drugs within the same class that work the same, and they might be covered by insurance,” says Rhinehart. For example, several types of statins are prescribed to lower cholesterol and treat heart disease. 

“There are many different options within the drug class, so you may have a better shot at finding an affordable alternative,” she says. When you look up a drug on GoodRx, you’ll see a list of alternatives you can ask your doctor about.

Use a preferred pharmacy. Many drug plans have preferred pharmacies with lower co-payments than other in-network pharmacies. If you have a Medicare Part D prescription drug plan, you can use the Medicare Plan Finder to compare costs for your medications at several pharmacies in your area. If you and your spouse have different health plans, make sure you know the preferred pharmacies for each one because you may need to go to different pharmacies to get the best deals. Using your prescription plan’s mail order pharmacy may save you even more money.

Buy in bulk. If you take maintenance medications every month, it can cost less to buy them in larger quantities. For example, ordering a 90-day supply of your medications instead of a 30-day supply could save you money, Rhinehart says. Ask your pharmacist for other ideas to trim costs.

Find out about pharmaceutical assistance programs. Several types of programs can help you spend less on prescription drugs. People with low incomes who have Medicare Part D drug coverage may be able to save money on premiums and co-payments through the government’s Extra Help program , which was recently expanded to include those with higher income levels. You may also be able to save through a state pharmaceutical assistance program or state discount program. Many pharmaceutical companies have programs to help with the cost of drugs that aren’t covered by insurance or co-pay assistance programs. Check with the drug manufacturer or go to this Medicare page .

Manufacturers also sometimes offer co-pay cards for certain name-brand drugs that don’t have generic alternatives, Rhinehart says. These cards cover part or all of the costs that aren’t covered by your health insurance. They don’t have income requirements, but most are available only to people who have private health insurance. You can find these co-pay cards either on the manufacturer’s website or through GoodRx.

Check out new benefits for Medicare Part D. The Inflation Reduction Act of 2022 included several changes to make prescription drugs more affordable under Medicare Part D. It capped the cost of a monthly supply of insulin at $35, but not all Part D plans cover all types of insulin. Use the Medicare Plan Finder to find out what the plans available in your area cover.

Use a health savings account

You can stretch your health care dollars by taking advantage of a health savings account, and it’s not too late to sign up for an HSA and make contributions for 2024. You can c ontribute to an HSA in 2024 if you have an eligible health insurance policy with a deductible of at least $1,600 for single coverage or $3,200 for family coverage — whether you get your health insurance through an employer or on your own. Maximum contributions for 2024 are $4,150 for self-only coverage and $8,300 for family coverage, plus $1,000 if you are 55 or older. 

Many employers offer incentives to participate in an HSA, such as by matching contributions or contributing a fixed amount for all employees who have a high-deductible health insurance plan. Some employers provide HSA contributions for employees who participate in a wellness program or take a health risk assessment, Ihrke says.

Contributions to an HSA are pretax if you have a plan through your employer (or tax-deductible if you don’t have an employer plan), the money grows tax-deferred through the years, and you can withdraw it tax-free for eligible medical expenses at any time in the future; there are no use-it-or-lose-it rules. You can withdraw money from the HSA tax-free for out-of-pocket medical expenses, such as your deductible and co-payments, as well as your costs for vision, dental and hearing care, prescription drugs, and over-the-counter medications. 

Once you reach age 65, you can even use HSA money to pay premiums for Medicare Part B (and Part A, if you have to pay premiums for it), Part D prescription drug coverage, or a Medicare Advantage plan. You can also pay a portion of long-term-care insurance premiums with HSA money (the amount you can cover with HSA funds is based on your age).

You’ll get an even bigger tax benefit if you keep the money growing tax-deferred in the HSA for future health care costs. You have an unlimited amount of time to with-draw money for eligible expenses you incurred since you opened the account — you can even claim re-imbursement for expenses years after you paid them out of pocket. Just keep your receipts for the health care costs you paid with cash, and then you can withdraw the money tax-free at any time.

If you plan to keep the HSA money growing in the account for future expenses, make sure your investments match your time frame. Many people keep HSA money in the plan’s savings account and don’t realize that they may have a menu of mutual funds to choose from. 

If you plan to use money in the account for medical expenses soon, check out the HSA’s interest rates on savings, which can also vary significantly by administrator. “It’s shocking to me how low the interest rates being offered by some major providers are,” says Greg Carlson , senior manager and research analyst at Morningstar and coauthor of the firm’s annual HSA landscape study.

In addition to comparing investment options and interest rates, pay attention to fees, which can vary significantly among HSAs. A study by the Consumer Financial Protection Bureau found that some HSAs charged monthly maintenance fees , paper statement fees, outbound transfer fees and account closure fees. “This complex fee structure may obscure the true cost of the product, and the financial impact of these fees directly reduces the funds consumers can spend on health care expenses,” the report said. 

If your employer offers an HSA, look for ways to minimize the fees, such as by receiving online account statements and keeping a minimum balance to avoid or reduce fees. For example, Carlson says, some plans don’t charge a maintenance fee if you have a certain account balance.

Note: This item first appeared in Kiplinger Personal Finance Magazine, a monthly, trustworthy source of advice and guidance. Subscribe to help you make more money and keep more of the money you make here .

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As the "Ask Kim" columnist for Kiplinger's Personal Finance, Lankford receives hundreds of personal finance questions from readers every month. She is the author of Rescue Your Financial Life (McGraw-Hill, 2003), The Insurance Maze: How You Can Save Money on Insurance -- and Still Get the Coverage You Need (Kaplan, 2006), Kiplinger's Ask Kim for Money Smart Solutions (Kaplan, 2007) and The Kiplinger/BBB Personal Finance Guide for Military Families. She is frequently featured as a financial expert on television and radio, including NBC's Today Show, CNN, CNBC and National Public Radio.

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