Yup, if you didn’t already catch on from the barrage of pregnancy-related posts lately, I spent the first half of the year expecting our second child.
Unfortunately, right before finding out we were expecting, I became yet another casualty of this tech winter period. Due to the company’s decision to exit Singapore, I lost not only my full-time job and co-workers that were more like family to me, but also my corporate insurance and most importantly the maternity coverage that came along with it.
Perfect timing – I know. My first reaction was to go into full financial planning mode. I had to ensure we were in a good position to cover major expenses even without insurance. I had given birth in Singapore five years ago, and a lot of things have happened since then, so I was looking for an updated estimate of the costs of giving birth in Singapore. That’s when I noticed how difficult it is to estimate the cost!
After going through the process of having a baby twice, I have learned a thing or two about maternity hospital bills and how to dissect them. So, instead of hoarding this knowledge in my brain, I decided to write this post and share it with all of you. I hope it will help someone else in the same situation.
- My Maternity Hospital Bill at Thomson Medical Center
- What affects the total amount of my bill the most
- How much can you claim from Medisave for your maternity bills?
- Cost of Pregnancy / Pre-Natal Expenses
- What you can do to lower the cost of giving birth in Singapore
Before we go on, I need to state the obvious:
Disclaimer: I am NOT a medical or financial professional. Any opinions, whether written or implied in this post, are simply my personal thoughts based on my own experience. It is not to be taken as a medical or financial advice.
My maternity hospital bill at Thomson Medical Center
Let’s get straight to the point. My Thomson Medical Center (TMC) bill came up to be $14,474.99 before Medisave claim. This bill was for the following scenario:
- 2-night stay at the 1-bedded room
- Natural delivery procedure with Epidural
This bill consists of two components:
- Mother’s bill – the delivery procedure and the hospital stay after
- Baby’s bill – the care received by the baby throughout the hospital stay
Here is the Mother’s bill (my bill). The total was $11,452.96 without Medisave claim.
And here is the portion for the baby. The total was $3,022.03 without Medisave claim.
What affects the total amount of my bill the most
Yes, looking at such a long itemized bill could be overwhelming, so let me point out a few major line items that made the most impact on my bill:
- Gynaecologist Fees – My Gynae fee is on the higher end at $5,668. It could be lower. I’ll talk more about it on the later section of this post.
- Delivery Procedure – whether you’re delivering naturally or via C-section would also affect the cost as they are different medical procedures. Typically, C-section has higher costs than natural birth.
- Pain Management (aka Epidural) – According to my detailed hospital bill (which is even more comprehensive than the one I shared above), the medication for the epidural costs about $370, while the Anesthetist fee is $981. So in total, an epidural costs around $1,350.
- Type of Accommodation – I opted for a 1-bed private room at $698 per night before GST.
How much can you claim from Medisave for your maternity bills?
If you are a Singaporean citizen or PR, you will be able to claim from your Medisave. The amount depends on the delivery procedure (C-section, assisted or natural) and the length of hospitalization.
In my case, I gave birth through a natural delivery procedure and I was able to claim $3,850 from my bill – $2,750 from the mother’s bill and $1,100 from the baby’s bill. If you’re giving birth via C-Section or assisted delivery, you might be able to claim more from your Medisave.
So out of the total $14,474.99, I paid $10,624.99 by cash.
Cost of Pregnancy / Pre-Natal Expenses
This post was meant to focus on the hospital bill, but we all know the total cost of the entire antenatal (from pregnancy until delivery) is more helpful in terms of financial planning.
Well, Pre-natal expenses are even harder to predict than hospital bills – the cost of it is entirely dependent on your choice of Gynaecologist. That’s why I hesitated to share my pre-natal costs at first. Each Gynaecologist will have their own fees and might even recommend different tests and scans.
But I figured more transparency couldn’t hurt. So to give you an idea, here are my pre-natal expenses:
| Gynaecologist consultation | |
| First Consultation | $ 194.40 |
| Ultrasound | $ 162.00 |
| Subsequent consultations (x 8 @ 162 each) | $ 1,308.00 |
| Scans and Tests | |
| NIPT (in Tokyo) | $ 1,127.27 |
| Level 3 Fetal Anomaly Scan | $ 403.30 |
| Antenatal Blood Comprehensive | $ 228.90 |
| Glucose Test | $ 54.50 |
| Bacterial Test | $ 92.65 |
| Urine Test (x 9 @ $5.40 each) | $ 48.60 |
| Vaccination | |
| Boostrix 0.5ml TDAP vaccine | $ 70.85 |
| TOTAL | $3,690.47 |
Please note that this is just an example and you don’t have to follow what I did! Your pregnancy journey is a personal choice and you can discuss it with your partner and Gynae. For example, I know some couples who chose not to do NIPT or fetal anomaly scan, which are designed to catch genetic abnormalities, as they have decided to continue with the pregnancy no matter what.
Also note, the cost above does not include pre-natal supplements that I took throughout the pregnancy, which if I had to estimate was about $500. Of course, this is entirely personal choice and there are more affordable supplements out there, so I did not include that cost here.
What you can do to lower the costs of giving birth in Singapore
Giving birth when you’re not insured is definitely anxiety-inducing, especially when you don’t know how much the bill is going to be. Here are a few ideas I have considered that could help lower the costs of your bill:
1. Go the public hospital route
While I can’t personally comment on the experience of giving birth at a public hospital in Singapore, I trust the healthcare in Singapore and I have heard positive feedback from those who did go the public hospital route.
In terms of finances, if you’re a Singapore citizen or PR and qualify for a subsidized hospital rate, giving birth at a public hospital is mostlikely going to be cheaper. One of my Singaporean friends told me they paid only $4,500 to give birth at KKH in 2022. Assuming it’s the amount after Medisave claims, that’s still less than half of the cash portion of my bill at TMC!
If you’re a foreigner, you would be paying the unsubsidized rate for giving birth at public hospitals. However, I’ve been told the total bill still ended up being lower than private hospitals. Some people have quoted that they paid $6,000 – 7,000 as foreigners giving birth at NUH.
2. Research Gynaecologist fees
There are three doctor’s fees involved during delivery – Gynaecologist, Anesthetist (if you opt for epidural), and Paediatrician.
But I specifically recommend shopping around for a Gynaecologist because out of the three, Gynae commands the largest fee. S/he will be the one delivering the baby and checking up on the mother after birth after all.
From the bills I’ve seen, a Gynae fee can vary from $2,000 to $6,000, or perhaps even higher. That’s quite a range! So, taking the time to shop around for different Gynaes and comparing their fees could really help to lower your bill, potentially by a few thousand dollars.
However, if you ask me, the peace of mind of having a Gynae whom you trust and are compatible with is priceless. Especially if it’s your first time giving birth! That’s why I chose my Gynae again, who also took care of me and my firstborn five years ago. Even though I knew his Gynae fees were on the higher end, I stuck around with him because I trusted his recommendations.
PS: Eagle eyes would have seen that my hospital bill listed Dr Paul Tseng as my Gynae, but he’s not actually my regular doctor. My gynae is Dr TC Chang who happened to be on vacation the day baby decided to come, so he recommended Dr Tseng to “sub in” 😂
3. Consider different types of accommodation
Hospitals usually would have many types of room accommodations at different rates. For example, TMC has shared rooms (2 and 4-bedded rooms), private rooms, and suites. It’s worth checking out the room rates and see what you’re willing to pay.
Personally, I chose the 1-bed private room since I didn’t want to share a room with other people after giving birth. But at the same time, I didn’t think the premier room or suites were worth the upgrade since I would mostly be resting or taking care of the baby during the hospital stay.
4. Be aware of the cost of pain relief medications
There are different types of pain management a mother can take during and after delivery – Epidural to manage labor pains and pain relief medicines for after birth.
Epidural at TMC costs about $1,350 when you take into account the medication and the Anesthetist fee. While I do not suggest skipping out on Epidural just for the sake of saving cost, it helps to be informed so you can prepare your finances.
Depending on how the birth goes, you might also be prescribed pain relief medicine which would be billed to Mother’s bill should you opt for them. Again, I don’t recommend skipping the pain relief medicine if you feel that you need it. However, depending on the strength and how many doses of pain relief medicine you are taking home, it could be a difference of $500-600 added to your total bill.
5. Get familiar with the different delivery procedure
As I mentioned before, the delivery procedures have different costs depending on what happened during birth. Usually, they are:
- Natural delivery with or without epidural
- Assisted delivery (using forceps or vacuum) with or without epidural
- Caesarian Section with general anesthesia or spinal
Typically, when having natural or assisted delivery you would only be staying at the hospital for 2 nights. However, if you gave birth via C-section then you’d be staying for 3 nights, which also adds to the bill.
In my opinion, the delivery procedure is not really within your control. Even if you plan for a natural delivery, you simply cannot anticipate what’s going to happen on D-day. It could be a matter of life or death for the mother or newborn baby. However, knowing the potential costs could help estimate the bill and with your financial planning.
You can talk to the customer service desk at TMC to find out the costs. You can also view TMC’s maternity packages here (scroll down) to gauge the different rates for each procedure.
6. Consider international maternity insurance if you are not yet pregnant
So back to my situation explained earlier in this post. You might be wondering – why didn’t I simply purchase my own maternity insurance when I got laid off?
Well, it’s not as straightforward as choosing a plan and paying the premiums. In order to be covered for routine maternity expenses in Singapore, all insurers impose a 10-12 months waiting period before conceiving. That ship had long sailed for me since I was already pregnant. But if you’re still in the planning phase, you can shop around for maternity insurance.
Note that no local Singapore insurers cover routine maternity and delivery bills, only international insurers such as Cigna or Bupa would cover those. Usually, the premiums for such insurance are pricey. In total, the insurance premium you pay might end up being similar to the cost of giving birth without insurance at a private hospital. However, you can claim routine maternity bills which usually include pre-natal expenses and delivery costs. When you take this into account, the insurance is not as expensive as it seems.
But where international insurance really shines is in the event of complications, such as premature delivery or if the newborn baby needs to stay at NICU after birth. Knock on wood that this doesn’t happen to any of us, but this is when the hospital bill could easily balloon above $20,000 or even in the $100,000 range if it’s a serious complication. You’d be glad you’re covered by insurance then!
Another thing to consider is the gap in insurance coverage for newborn babies. International insurance typically covers newborns from birth. On the other hand, local Singapore insurers usually only cover newborns 14 days after birth. Yes, even Integrated Shield Plans for hospitalization!
I recommend speaking to an insurance agent if you’re keen on taking up international insurance. Make sure you ask them what the routine maternity coverage is (what is the limit, what’s covered), what complications are covered, what the newborn coverage looks like, etc. Ask about different scenarios too, to make sure you’re getting the plan you want.
7. Ask for a detailed itemized hospital bill
The bill I shared above is not the most detailed. There is another even more detailed hospital bill that lists every single medication, medical supplies, equipment, and procedure administered. You’d want to take a look at those.
In my case, despite not taking any pain relief medicine (I was really lucky to not have any perineal tearing), I was charged for 20 tabs of Paracetamol. It was not a huge amount and was refunded back to me so it’s not a big deal, but make a point to check just in case. Mistakes do happen and we’re all only human!
8. Pay using a credit card that earns points from hospital charges
To lessen the pain of paying such a huge bill, you can pay your hospital bill using credit cards that earn points for hospital charges. These points can then be converted to airline miles for free trips (almost, you still need to pay for airport tax and fuel charges) or shopping vouchers.
Typically, hospital charges are excluded from earning points. You can read your credit card’s T&C and look for hospital exclusions. However, AMEX cards do not exclude hospital bills. Sometimes, banks will run promotions for new customers and you can potentially earn even more points that way, so make sure to keep an eye out!
Unfortunately, TMC does not accept AMEX as a method of payment. Luckily at the time I gave birth, Standard Chartered Bank was still awarding points for hospital bills. So, I applied for a credit card with them and used it to pay the bills. I earned points from the new customer promotion on top of the hospital charges, and I received 60,000 miles which is enough to redeem one round-trip economy ticket from Singapore to Tokyo.
And that’s everything I know about the costs of giving birth in TMC and Singapore! If you want to discuss something or have any questions about my specific experience, please feel free to leave a comment below.
Disclaimer: I am NOT a medical or financial professional. Any opinions, whether written or implied in this post, are simply my personal thoughts based on my own experience. It is not to be taken as a medical or financial advice.