The Toll of Healthcare Cost Confusion

February 1, 2026
3:58 am

by Jennifer Jane, BSN, RN

In a national study of pregnant and postpartum women, 24% reported unmet health care needs due to cost, and 60% reported health care unaffordability. Having private health insurance was linked to a lower chance of unmet health care needs but a higher chance of health care unaffordability. Out-of-pocket costs for pregnancy and postpartum care increased by 50% between 2008 and 2015, largely due to the need to meet increasingly higher deductibles. Lower household income was associated with both unmet health care needs and increased difficulty affording needed care (1).

Pregnancy and postpartum care can be full of anxiety about the unknown for both you and your baby. The last thing you need is the added stress of not knowing how much your care will cost and whether or not you can afford the care you need.

Healthcare cost literacy is the ability to understand what care will cost and why, and how the pieces fit together: deductibles, copays, coinsurance, in-network and out-of-network rules, and how care is billed.

The emotional toll of a lack of healthcare cost transparency

A lack of healthcare cost transparency can lead to more than medical bills in the mailbox. Not knowing what to expect can cause:

Anticipatory anxiety: You’re not only worried about the test, you’re also worried about the bill that will follow. Medical debt is linked with delayed and skipped care, especially among people experiencing anxiety or depression (2).
Decision fatigue: Appointments can become sources of worry about whether the test or screening is needed, and if the need is worth the cost.
Embarrassment: People avoid asking questions because they may feel like they should already know.
Loss of control: Surprise billing and unclear pricing create financial stress. Unexpected bills occur for both emergency and non-emergency/routine services and are most often related to indirect care behind the scenes (3).

This is important because feeling stressed can change our behavior, and our behavior affects our health.

How cost confusion leads to delayed care

When you don’t know what you’ll owe, especially if you’re already swimming in bills, you’re more likely to postpone care until you feel better able to afford it, even when care is time-sensitive, such as:

Putting off lab work because the last blood tests were more expensive than expected.
Skipping or delaying recommended ultrasounds because imaging bills are expensive.
Avoiding recommended extra monitoring (growth scans, non-stress tests) in pregnancy because you’re hesitant to owe even more money.

A study looking at delayed care during pregnancy and postpartum found a link between delayed care and worse maternal mental health symptoms, particularly during the postpartum period when monitoring and emotional support are so important (4).

Avoidance of follow-up appointments

Postpartum care is not optional; it’s critical for mom’s and baby’s well-being. The American College of Obstetricians and Gynecologists recommends ongoing support for new moms to optimize mom’s and baby’s health, starting within the first 3 weeks, including a comprehensive postpartum obgyn visit by 12 weeks after birth (5).

Cost confusion can lead to moms avoiding the visits that are in place to catch potential problems early. If moms are worried about costs they might:

Skip blood pressure checks after delivery, telling themselves they’re “fine”.

Delay pelvic floor therapy because it feels like it’s “extra”.
Avoid lactation support even if they’re struggling with breastfeeding and pumping on their own.
Put off postpartum mental health care, thinking they’ll feel better with time.

When postpartum care might become financially stressful, moms may take the “wait and see” approach. That’s a risky strategy at a physically and emotionally delicate time when you need all the care, help, and support you can get.

The emotional aftershock of surprise medical debt

The No Surprises Act can protect from unexpected billing for:

Most emergency services, including urgent mental health services
Non-emergency services from out-of-network providers (like anesthesiologists) at in-network hospitals or ambulatory surgical centers
Services from out-of-network air ambulance service providers (6)

But, even with policy protections, surprise bills still happen, especially when coverage details are murky, consent forms are rushed, or you didn’t get a choice when an out-of-network doctor provided care.

Anxiety can spike, mail goes unopened, follow-up appointments get postponed, and payment plans become another financial stressor.

Ways to improve healthcare cost literacy

Here are some strategies that might help to reduce stress and uncertainty around healthcare:

Ask for the “patient responsibility estimate” in writing before scheduled services (labs, imaging, anesthesia, procedures).
Track three things: the deductible remaining that you still owe, the out-of-pocket max remaining that you still owe, and whether the provider or hospital is in-network (call your insurance plan’s member services to get these details).
Keep your Explanation of Benefits (EOBs): they explain how the claim is processed before you pay a bill.
Request itemized bills for large charges (errors and duplications are more common than people think).

How Lyvona can help

Lyvona was built to help families understand the costs of care and offer support with:

Community cost transparency: see what other moms with similar insurance paid for delivery and postpartum care.
Calendar planning tools to model deductible resets — the “double deductible” trap
Bill review support: upload bills, catch errors, understand charges, and get help negotiating.
Lumin AI support for cost and health questions 24/7, including scenario modeling.

Pregnancy and postpartum care require months of ongoing appointments and ongoing bills. Lyvona helps ease stress related to understanding health costs, insurance, and bill confusion, using tools and offering community support so new moms can put their energy where they want to — taking care of themselves and their babies.

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