Baby’s First Year of Healthcare Costs: What New Parents Can Expect

January 11, 2026
4:55 am

By Jennifer Jane, BSN, RN

The first year with a new baby is a blur of sleepless nights and taking care of this tiny new human in your life…and a surprising number of doctor visits. And figuring out what is and isn’t covered by insurance while you’re barely sleeping can be confusing. Let’s talk about what to expect, what’s usually covered, and how tools like Lyvona can help bring clarity to the uncertainty.

The medical care your baby needs in the first year

The American Academy of Pediatrics (AAP) recommends frequent well-child visits during the first year to monitor growth, development, feeding, and sleep.

Typical visit schedule:

Newborn visit – within a few days after birth. Many hospitals want you to schedule a newborn appointment with a Pediatrician before your baby is discharged.
2 weeks – weight check, physical exam, discuss feeding, jaundice
1 month – monitor growth, development, immunizations, breastfeeding support
2 months – monitor growth, development, immunizations
4 months – monitor growth (doubling birth weight), immunizations
6 months – monitor growth, discuss the introduction of solid foods, immunizations
9 months – monitor growth, feeding, motor milestones, possible hemoglobin check, immunizations
12 months – age one year physical, growth, immunizations, discuss self-feeding, walking, introduction of new foods, like cow’s milk instead of formula

At these visits, babies receive:

Physical exams: weight, length, head size/circumference, heart rate/rhythm, lung sounds, bowel sounds, etc.
Developmental milestone checks: rolling over, smiling, babbling, sitting, etc.
Guidance on feeding, sleep, safety, and coping for parents
Recommended vaccines at several of those visits: refer to the American Academy of Pediatrics vaccine schedule on their website aap.org (1).

Research shows that children who get regular well-child care and preventive services are more likely to be up-to-date on vaccines, have developmental concerns identified early, and are less likely to end up in the emergency department (2).

On top of well visits, parents can expect:

A few sick visits for things like fevers, ear infections, rashes, or breathing concerns
Possible urgent care or emergency visits if your baby has trouble breathing, high fevers, injuries, or acute, concerning symptoms

Preventive care and sick visits: what is covered?

Under the Affordable Care Act (ACA), most health plans must cover a set of preventive services for children at no cost when you use in-network providers, including:

Well-child checkups on the recommended schedule
Routine vaccines
Routine developmental screenings
Routing hearing, and vision screenings

You typically don’t pay a copay or coinsurance for these preventive services, even if you haven’t met your deductible yet.

If a visit or test is coded as a problem-focused visit (for example, a sick visit about an active illness, an urgent care visit, or ER visit), it is not considered preventive care, and your plan may apply your deductible or copay (3).
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First-year healthcare costs can vary

Your family’s costs depend on:

Your insurance plan’s deductible, copays, coinsurance, and out-of-pocket maximum
If your baby has chronic health conditions or needs NICU care
Whether or not you use in-network providers

Without insurance, one analysis estimated that the full set of recommended first-year pediatric visits and immunizations would cost approximately $3,000 (4).

According to a national cost analysis, families pay around $1,700 in out-of-pocket costs over the first 18–24 months of life. Families with babies that need NICU care often face much higher bills (5).

For a healthy baby with typical needs, many insured families see:

$0 for in-network well-child visits and vaccines (preventive coverage)
Copays or coinsurance for:
- Sick visits (for example, $20–$40 per visit, or full cost until you hit your deductible)
- Urgent care or ER visits
- Certain tests, imaging, or prescriptions

Health insurance overview

Insurance is confusing, even when you’re not exhausted by new baby care. Here’s a quick basic refresher on insurance terms:

Premium – The amount you pay every month to keep your insurance active.
Deductible – The amount you pay each year for covered services before your plan starts paying its share (preventive care is usually an exception).
Copay – A flat fee you pay at the time of service (for example, $30 for a sick visit).
Coinsurance – A percentage of the cost you pay (for example, you pay 20% and the plan pays 80% after you’ve met your deductible).
Out-of-pocket maximum (OOP max) – The most you’ll pay in covered costs in a year (not counting premiums). Once you hit your OOP, the plan typically pays 100% of covered services for the rest of the year.

Your baby usually has their own deductible and out-of-pocket maximum, separate from yours, once they’re added to your policy. Plans often have individual deductibles for each family member on the policy. If your plan covers your whole family, there will likely be a deductible for each person and a separate family deductible.

Once the family deductible is met, you and your plan start paying coinsurance for everyone’s care. Commonly, after your deductible is met, you pay 20% and insurance pays 80% even if some family members haven’t met their individual deductible.

How Lyvona can help

This is the kind of confusion Lyvona was built for. Lyvona focuses specifically on pregnancy, birth, and newborn and new mom costs.

In Lyvona’s communities, you can:

See real bills from other moms in your city with similar insurance
Compare what different hospitals charge for newborn care
Ask cost and insurance questions in a moderated space that blends peer support with expert guidance

Instead of guessing, you get real costs from other real families on lyvona.com and a clearer picture of costs for pregnancy, delivery, and your baby’s first year. Cost transparency can’t erase the stress of new parenthood, but it can help relieve some of the financial stress from not knowing what to expect, stress that can overshadow a time that deserves as much peace as possible.

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