Will Insurance Cover a D&C After a Miscarriage? - GoodRx (2024)

Healthcare providers sometimes perform dilation and curettage (D&C) after a miscarriage to ensure that all of the tissue has been removed from the uterus. This procedure also can be used to investigate or diagnose uterine cancers and to perform a surgical abortion.

It’s a very common procedure covered by many health insurance plans. However, without coverage, the financial burden can be significant. Even if you have insurance, you can expect some out-of-pocket expenses.

What happens during a D&C?

A D&C is a relatively short and straightforward procedure, usually performed in an outpatient setting. Beforehand, an anesthesiologist administers medication so you don’t feel pain. A D&C can be done with many types of anesthesia, like an epidural or general anesthesia.

The dilation aspect of D&C involves opening your cervix, which separates your vagin* from your uterus. There’s several ways to do this; the right option for you depends on your specific situation.

Once your cervix is open, your healthcare provider will pass a spoon-shaped instrument called a curette (hence curettage) into your uterus. They’ll use the curette to scrape away any tissue that needs to be removed. They also may use a small camera to look at the inside of your uterus to make sure all the tissue is gone. If there’s a lot of tissue to remove, they may use a suction device to help.

The removed tissue may get sent to a lab for testing. After the procedure is complete, you’ll rest in the recovery room until the anesthesia has worn off.

How much does a D&C cost?

Many factors impact the price of a D&C, including:

• Whether you have insurance

• Your location

• The type of facility where you have the procedure

• Anesthesia cost

• Procedure cost

• Facility fees

The procedure alone can cost several thousand dollars. And, depending on your situation, there may be additional expenses, like transportation, child care, and lost wages

One of the more economical options is to have the procedure at a Planned Parenthood location. These clinics offer induced abortion by D&C for up to $1,100. Other clinics that don't focus on delivering low-cost care may charge much more.

FAIR Health, a consumer tool for estimating healthcare expenses, places a Chicago-area hospital outpatient D&C with anesthesia and tissue pathology at about $5,000 with in-network providers. That’s the amount that would be billed to your insurance. The bill could be about $3,500 less if you had the procedure at an in-network ambulatory surgery center.

The same scenario with out-of-network providers or without insurance would cost about $10,000 in a hospital outpatient setting and roughly $3,000 at an ambulatory surgery center.

MDsave, a price-shopping tool for people without insurance and those who have high-deductible health plans, lists national and regional price ranges for a D&C. Without insurance, the national average for this procedure is about $9,500.

Here are some regional averages for a D&C purchased through MDsave (redeemable at participating providers) at the time of publication:

• Atlanta: $4,776

• Chicago: $5,242

• Dallas: $4,748

• Denver: $6,985

• Orlando: $4,967

• Phoenix: $4,882

Does health insurance cover the cost of a D&C?

Many health insurance plans cover some of the cost of a D&C, as it is often considered medically necessary. However, depending on your coverage, you still may have out-of-pocket expenses.

For example, you may be responsible for the entire cost of the procedure if you have not yet met your annual deductible. And, even if you have met your deductible, you may be responsible for copays or coinsurance.

Contact your health insurance plan to find out what is covered. You should also ask the providers and facilities involved in your D&C to help you estimate the financial responsibility you’ll face.

If I don’t have insurance or intend to self-pay, do I have pricing options?

Yes, you can ask for a good faith estimate (GFE) of the costs for your D&C if you don’t have insurance or plan to self-pay. A GFE is a list of expected charges, not a bill. Most healthcare providers must give you a GFE if you request one and are uninsured or plan to pay the bill without insurance. You can dispute the final bill if it’s at least $400 more than the GFE.

Will insurance cover additional care needed after a D&C?

There isn’t a high risk of complications with a D&C, so you won’t likely need additional care after the procedure. If you do have complications, your insurance will likely cover any medically necessary follow-up care. But you may have more out-of-pocket costs (deductibles, copays, coinsurance).