Home birth and insurance in Florida

[jenfl]

After a fabulous (non-reimbursed) home birth in California, my husband and I would like to do another home birth if we have another child here in Florida. I know that Florida law requires insurance companies to pay for midwives and home birth... unless the company providing the insurance is self-insured. And we're under a self-insurance plan (Healthchoice from Orlando Health).

Anyone want to share stories of how your fight to get your home birth covered went?

Thanks!

[purplevega]

I have private health insurance with blue cross. They did not pay a dime. I did have the option to add maternity coverage for about $150 a month. It was not worth it for me. My midwife took cash and gave me a discount for it. It worked out cheaper to self pay then to pay insurance.

Kim

[1hautemama]

Where in S. FL are you? I know a midwife who can work either way for you since she is a CNM but also does homebirths. Best of luck t you momma:

[1hautemama]

Sorry to go off topic BUT: I should also add that I chose to go unassisted VBAC bc the Docs in our area do not attend or support VBAC, and the local midwives have their hands tied behind their backs legally to attend out of hosp vbac. However in this neck of the woods we are fortunate to have an MD who is supportive of natural pregnancy/childbirth/and all around pro-mom-pro-baby care. If you wish to know more just PM me and I'll point you in the right direction.

[Hallielynn01]

not a fight story, but I'll toss the insurers who were helpful out- I had cigna then switched to united and I didn't pay a dime for our homebirth

[ErikaG]

Originally Posted by Hallielynn01

not a fight story, but I'll toss the insurers who were helpful out- I had cigna then switched to united and I didn't pay a dime for our homebirth

United covered your whole homebirth? That's really great to hear. I'm hoping that if/when there's a next time I don't risk out of homebirth and I have United. The midwife we interviewed mentioned that she's had trouble with United before, and we've been putting some money aside in case it does happen that we have a significant portion of the birth to pay for.

Were there any hoops to jump through, or anything? Or did you/your midwife just submit the claim and they paid it?

[CanidFL]

I had BCBS through my work and they said my midwife was out of network, which she was but they did not have a homebirth midwife in network. Soooo I sued them and got the fee covered 100% plus all the court costs.

[ErikaG]

Originally Posted by CanidFL

I had BCBS through my work and they said my midwife was out of network, which she was but they did not have a homebirth midwife in network. Soooo I sued them and got the fee covered 100% plus all the court costs.

Can I ask who your midwife was?

[FLPanther]

Yes, Florida law requires all healthcare insurers licensed in the state to pay for home births. If a licensed midwife attends the birth, she is a legal maternity provider. Here's a link to the Florida Statutes:
http://www.leg.state.fl.us/statutes/...27/Sec6574.HTM
See especially Section 7.
Please note that the law does not apply to Tricare dependents (Tricare is not a state licensed provider, but a federal one).

[Hallielynn01]

Originally Posted by ErikaG

United covered your whole homebirth? That's really great to hear. I'm hoping that if/when there's a next time I don't risk out of homebirth and I have United. The midwife we interviewed mentioned that she's had trouble with United before, and we've been putting some money aside in case it does happen that we have a significant portion of the birth to pay for.

Were there any hoops to jump through, or anything? Or did you/your midwife just submit the claim and they paid it?

As far as I know that's all they did. I'm not sure if United has different types of plans or not, I know this plan (we had to switch because DHs employer was dropping cigna and it was the most like the cigna plan we had). But we just got a statement showing recent actitivy,and it showed the charges from the birth center and showed us not owing anything. So....looks like its all said and done now. Some insurance we looked at it was gonna be an 80/20 (since it was being concidered out of network, or outpatient, or something that seemed rediculous), but still.... thats better than complete out of pocket

[ralphyl44]

I know this is a few years after the last post was posted, but when y'all are talking about FL insurance having to cover home births, is that only IF you have maternity coverage?

[gnvdude]

I hope this email finds you.

You mention you sued and won against BCBS. Can I ask who your lawyer was ?

We are expereriencing the same thing as you, and hiring your lawyer might be the easy button.

Thank you.

[mtrand2]

(very interested in this thread! I'm a 2 time HBAC newly looking for someone in SWFL and I can't afford to pay homebirth out of pocket!)

[jamebaby]

Don't know how relevant this is for any of the previous posters, but I thought I'd add my experience here. I have AvMed, called before I was preggo to ask if they cover homebirths, they said they did, so I decided not to switch insurance companies. Of course, it was more complicated than that. After getting pregnant, I met a midwife that I liked, but her billing service said that she would be considered out of network and that because our plan was a PPO it was unlikely that we would be able to get her covered as in-network. It would end up being about $3200 out of pocket instead of about $1100. I prepared for a fight since there are no in-network homebirth midwives on our plan, but after a little more digging found that there is a nearby birth center that is in network, and the midwives there will also attend homebirths and are able to bill through the birth center and get it covered in-network!

Just an idea for anyone who's unsure of what to try next...

Also, keep in mind that our hospital birth (completely uncomplicated, no meds) that was "covered" still ended up costing us about $2500 out of pocket, so the expense might not be as different as you think.

[AtomHeartMother]

depending on your household income, i would strongly suggest applying for pregnancy medicaid if you're insurance isn't covering your desire to have a home birth or if you don't have maternity coverage. florida medicaid will pay for a midwife (lm or cnm), whether in a birthing center or at home. as long as the midwife you've chosen will accept the medicaid, you'll be good to go. if you're approved for the program, your medicaid counselor/"momcare adviser" will be able to refer you to local midwives that'll accept the medicaid and are certified by the state to do so. i work as a "momcare adviser" and refer women to our local midwifery all the time (i'm also a client and pregnancy medicaid recipient). if anyone has questions about this, i'm happy to answer anything off list. :)