Blue Cross of MN does not cover hb

[Ila]

I just called the insurance company and was told that Blue Cross of MN does not cover hb. I am so so disappointed.

[NaturalNixi]

They wouldn't cover it for me either. My plan only covers 70% of labor and delivery and NO prenatal visits. So having a homebirth with a midwife was cheaper anyway.

[CallMeMommy]

Ditto - my insurance (through Mayo Clinic) only covers 80% of maternity AFTER a $1500 deductible and NO prenatals. Seriously?! You think them of all people would know the benefits long-term associated with providing prenatal care! DH freaked at the midwife fee at first until I reminded him the prenatals alone would probably cost that much if I went to an OB.

[lindsayjean]

MN medical assistance doesn't either

But I'm having one anyway My midwife was soooo accommodating about payment plans and a reduced rate for low income. *LOVE*

[Mama~Love]

Medica doesn't either, and I had a HB. Paid out-of-pocket for it though. Wasn't too much.

[Vaske]

They should still provide some coverage for prenatal care; that what most of the midwife's fee is for. MN has a statute (Chapter 62A, Section 047) that most insurers (including HMOs) must provide prenatal care coverage, with no deductible/co-insurance. But maybe that section doesn't apply to Blue Cross or medical assistance?

I have Medica, and have had HealthPartners, neither will pay for the birth itself, but HealthPartners covered my CPM as an out-of-network provider, and I expect that Medica will do the same. Though I think I had to pay the deductible and coinsurance percentage last time (?), and will have to again. I should check into this some more.

I hate this insurance stuff. I am only one step away from being a rocket scientist and I STILL have trouble understanding it. I can read English just fine, but Insurance is like a foreign language that only looks like English.

[jennyfah]

Originally Posted by Ila

I just called the insurance company and was told that Blue Cross of MN does not cover hb. I am so so disappointed.

Yeah, that's what they told me, too. Then they paid 70%.

Submit, re-submit, and write letters if you have to! Don't give up. Does your midwife use a billing service? That helps a ton. Is she a CNM, CPM, or direct-entry? *Sometimes* CNMs and CPMs have better luck getting things through. It really just seems to depend on how the bills are coded.

Remember, insurance companies tell their reps to deny as much as possible so they pay as little as possible. They hope that you will not submit your claims. But with the right coding, it's amazing how much stuff can get covered. (This is my personal experience with BC/BS of MN.) Seriously, when I called to ask about HB coverage, they LAUGHED at me. Nice.

Jen

[Ceili]

We have a $5000 deductible per person, so my homebirth ends up being cheaper for us whether they cover it or not.

[chi_mama]

our insurance covers home-birth... in theory since they don't cover any of the home-birth midwives in the entire state!

still, we're in the same situation as others were the hb fee isn't significantly different than our out-of-pocket costs for a "covered" birth.

actually, it may even be less b/c we will have a lot less intervention this time than last. I had 3 u/s last time to determine positioning... my mw assures me she can do that with her hands

[Ila]

Jennifah

Hi Jennyfah (sorry i misspelled your name in the title):

I submitted a question through the message center on the BCBS of MN site but never received a reply (which they say would come in 1 to 2 business days). So I called and a the first customer rep I talked to (a man) hung up on me after hearing my question! The next one I talked to was a woman and she told me that hb will not be covered.

I have decided to go with the hospital birth, since this way, they pay for everything after the deductible. I called the midwife, a licensed NYS CNM to let her know. (Her fee was $6000 for the entire prenatal, 2 postnatal visits and delivery).

I am going to St. Mary's in Troy, NY with a midwife there. Their brochure says they offer waterbirths. I think I will get a doula and prepare myself thoroughly with all the natural means possible (exercise, drinking red raspberry leaf tea, perineal massage, primrose oil capsules, etc..) I also want to take the placenta with me and not have them dispose of it in the hospital. So I am taking a notebook along for my next midwife visit.

This forum is so great. I am reading it everyday.

[MidwifeErika]

I would really recommend NOT asking an insurance company if they cover "homebirth." Instead, ask them if they cover your individual midwife. They may cover it as out-of-network or they still may not cover it at all, but I would bet that more people would get covered if they weren't asking for homebirth as a specific to be covered. Even if they don't cover the birth, they may cover prenatals or lab work or the newborn nursing care..... bits and pieces that may end up adding up to enough of a fee that it covers almost the entire fee anyhow.

[jennyfah]

Originally Posted by Ila

I called and a the first customer rep I talked to (a man) hung up on me after hearing my question! The next one I talked to was a woman and she told me that hb will not be covered.

That is appalling! That kind of "customer service" is abusive and disgusting. You should write a letter and complain, at least. Customer service for an insurance company should be far more professional than that!!! :

When BC/BS (and I think the BS stands for bull****, IMO!) says that they do not cover homebirth, it's true; they don't pay for the actual birth, but they pay anything that's coded for maternity care (prenatal/postnatal) and usually other things as well. When you spoke with the homebirth CNM, did she say that she's been well reimbursed by BC/BS of MN? I'm just curious, because I know several people who have had a good portion of their homebirths covered. Computerized codes for maternity service are all the same.

Best wishes for a beautiful birth, no matter where it is!

Jen

[Talula Fairie]

There are only a handful of insurance companies that will cover all -or, usually, even just a portion- of homebirth. You're not alone.

[MidwifeErika]

Originally Posted by Talula Fairie

There are only a handful of insurance companies that will cover all -or, usually, even just a portion- of homebirth. You're not alone.

But, there are tons of them who claim to not cover homebirth and yet when they are billed for one they pay enough to really make the billing worth while.

[Talula Fairie]

Originally Posted by hotwings640

But, there are tons of them who claim to not cover homebirth and yet when they are billed for one they pay enough to really make the billing worth while.

I know that, actually. I was actually going to mention that sometimes you can get things covered with clever billing. But that's harder to do and doesn't work in every case. In my case, I have Kaiser and they are a whole other ball of wax. I'm paying for my homebirth, every cent It'll be worth it though!

[jennyfah]

Originally Posted by Talula Fairie

I'm paying for my homebirth, every cent It'll be worth it though!

You bet it will!

Someone on this board said once (I hope I'm not misquoting here) that 'most people would think nothing of paying for a vacation that costs a few thousand dollars---saving up for it, even putting some of it on a credit card. And a birth is so much more memorable than any vacation you'll ever take!'

I know how hard it is to write that check for the HB midwife (and in our case not knowing if anything would be reimbursed) but it was definitely some of the best money we've ever spent. I also know that it is not realistic for all families to pay and not be reimbursed, and it makes me so sad that the stupid insurance companies dictate where people birth. OK, I'm off my soapbox now.

Best wishes and awesome birth vibes to all the mamas here!

:

Jen

[sunflowergirll]

Aetna?

Anyone have any experience with Aetna in MN?

[Turquesa]

OP, don't give up yet!

http://www.gentlebirth.org/archives/CFMInsurance.html

[Ila]

Thanks!

Thanks to everyone for all your answers and support and the examples/stories you gave.

I do agree, hb would be worth every penny but it does cost more than I can afford right now. I have never taken a vacation that costs thousands of dollars. And thank God, last year my husband and I paid off all our credit card debt and our cars. We're debt free (except for the mortgage).

The hb mw I contacted recommended I get the prenatal care at the hospital (at least early stages), so I don’t think I can submit a claim from her for more prenatal care. She also recommended some genetic testing, which I decided not to do. I like her and she has given me advice even though she won’t be attending me.

The mw at the hospital seems nice also, although I have not asked their policy on interventions, etc. They do have a Jacuzzi in the room and I’ll ask about the waterbirth they mention on their brochure. I am just going to go there absolutely prepared for a natural birth. I am going to a chiro, ordering Hynobabies and researching like crazy. It would be nice if I had a short labor and managed to birth at home before I need to go to the hospital. I will get a birthing kit at home just in case. That would be so great. My husband is very supportive and I know I can do this naturally.

I don’t hold anything against the insurance company reps since they are told what to say. I was told that the reason they don’t cover hb was because of Obstretics (or some such organization) guidelines. I won’t stress out over this, although it is unfair.

The other night, during my regular nocturnal snacking, I felt my baby move for the first time. I felt a lump in the front of my uterus and when I put my hand on it, it moved. I felt that four times. I was so touched and so awed. Last night, nothing. Maybe he/she was sleeping.

I am very happy and positive now and perhaps may even have a homebirth, unassisted. In all things, after all my preparations, I trust in God.

Thanks for the good wishes. I’m so happy to have found this forum and never tire of reading. God bless you all for being so generous with your time to share your experiences, your courage and kindness.

[CT Mommy]

This discussion couldn't be more timely. We just moved to MN, so this has been overwhelming for us!

We have PatientChoice Insurance, and they cover 100% of maternity care after a $25 co-pay for the first prenatal visit. That of course is if I see an expensive OB/GYN and birth in a hospital.

They will cover 80% out-of-network prenatal visits (and, frankly, I'm assuming that's with an OB also) after the $850 deductible with a $2750 out of pocket max. Basically, we would have to cover the inexpensive homebirth almost 100% from what I understand.

They did say that they would cover MW care, if I see one in network. But, of course, they do not have a CMW directly, only a physician directory. Apparently, their MWs work UNDER an ob/gyn. So, if I want at least my prenatal to be covered, I have to work with one of them. But how do I find a good one? And are these physician practives with MWs simply just another hospital based doctor's office with a few MWs available? Do these midwives birth at home?

HELP!