Homebirth Costs?

[FertileMertel]

For those of you who have had home birth, I have a question about inusrance. Our insurance pays 100% after our $100 deductible is met. So if we delivered at a birth center or hospital, I know everything will be completely paid for. For a homebirth, I know the midwive's services will be completely covered but what about all the supplies? Would a birthing pool be covered? What about all the other homebirth supplies? I was thinking if the midwife brought them then she could bill for them but usually isn't it the patient's responsibility to get the homebirth kit ahead of time? So many questions! I know I can get the answers from my insurance carrier, but who wants to talk to them when I can just talk to you girls first!

[wendimarie]

Our midwives were covered out of network so we did pay out of pocket and I think it was $1500 for all pre/post natal care and the birth. I bought a birth kit from the midwives that was $35 (included all the birthing supplies) and our pool was the infamous fishy pool that was about $15. The midwives worked hard at trying to code things so that we would get more covered. I could have filed for a one time in network exemption with our insurance but things got busy and I didn't do it. I am going to do it this time around with this birth.

HTH!

[Fujiko]

I think you should talk to your midwife and read your coverage policy.

When I had my daughter with a CPM (well, I ended up with OB care in a hospital at the very end, but the two things were separate, financially), my insurance was supposed to cover 60% of my midwife's services and nothing else (supplies, etc). They ended up trying to screw her our of her money by "negotiating" with her (read: "We'll only pay your this much, suck it.") What a nightmare.

Anyway, we did have to order our own birth kit, which she had arrange through a medical supply company ahead of time. It was about $100.

[Willowrose]

Definitely check w/your midwife and insurance company. Every one is different. I've had 4 homebirths, none covered up front by my insurance, although 2 reimbursed about 50%. The other 2 midwives did not accept insurance, so it was all paid out of pocket with no reimbursement.

[FertileMertel]

I checked with my insurance today and if I choose a midwife in-network (which all of the ones I would like to see are in-network), then she and the homebirth will be covered at 100% after our $100 deductible. If I choose one out-of-network I would have to pay more. Also, the midwife can bill for supplies or I can get supplies from medical supply companies covered under my insurance plan and file for durable medical equipment reimbursement.

Here is some info I found on Babycenter.com:

Will my health insurance cover a midwife's services?

Many U.S. insurance plans, including Medicaid, cover certified nurse-midwife services. In fact, Medicaid reimbursement for CNM care is mandatory in all 50 states, and more than half the states require other insurance plans (including HMOs) that provide coverage for pregnancy to allow women to choose a nurse-midwife as their pregnancy care provider.

[Mommy2Austin]

I was on Medicaid for my last birth and all I paid for was my birthkit and a liner for their birthpool. Maybe a grand total of $50.

I have insurance now (BCBSFL PPO) and from looking at the plan benefits it covers 80% after deductible. I'm not sure if I've met my deductible this year or not, but I'm probably close. I'm probably looking at $500-$1000 OOP.

[Mommy2Austin]

I thought I would add that prices vary depending on where you live, but from what I've seen it can range from $1000 up to $9000 depending on where you live but thats usually a pitance of the amount it would cost for a hospital birth (not counting OB care pre and post natal.)

From the standpoint of not having any insurance, a homebirth (or birth center birth with midwives) is cheaper (and of course better care) than a hospital birth.

[annettemarie]

Moving to the Homebirth forum

[nashvillemidwife]

Originally Posted by FertileMertel

What about all the other homebirth supplies? I was thinking if the midwife brought them then she could bill for them but usually isn't it the patient's responsibility to get the homebirth kit ahead of time?

No, it varies. For example, I supply everything that's medically necessary and have the client pick up things that are for their comfort or to protect their furnishings, all which can be picked up at the local drug store. Some midwives make clients special order a custom kit. Your midwife is the only person who can tell you how she handles supplies. Have you asked her?

[FertileMertel]

Originally Posted by nashvillemidwife

No, it varies. For example, I supply everything that's medically necessary and have the client pick up things that are for their comfort or to protect their furnishings, all which can be picked up at the local drug store. Some midwives make clients special order a custom kit. Your midwife is the only person who can tell you how she handles supplies. Have you asked her?

I did just speak with my new midwife. She gets a discount through a supply companny and for the birth kit she create herself, a towel service she provides for the birth, and the birth pool (she already owns all the pumps and hoses, etc.), it will only be $160 out-of-pocket. My insurance will cover everything else. She also always brings a birth assistant but pays the asst. out of her own commision so there won't be any other charges. I was very happy with that. She said if I went through the only free standing birth center around here, they provide their own birth asst. that the insurance won't pay for which would cost $250.

[averlee]

I was told, no medical insurance company will cover midwife fees for a homebirth. Medical insurance will only cover things that happen in clinics, hospitals, and doctor's offices, or services provided under a physician.

My medical insurance payed 80% of the costs of the MEDICAL care I received- labwork, etc. But the midwife fees? No way.

My midwives charges $2,000 for pre-natal, postpartum, newborn care, & the birth. This did not include any supplies, but did include the back-up midwife who came to give me stitches after the birth, and I was not charged for suture supplies or lidocaine.

[Mommy2Austin]

Originally Posted by averlee

I was told, no medical insurance company will cover midwife fees for a homebirth. Medical insurance will only cover things that happen in clinics, hospitals, and doctor's offices, or services provided under a physician.

My medical insurance payed 80% of the costs of the MEDICAL care I received- labwork, etc. But the midwife fees? No way.

My midwives charges $2,000 for pre-natal, postpartum, newborn care, & the birth. This did not include any supplies, but did include the back-up midwife who came to give me stitches after the birth, and I was not charged for suture supplies or lidocaine.

I'm thankful Florida law says that medical insurance companies in Florida must cover midwifery at the same level as OBGYN care

[nashvillemidwife]

Originally Posted by averlee

I was told, no medical insurance company will cover midwife fees for a homebirth. Medical insurance will only cover things that happen in clinics, hospitals, and doctor's offices, or services provided under a physician.

My medical insurance payed 80% of the costs of the MEDICAL care I received- labwork, etc. But the midwife fees? No way.

Do you mean specific to your state and the legal status of midwives there? Because otherwise that's just a blatant lie. Midwives are much more likely to be paid if they are licensed, but "no medical insurance company will cover midwife fees or a homebirth" is simply not true across the board. If midwives are legal in your state you need to talk to someone else at your insurance company, or at least know they are lying to you to attempt to justify their policy.

[MidwifeErika]

Originally Posted by averlee

I was told, no medical insurance company will cover midwife fees for a homebirth. Medical insurance will only cover things that happen in clinics, hospitals, and doctor's offices, or services provided under a physician.

Lots of insurance companies pay for midwifery services provided at homebirths. Some insurance companies may not, but many do.

[averlee]

Looks like I got reamed, huh?

In the community I lived at the time, there were only 2 homebirth midwives available, who served outside the Mennonite community. They were both cash-only.

[MidwifeErika]

Originally Posted by averlee

Looks like I got reamed, huh?

In the community I lived at the time, there were only 2 homebirth midwives available, who served outside the Mennonite community. They were both cash-only.

Were you told this by the midwives or by your insurance company?

[Mommy2Austin]

Originally Posted by averlee

Looks like I got reamed, huh?

In the community I lived at the time, there were only 2 homebirth midwives available, who served outside the Mennonite community. They were both cash-only.

Aww I don't think anyone meant to ream you!! They seemed to be upset that you were told a lie.

[averlee]

I meant, by the insurance company! You nice mamas don't ream!

I am so surprised that in other states, things are SO different!

Here in California, I've never known a CNM to attend homebirths. Maybe some other California moms could offer some info? I was referred by my sister's hospital CNM to another group of CNMs, who knew two ladies who would attend a homebirth. They were actually an apprentice direct-entry midwife and her assistant.
The CNM who came to my house was technically breaking the law under her license. The OB/GYN she worked under allowed the fudging of records to omit the location of treatment for my sutures.
Similarly, my midwives technically broke the law by carrying medications like pitocin & antibiotic eye drops.

[FertileMertel]

CA Midwifery

Originally Posted by averlee

I meant, by the insurance company! You nice mamas don't ream!

I am so surprised that in other states, things are SO different!

Here in California, I've never known a CNM to attend homebirths. Maybe some other California moms could offer some info? I was referred by my sister's hospital CNM to another group of CNMs, who knew two ladies who would attend a homebirth. They were actually an apprentice direct-entry midwife and her assistant.
The CNM who came to my house was technically breaking the law under her license. The OB/GYN she worked under allowed the fudging of records to omit the location of treatment for my sutures.
Similarly, my midwives technically broke the law by carrying medications like pitocin & antibiotic eye drops.

I'm not sure where you got your information but I looked up California and midwives on the internet and I easily found a website you can look up your city and see the listing of all the midwives (including ones that do homebirth) and birth centers. Some of the midwives' sites even discuss how much insurance will typically cover for a homebirth.

http://californiamidwives.net/

It is true a midwive can only repair 1st and 2nd degree tears and do episiotomies in hospitals and birth centers. Here is the CA laws on midwifery:
http://www.socalbirth.com/pathways/midwiferylaw.html

This is also what I found:
"Status of Midwifery in California
Direct entry midwives have attended home births in California for decades. After 17 years of legislative efforts, a licensing law was passed in 1993, and licenses became available in 1997. There are now more than 100 licensed midwives practicing in the state.

California statutes regarding midwifery may be found at http://www.socalbirth.org/school/midwiferylaw.htm or http://www.leginfo.ca.gov/cgi-bin/di...file=2505-2521

California rules regarding midwifery may be found at http://ccr.oal.ca.gov/cgi-bin/om_isa...wse_Frame_Pg42

Many CNMs also practice in California; some of them attend home births."

I hope this information is helpful to you!

[nashvillemidwife]

Even when a licensed provider does not accept insurance payments, they can give you a receipt and you can file an out-of-network claim yourself. Many midwives do it this way because dealing with insurance is such a pain. I even have a doctor who does it.