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Homebirth costs

post #1 of 22
6/30/09 at 4:27pm
Thread Starter 
It is starting to look super likely that we will be moving for DH to work in Bethesda. I would become a SAHM and so our income would dramatically drop. I am trying to use the time I would have left working to pay off bills and save for a few things that I would like to do in the future. One of those things would be a homebirth.

Could you guys give me an idea of how much homebirth rates are for that area? I am assuming the CPM and CNM rates may differ so I would like to know about those as well as birth center rates (just to cover all my bases).

Thanks!

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post #2 of 22
6/30/09 at 6:29pm
Most CPM's in the area are around 2K. Most CNM's are around 4K. Someone else will have to pipe in about the birth centers.
post #3 of 22
7/1/09 at 6:56am
My understanding is that the homebirth CNMs are around $4000 (plus birth assistant), and CPMs are more like $3000. However, many of them can accept your insurance, even if it only partially covers it. And, if you don't have insurance and money is very tight, I know they (some of them) will work with you. Insurance definitely covers the birth centers around here. I think Birthcare (birthcenter) is around $4000, but the other birthcenters (DCBC and Special Beginnings) are more expensive, but take most insurance.
post #4 of 22
7/1/09 at 9:09am
Ditto. Those are the full costs, but at times insurance will cover part of the fee.
post #5 of 22
7/1/09 at 9:23am
Regarding insurance paying some of the fee -- I've been dealing with this lately and have learned that in most cases, if you call your insurance company and ask if home birth with an out of network provider is covered, they will say no. But if your midwife just submits an invoice for the costs to the insurance company and doesn't mention that the services were provided at home, insurance companies will usually cover it because they have no idea that it was at home. I have heard of women with CPMs having their costs covered this way, as well as women with CNMs. So it's hard to know in advance whether insurance will cover, but they often will. As far as I understand it though, HMOs rarely will cover it because most home birth providers are out of network (some birth centers may be in network for HMOs though ... I think BirthCare used to be in network for some?), but PPOs will often pay 60% to 80% for an out of network provider. Good luck!
post #6 of 22
7/1/09 at 10:51am
I paid $1800 to a CPM that covered everything. Prenatal, birth, assistants at the birth and after-birth care.
post #7 of 22
7/1/09 at 4:42pm
I just called a number of CNMs. They charged a little under $4000, with a several hundred dollar discount if you paid by 32 weeks. Several said that their patients had had good luck getting coverage for the whole thing, and others said that just the prenatal care was covered.
post #8 of 22
7/1/09 at 5:51pm
Some CNM's also have a birth assistant fee of $5-600. This is not covered by insurance.
post #9 of 22
7/2/09 at 12:50am
Thread Starter 
Cool! I think I will budget $4000. $500-600 for labor assistant is not bad. We paid $700 for ours in CA and she was one of the cheaper ones (the more experienced was around $1300).

And we could definitely pay by 32 weeks if I already have it in a little fund for myself

I think we would be able to get insurance to pay for some of it. I guess I am figuring on also the potential of hospital transfer and then having to cover everything ourselves.

Thanks so much for the info!
post #10 of 22
7/8/09 at 4:27pm
We are using Birthcare at the birth center, but their fee is $4000 at home or at the center. Plus about $700 for the birth assistant. They are in network with our insurance and so will be covered 100%, and told us that usually the birth assistant is covered about 50% (the MW will submit the invoice for the birth assistant, who we pay in advance and then the MW will send us reimbursement for the ins portion once it arrives).
post #11 of 22
7/8/09 at 4:43pm
Mariacm - just curious what insurance you have? We have BCBS and are trying to determine if the birth assistant we use with BirthCare might be covered. I think some insurances cover it (Kaiser perhaps?) and others don't. If it's not covered, then we can use our Flex Spending Account for it, but we have to budget for it ahead of time..
post #12 of 22
7/9/09 at 4:18pm
Quote:
Originally Posted by pssimon View Post
Mariacm - just curious what insurance you have? We have BCBS and are trying to determine if the birth assistant we use with BirthCare might be covered. I think some insurances cover it (Kaiser perhaps?) and others don't. If it's not covered, then we can use our Flex Spending Account for it, but we have to budget for it ahead of time..
I have Fed BCBS. Regina told me that BCBS usually pays about $320 IIRC for the birth assistant. From what I understand, that you choose (I gather everyone chooses from BirthCare's list) and then contract and pay the birth ass directly. Then when they bill for your birth and prenatal care, they also bill for the birth assistant. They get paid, then send you the portion that was for the birth assistant. I have to confirm that with the front desk staff at some point, but it made sense. I think of it like them billing for a nurse - but since not all ins covers it, they have you pay up front and get back for your what they can.

We got preg in 2009, so didn't really budget in the Flex account for that, but it looks like when babe is born, it's a Qualifying Life Event for Flex account, and not just for ins. ie. it looks like we can add money to the 2009 flex pot after babe's birth to have enough to cover birth assistant and such (and my expensive prenatals, hopefully, too). If true, that will help bc we definitely underestimated this year's Flex expenses given the preg. Of course, it will come out in big chunks in the last couple paychecks of the year. Babe is due in Nov, so say if we want to add $400 to the Flex money, over 2 pay periods, they'll take out an extra $200 those last two paychecks.

Question for you, pssimon: Any idea if BCBS covers Bradley or other CB education classes? I couldnt' find anything on that...
post #13 of 22
7/10/09 at 9:34am
Mariacm - We were actually at BirthCare yesterday and got the same info from Leo, the insurance biller guy. I'm glad to hear this! I did ask him about the Bradley classes, or any other expenses, and he said they weren't covered.

He also said that for FSAs, you submit the whole $700 (or whatever) expense for the BA, so you're paying that pre-tax. You still get the $320 back. Bradley classes are also covered under FSA.

As far as FSAs, we haven't yet signed up for one for ourselves, but plan to in the month before birth. The FSA folks said to be sure you give yourself enough time in case the baby comes early! I'm sort of at a loss estimating how much money we should be putting aside, but I guess it'll work out in the end!
post #14 of 22
7/10/09 at 9:15pm

CPMs in MD

It is my understanding that it is ILLEGAL for CPMs to practice in MD.
Nonetheless, they will deliver, but you will have to have someone else's name on the birth certificate when the Community Health Nurse comes to your home for the postpartum visit.

I have heard less than $3K, but don't have any names for CPMs.

The CNMs can usually take insurance.

Good luck deciding mama!
post #15 of 22
7/11/09 at 12:01am
Quote:
It is my understanding that it is ILLEGAL for CPMs to practice in MD.
Which is a real shame, after my wonderful experience with them.
post #16 of 22
7/12/09 at 1:44am
FYI: you do not have to have anyone on the birth certificate listed as attending.

Also, unattended is a birth option.
post #17 of 22
7/12/09 at 11:30am
Quote:
Originally Posted by Alanamom View Post
FYI: you do not have to have anyone on the birth certificate listed as attending.

Also, unattended is a birth option.
We had an unattended birth. I spent about $30 on supplies. It was a wonderful, peaceful birth.
post #18 of 22
7/12/09 at 11:37am
My CPM was also able to bill my insurance.
post #19 of 22
7/13/09 at 2:25am
Thread Starter 
I would be on Lockheed's new plan so I am waiting to get the "fine print" to see what things will be on there. It will be through Aetna so if anyone has any experience with them, that would be nice to hear.

I will be a VBAC so I am not comfortable with an unassisted birth. I seriously doubt my husband would be since the last one scared him pretty good (which is amazing he is being so good about considering all this for future #2). I am going to need someone in my face telling me that I can do this and that things are ok and what not. My husband is not that person

How would a CPM not licensed to give care in the state be able to bill insurance? Just curious because I don't thing naturopaths are licensed in the state of MD either....

I will have to look into Birthcare.
post #20 of 22
7/13/09 at 3:28pm
Quote:
Originally Posted by Alanamom View Post
FYI: you do not have to have anyone on the birth certificate listed as attending.
: For my cpm-attended birth, I told the health nurse, "I'd rather not say" when she asked who attended the birth.

Quote:
Originally Posted by mysticmomma View Post
My CPM was also able to bill my insurance.
And :, too.

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