Homebirth and SelectMed in Utah

[smartalec]

hey! i'm getting ready to submit to selectmed for our expenses for our upcoming homebirth and i guess i'm gearing up for a fight... i'm wondering if anyone in the area has had to do this specific task, what your course of action was, results, overall experience and if you feel there is any encouragement for little ole me . a little background: i've had 2 normal births at the birth and family place and now our awesome midwife from there does homebirths. this is our 3rd. thanks in advance!
mare

[livnanismama]

We had SelectMed with our last homebirth I believe. After we paid our deductible ($500) they paid whatever percentage it was for an out of network provider. I don't remember what it was they paid. We tried to get an in network exemption and the HR people at dh's work talked to the insurance and so did we but in the end they wouldn't allow the exemption because it wasn't a physician. This was a couple years ago though and my midwife also had a billing service and they did a lot of work with it. I'm not sure what's going on with insurance now. Asking your midwife is probably the best bet because she should know what companies regularly reimburse expenses and which ones put up a fight.

[MamaMayme]

Originally Posted by livnanismama

We had SelectMed with our last homebirth I believe. After we paid our deductible ($500) they paid whatever percentage it was for an out of network provider. I don't remember what it was they paid. We tried to get an in network exemption and the HR people at dh's work talked to the insurance and so did we but in the end they wouldn't allow the exemption because it wasn't a physician. This was a couple years ago though and my midwife also had a billing service and they did a lot of work with it. I'm not sure what's going on with insurance now. Asking your midwife is probably the best bet because she should know what companies regularly reimburse expenses and which ones put up a fight.

If you don't mind me asking... what midwife was this with? I'm pretty sure we have the same insurance and every homebirth midwife I have talked to says that SelectHealth will pay nothing and that it's not even worth submitting anything to insurance. I, myself, thought for sure they would pay the Out of Network portion as you mentioned, but everyone keeps telling me it's a no-go.

[livnanismama]

Heather Johnston was my midwife. And it's true - getting an out of network exemption was impossible. This was also a couple years ago and things could have changed! I know they try to get rid of as much coverage as they can. They ultimately ended up paying for an out of network provider after our deductible was met. I think it was only like $500. It's so worth it to submit even if you think they won't pay. I think it's good for them to see the few thousand dollars vs. the MANY thousands of dollars. Also, if you have a good HR person over the insurance sometimes they can help you.

[RoseRed]

Heather Johnston is my midwife now and she said she had a few slip by in the past but there official policy is not to pay for homebirths.

worth a shot though.