Mothering › Forums › Pregnancy and Birth › Birth and Beyond › Homebirth › anyone with experience with insurance in a state where CPMs are not licensed?
New Posts  All Forums:Forum Nav:

anyone with experience with insurance in a state where CPMs are not licensed?

post #1 of 13
10/1/09 at 12:26am
Thread Starter 
i really appreciate all the info that is already on here and have searched for and read many insurance posts on here already! i am wondering if anyone has experience getting insurance to cover (or not getting insurance to cover!) their home birth if a state where CPMs are not recognized/licensed? my hope is to have a CPM come in from a neighboring state that does license CPMs and hopefully bill my insurance (anthem bcbs) but i'm worried they will say no because she's not licensed in my state (kentucky). i have heard from one woman in my town who has successfully billed insurance for the midwife i am considering but it's a different company and i just wanted to see if anyone else has had success like she did. thanks in advance!!!!!!!!!!!
Reply
Reply
post #2 of 13
10/1/09 at 2:15am
I'm in Maryland and CNMs are the only out-of-birth attendants recognized. I had a CPM and she was still able to bill my insurance, they paid her as an out-of-network provider with no problems. Usually you midwife will have a decent idea of if they'll pay or not. My mw was already in their system (carefirst/bcbs).

Good luck!
Reply
Reply
post #3 of 13
10/1/09 at 9:07am
Not trying to hi-jack and thought this might also benefit the op so I'm going to ask.
Even if insurance doesn't reimburse, can't one declare mw expenses as medical expenses on taxes? That is, provided one has a receipt for the payment in full. Then wouldn't that be part of a tax refund?
Reply
Reply
post #4 of 13
10/1/09 at 10:52am
I was not able to get direct payment for my mw from my insurance, but I was able to submit claims for all of her prenantal visits, and I just happened to exclude the birth. So I did not submit a claim for the whole mw fee, but I was able to get a 1/3 back, which is better than nothing.

You can pay CPMs from your flexible medical spending account, to my knowledge, and it would qualify as a medical expense for tax purposed.
Reply
Reply
post #5 of 13
10/1/09 at 12:45pm
Also in MD where CPM's are "illegal." My CPM was reimbursed by bcbs PPO.
Reply
Reply
post #6 of 13
10/1/09 at 1:02pm
I'm in MD also and my insurance (OneNetPPO/Alliance) covered my CPM as an out of network provider. I'm paying my share with a flexible spending account with no problems. Good luck with your insurance company!
Reply
Reply
post #7 of 13
10/1/09 at 2:06pm
Thread Starter 
thanks ladies. this is really helpful. it seems like people have a lot more luck than i expected! this gives me hope. i know the thing to do is to call my insurance company but i'm expecting it to take forever and to be frustrating. lol. i'm actually not even pregnant yet but TTC and i wanted to plan ahead. i delivered my son in a hospital, attended by a midwife, and it was great. but we moved and the hospital here is not mom/baby friendly imo. the hospital where i had my son, you didn't have to get monitored on EFM, and they allow waterbirth. the hospital here, they pretty much want you in bed the whole time and no water! no thanks! lol. there is a "good" hospital an hour from here (EFM for 15 minutes, allowed to labor in water, but no water birth allowed) but i prefer home!!!!!!!!! i am optimistic things will work out ! please keep em coming though if anyone else has experience
Reply
Reply
post #8 of 13
10/1/09 at 10:17pm
I'm in NC (only CNMs are licensed here), and my midwife asks to be paid in cash so there is no record.

She does give us a receipt, so we still may be able to declare it as medical expense for our taxes, at least.

I hope you have luck with your insurance!!!
Reply
Reply
post #9 of 13
10/2/09 at 2:27pm
wow, amazing insurance companies don't take the easy way out and say, nope we operate by state and the state doesn't recognize your care provider, so neither will we. those of you in MD, i can't wait to tell my friend there - she did her prenatal care and labor w/the only bc in the state and did NOT like her care... if she's willing to HB next time, this is great info for her.

aldente, i'm in NC too, and will be using my HSA to pay (in cash) my cpm and traditional midwife, who are going to write a receipt as well. b/c it's a federal program, it bypasses the state.
Reply
Reply
post #10 of 13
10/3/09 at 5:14pm
The Anthem policy KY is that services by unlicensed providers of any type are not a covered benefit :-( It stinks that your state refuses to license the midwives. I don't know what type of plan you have, but if you have an HRA or HSA, it might be a qualifying expense that you could pay out of your account.
Reply
Reply
post #11 of 13
10/4/09 at 2:59pm
Thread Starter 
Quote:
Originally Posted by LittleBagOfBones View Post
The Anthem policy KY is that services by unlicensed providers of any type are not a covered benefit :-( It stinks that your state refuses to license the midwives. I don't know what type of plan you have, but if you have an HRA or HSA, it might be a qualifying expense that you could pay out of your account.
wow. thanks for being the bearer of bad news. that's kind of what i expect them to tell me. but i guess i better call them anyway! thanks again
Reply
Reply
post #12 of 13
10/4/09 at 3:36pm
You should be aware that medical expenses are only tax deductible in the amount that exceeds 7.5% of your income. So it's not an automatic deduction.
Reply
Reply
post #13 of 13
10/12/09 at 4:47pm
Peace + Hope,

Thanks for the info!!!! I didn't know that was a possibility.
Reply
Reply
New Posts  All Forums:Forum Nav:
  Return Home
  Back to Forum: Homebirth
Mothering › Forums › Pregnancy and Birth › Birth and Beyond › Homebirth › anyone with experience with insurance in a state where CPMs are not licensed?