BCBS NJ Homebith coverage

[Olake]

Does anyone have experience in NJ BCBS Essential EPO Plus plan and Homebirth coverage?
Please any advise I will apprutiate. I would like to have a homebirth, but all midwifes are out of network who do homebirths. I am afraid that I can not afford it if my insurance does not cover any of it.

[Defenestrator]

The insurance biller I work with will verify benefits for a $20 fee and try to get you an in-network exception. If you do this, you will have a little bit more information about what kind of reimbursement you are likely to receive.

Visit midwifebilling.com. She's fast -- usually answers in 1-2 days.

[Olake]

Thanks. I will try it right now.

[engineer_mom]

I have NJ BCBS federal and I got them to pay last time with an in-network exception. I started by calling the customer service line and asking for them to find me an in-network MW who performs HB. They gave me hospital MWs, I told them they didn't do HB. And after several phone calls they sent my case somewhere else. And eventually I ended up with some office who negotiated with my MW.
The details are fuzzy now. And I just tried that route again and was told they don't have that sort of thing. LOL But I've already done it, so I know it isn't true.
And my MW has done this a couple of times with BCBS this year.

I'm not sure if you live near NY, but there are some in-network MW's over the border aways.

[SpuglyRoo]

May I ask what midwives you are using? I also have NJ BCBS (HMO) and ended up paying out of pocket for my last HB because I didn't have the energy to deal with it, but we just bought a house and can't afford a home birth if we have to pay for it. I've called every midwife on our insurance in a 25 mile radius and none do home births. Do you think I might have to go further before insurance might grant an exception?

[tvantol]

I live in MN, but have BCBS NJ through DH's job. I got them to cover my acupuncture appts through a similar method mentioned namely there was no provider in a 30 mile radius. I will have to investigate that avenue. This method requires calling for a pre-authorization correct? I read recently not to contact your insurance until the birth is complete as not to put them on alert. Hummm...what to do?