Who had their insurance end up covering their homebirth?

[mamatogirls]

My contract stated it will pay for a CNM in a hospital or approved birthing center(BCBS PPO of MI). I was wondering if anyone else had insurance that stated this and still ended up getting approval for homebirth coverage.

My midwife is a retired RN and her current title is Women's Health Care Nurse Practitioner. Is there any way I can get my insurance to cover my prenatal visits at the very least(She does have an office). I have sent one prenatal bill in but still haven't heard anything.

[thebigfam]

I have VA insurance and they had no idea what I was talking about and I got them to pay for prenatals but not for the birth itself. They told me no at first then I asked for their policy in writing and they didn't have one so then they approved it.

Big Momma

[firewoman]

My policy doesn't have anything about homebirth coverage or coverage with a CPM, but I was still able to get it covered. You can read the thread I started yesterday about how I go them to cover me.

http://www.mothering.com/discussions....php?t=1174559

I think it also depends on the state you are in and the laws surrounding midwifery. If you live in a state that licenses CPM's I would fight tooth and nail to get coverage stating that a CNM at a birth center does not provide the care you are seeking because you intend to give birth at home. You may run into people that tell you no, but keep calling and you may find someone that will work to figure it out for you.

[IdentityCrisisMama]

Our insurance paid for a HB AND a hospital transfer back in California in 2001. I can't remember the details exactly but I think that the HB charge was so small and mixed in with the prenatals that they didn't really notice. I know that they were originally not willing to pay for both in the event of a transfer.

[eternamariposa]

I was very happy when my insurance, united health care, just sent me the letter saying that they would allow my midwife to be granted an in network exemption allowing her to be covered as an OB would be. We had to file an request for the exemption, which they denied, and then an appeal to the request in which we sited the florida statutes that supported my option to choose the method and setting I birth in. I also had to call every OB that was in network within a twenty mile radius to confirm that there were not comparable services available in network.

The thread that a PP linked is very helpful. There are also people who will work with your midwife as a representative on your behalf and I have heard that sometimes that third party advocate can be extra persuasive to the insurance company.

[mamatogirls]

Thanks for the replys. CPMs are licensed in my state however I am not sure what my midwifes exact title is because her invoice said Womens Health Care Nurse on it so I have to find out what title I should say she is. The total fee she charges is $3800 which compared to my last c-section(failed HBA2C) that was $25,000 and I was only there for 1 night, you would think they would be willing to cover the homebirth. I will definately look into fighting it.

[IdentityCrisisMama]

Yea, Mamatogirls, it's crazy that the even consider NOT paying just from a finanical perspective. My hospital transfer cost like 10 grand and I gave birth 20 minutes after I arrived / uncomplicated vaginal birth!! I think the charges from the hospital were so high that insurance just didn't even notice the little baby charge that was the MW's portion for the birth alone. (I recall that the total charge for all prenatal visits and the birth and the post birth stuff was round $3,000).

[wannathird]

i did

my first home birth was covered 80 % full payment my second i pay max 1200and they pay 100 % after that.

[Catherine12]

My insurance (Cigna) said they wouldn't cover a homebirth (like yours, they covered midwives but only in hospital/birth centers). After the birth, we had our midwife submit the claim anyway. We expected the insurance company to reject it and were planning to appeal the rejection.

To our great surprise, they actually accepted the claim and even treated it as in-network.

I don't know if they changed their policy, made a mistake, or had realized we would give them trouble if they rejected the claim (we had pestered them a few times). Since our deductible was high, it didn't cost them much to accept the claim.

[Belle]

Our insurance (UHC) said they'd cover our midwives at the out of network rate of 60%. But my midwives did some creative billing and billed for prenatal care, home visits, and newborn exams and got the ins. to pay closer to 95% of their fee. It worked out really well.