How does one afford a homebirth?

[sleepingbeauty]

I'm not pregnant yet. We're not even TTC yet but I was just thinking about this...

OH and I don't have a lot of money. (That's a bit of an understatement! hahaha) and I've been toying with the idea of a HB for baby #1 when s/he comes, assuming we've moved into someplace a little more private. We currently share a house with our landlord and his girlfriend (we're in the basement apartment). the plan right now is a BC birth. I don't want to bother them up there for hours on end! lol

If you don't mind my asking, how did you afford it? Did your insurance cover it or at least help? I hear that they only cover hospital births (no offence if you've had one but NO THANKS!). What about Birthing Centers?

Thanks in advance. We're not trying until Jan 2013 but I'm so broody that I feel like I need to do as much preparing right this second as possible! lol I think I'm driving OH nuts. He's so sweet for dealing with me!

[MrsMike]

Insurance coverage varies by company and by state. Here in Pa, my best friend had half of her homebirth covered by insurance. She ended up paying $1,800 out of pocket. I don't have insurance and will pay out of pocket. However, my midwife offers payment plans. I want to make a payment everytime we see her so that we don't have a large balance left by the time I give birth.

[jdg]

We are fortunate to be able to afford our upcoming homebirth. No "magic" to it - we just had enough back in savings to swing the cost, and we were willing to give up the things that money had originally been intended for. We'll be making other sacrifices (such as selling my car and going down to being a one-car household) to make some of the other financial stuff such as a nanny work for us. While some of the choices have been more painful than others, when we looked at our bills and our plans, it became obvious what the trade-offs had to be and then we had to decide which ones were worth it to us.

You aren't going to be trying for almost three years, and then most midwives allow you to the end (or near the end) of your pregnancy to pay up fully. Call around and find out what the going rates are in your area and figure out what you would have to put into savings per month to make that work. There are some big price differences in different areas - here it's around $2000, other places it's around $4000. Do you get money back on your taxes? Can you put that into savings towards the homebirth?

Our insurance won't cover a penny of it.

[Carrie Posey]

Check in with your insurance, mine was covered. I think we paid a few hundred out of pocket, it would have been a lot more if we'd gone to the hospital.

[smeisnotapirate]

I couldn't afford to NOT have a homebirth, honestly. I'm one of those people who works and gets no benefits from my employer, and also makes too much to qualify for insurance help, so my choice was a $3700 homebirth or $6k-ish hospital birth. We paid $17k out of pocket for DS's birth in the hospital in 2008 (birth center fees + transfer to hospital for c-section).

No contest there, for me.

My CPM is great at working out payment plans or even bartering if need be. Just find a MW who is willing to work with you.

[AAK]

My hb was partially covered by insurance. My mw was not a "preferred provider" so she was only covered 50% instead of 80%. However, my mw had taken lots of classes on billing insurance. And she went crazy! LOL. Actually though, she expected to receive $2500 for the prenatal care/birth/postpartum care. She billed whatever she could for the insurance, and I just made up the difference. Apparently, you are allowed to line item billing for loads of things that my mw thought should be "all inclusive". So, I ended up paying about $1000 out of pocket for my hb. I paid a bit more for my mw attended hospital birth a few years earlier ($1500). If I didn't have insurance for either, my hb would have been WAY less expensive than the hospital.

Amy

[StrawberryFields]

My insurance doesn't cover homebirth, but my homebirths were pretty much the same as my deductible/out-of-pocket costs for a covered hospital birth.

[mrsgrasty]

my insurance is supposedly covering the midwife, but not her assistant. though she's had problems before about the insurance saying they'll pay, and then not. so we are paying $800 on a pmt plan for the assistant, and we told her we would pay her what insurance would pay her if they end up not covering it. that would be another $1200 in addition to initial $800. we can't afford it, but we can make it work with a pmt plan.

if i had planned a hospital birth, it literally wouldn't cost a dime through our insurance. so its a risk. but to me it is worth it. i've made it work in the past when i've had hospital bills or credit cards to pay, and i can make it work with something as important as homebirth. so we will work it out if it comes to that.

[emnic77]

Tax refund money (we usually don't get much back but we bought a house last year and have the first time buyers credit coming to us). If we didn't have that, we would've started saving for it early last year after we bought the house (before that, every red cent was being saved for the downpayment) OR actually put off getting pregnant for a few more months.

As it turns out, we weren't going to get our taxes done in time and we have home improvement projects we want to spend that money on as well as padding our savings account, so we decided to take out a small loan from my 401k. It's just enough to cover my midwife, and I'm paying it back very aggressively with very little fee/interest penalty, so it was a no-brainer. Especially since DS starts kindergarten this year, which will save us $600-700 a month in preschool fees, I can pay off the 401k loan in just a few weeks.

And it was either homebirth or unassisted for me, even though I'd pay just a $20 copay for another hospital birth. There was just no possible way I am giving birth in a hospital again unless it is a life or death situation.

Our total for our homebirth midwife is $3500, standard around here, and we hope maybe to get some of that reimbursed through some insurance finagling, but we're not counting on it. She has been worth every single cent and more.

[Marilyn82]

Tax returns!!! I'm fortunate that I live in Oregon and can get it covered with the State medicaid coverage (very, VERY lucky) but if you do not have insurance I would highly recommend having them take out a little extra from your paychecks in hopes of getting a bigger refund at the end of the year. Especially if you are planning to TTC soon.

Other people make payment arrangements with their midwives and I know *some* midwives will take extended payment plans and/or partially or fully barter on an individual/case by case basis.

One thing to keep in mind is if you are checking if your insurance will cover a homebirth, do not ask "will you cover homebirth" ask if they cover a Licensed MW (depending on your state) Or CNM services etc.

[Pyrodjm]

I see you are in NY. Getting homebirth covered here is not hard at all. I believe insurance companies in NY have to cover it, even Medicaid. I live in NYC and simply contacted a few local HB midwives and picked the one I liked. She copied down my insurance info during a prenatal visit and her billing person did the rest. They submitted a claim to my insurance company after the birth and I never had to do anything. I know several people that have had homebirths in NY, everyone had it covered by their insurance.

[sleepingbeauty]

Thanks for taking the time to tell me your stories guys! I really do appreciate it.

I'm really happy to hear about the rules in NY! I wonder how the new health set-up will affect other states....

[To-Fu]

My first home birth was on a sliding scale and my second is covered by insurance (for the most part).

The one we paid for on a sliding scale was financed gradually, and she was even open to doing bartering! Ask around, you might be surprised how willing some HB MWs are to work with you on the money aspect to help you get the birth you want/deserve.

[Magelet]

we're already saving and we're not even officially engaged yet. Seriously. My entire tax refund (all 300 dollars) is going straight into a fund earmarked "babies/midwife/ppdoula". We'll save and save and if need be hope to find a midwife with a payment plan or something if we can't save fast enough.

[dannic]

We dont have insurance and have paid for all our births out of pocket--hb is cheapest, but I had 2 bc births before that. We're spread pretty thin this time around as we've lost about 60% of our income the past couple of years, but we are still-barely_being able to make to fees. We've given up eating out, netflix, texting, ect to help afford this. It's actually been really good for our family. Many mw's are willing to help you figure out a payment plan or have discounts for cash/early pay. GL!

[Baby_Cakes]

Insurance did cover a chunk of DD's birth, but we did have to pay the entire fee up front first, which was $6500. Our midwife let us pay in 3 installments, which definitely helped. Always discuss payment plans, etc, with you midwife but more than likely they will only require the last payment after the birth (and may even give you a year or something to pay that last bit).

[ghuaghua]

Our first home birth we used our tax return, and for the second one we saved up. Our insurance would not cover either, but as others have said, a home birth was cheaper than the out of pocket costs of our previous c-section/hospital birth.

[bclare]

We saved $100 / week and paid our $3600 by 32 weeks-- but I will say that here in Maryland there is one CNM who accepts medicaid for homebirths and a lot of my friends have used her. We hope to get at least half reimbursed but won't know until baby arrives!

[etsdtm99]

where i am, HB is much cheaper than other parts of the country ($1500 + $150-250 for the back up OB visits) ..it is less than what i paid WITH insurance for my hospital births... when we had our first we didn't have any idea how much it would cost for hospital bills and set aside about 3-4k to cover it..

you have SO much time, is there anyway you could put aside 30-40$ a week? you would probably have enough by the time you wanted to TTC, a little less and you could continue setting aside money during pregnancy .. its always good to have a savings account either way, and if you have a goal as important as homebirth you'd be more likely to keep up with it

[TabithaB]

No insurance

I don't have insurance so this is going to be WAY less expensive for me. The OB/GYN's either won't take private pay or they want $7,000 for a global fee ($3K deposit) before they will even see me. (that doesn't include any labs) and another $7K-10K for the hospital expenses. and that is if there are no complications.

So the $2-$3K for the midwife is a deal breaker for me. It shouldn't cost $17,000 to bring a child into this world.