Where to start?

[babymango]

I am newly pregnant with my second kid. I'm also new to this country (well, new-ish, we've been here a couple months) and my head is spinning right now with all the things to figure out. Im not used to this private health care thing and I don't know where to start.
I have a nice GP who does do delivery, my care would be covered 100% with him, but because im due between christmas and new year, he would likely not be at the birth. He works solo, so I would end up with an obstetrician I have never met before. That makes me a little nervous because Im more the midwife type...
I'd like to go with a midwife, like i did for my son, but im getting mixed messages from my insurance company as to what would be covered and what would not.
Typically, if you go with a homebirth midwife, do her fees include the tests (pap, blood test, GBS, ultrasounds)?
Where do I even start if i want to find a midwife who does homebirth?
How can I get a straight answer as to what's covered and what's not?? Does it *have* to be a surprise after the delivery??
Does anybody know a website or a book, or something, where i can learn about private insurance? People are telling about about gatekeepers and managed care, primary clinic and such, and I don't really understand what they mean...

[karen1968]

Oh boy. It can be a maze, that's for sure.

The best way to find out what's covered is to call your insurance company. But know that many companies say they won't cover hb, but they WILL cover prenatal exams with a hb mw, if the billing is done correctly.

With our midwife, we will pay cash and hope for reimbursement. Labs, ultrasound, etc. are done through external/independent labs and ARE covered by insurance without pre-payment. Our mw has a great billing person and says most people get full coverage eventually.

One good way to find a mw in your area is to go to the Funding Your Tribe area and search the old threads or start a new one. I know the question is asked and answered a LOT in the Oregon/Washington area.

Good luck and I hope you get some answers!

[Rico'sAlice]

It might help to post this question in the finding your tribe area for the state that you live in. Different states have very different regulations regarding midwives, homebirths, insurance, etc.

Or atleast share your state and insurance company here, so someone can give you advice based on your specific circumstances.

[babymango]

Thank you ladies!
I did post in the Minnesota forum. And to answer your question Rico'sAlice, Im with Medica

Karen, your answer is encouraging. I was starting to think it would be easier/cheaper to temporarily move back home!

[Greenlea]

Please note that you may have to look for a CNM (certified nursing midwife) instead of a regular midwife. Obviously different states have different laws and I'm not sure on MN's laws. But in Illinois, where I live, it is illegal to practice midwifery. You must be a CNM, and insurance will only cover CNM's.

When I was looking for a midwife to do my homebirth with my current pregnancy, I just googled "homebirths in IL" and got a bunch of links and pages. I found some that way.

[laughingfox]

Where I live, CPMs don't generally do ultrasounds or paps. Blood tests and GBS testing vary, but generally you have to pay out of pocket for that.
Homebirth midwife fees usually include every prenatal visit, the birth, and care for mama + babe for 6(ish) weeks postpardum.
It can vary by area/midwife.

If there's a birth center near you, that's more likely to be covered by insurance. Birth centers generally have more equipment available for things like ultrasounds and paps, as well.

My homebirth midwife's fees seemed like a lot at first, but it actually was less than I would have paid out of pocket for copays and deductibles with my insurance company if I deliver in a hospital.

There's a chance that my insurance company will reimburse me, but unfortunately, they either can't or won't give me an answer beforehand, because I don't think we can bill them for the birth until after it happens.

[welsh]

I know how you feel!
I moved to the US from the UK in 2004. DH had already been there 6 wks when I arrived and he dumped a huge pile of insurance paperwork in front of me given to him by HR.
It took a really long time for me to understand!
Our insurance company had a website which showed coverage. Alternatively call them up and ask what the maternity coverage is. Or find a midwife/birth centre you like first and quiz them!
Good luck!!