How to get HB covered?

[mauraa629]

I would really like to at least attempt a HB next time around, checked with my insurance if they cover homebirth. The woman I spoke to at insurance company said that they did cover midwife services, which I already knew because I've used one before but didn't say anything about the birth having to be in a hospital, an hour later she called me back and said that they would only cover midwife who worked in a "facility". I don't understand why it matters where the midwife works, if they cover a midwife I would think they would cover her services no matter where she worked. Have any of you been told this? Is there anyway around this? Could I just have the midwife do the homebirth and submit bill to the insurance without it saying where the baby was born? It really annoys me that we pay for insurance but they get to decide where I can have my baby.

[DirtRoadMama]

I found a midwife, who does home births, who also is a provider under my insurance. She called the insurance people, and confirmed that she is a provider, and she confirmed what my maternity benefits are. She never asked them if they cover an out-of-hospital birth. I'm going to ask her about how she will bill them, but I assume she is just not going to mention the location. My appointment is on Friday. I'll come back and let you know what she says!

[DirtRoadMama]

Ok, I spoke with my midwife about how she handles the billing. Apparently, she does a universal charge after the birth. On that form, she has a code that indicates the baby was born out of the office. She has, however, billed through my insurance company before (it is a nationwide plan, but claims are processed locally, and by State), so she knows that they pay, even though they won't explicitly TELL you that they pay.

My midwife is a preferred provider under my plan, so if I go to her, and she bills for allowable services (which my plan just blanket statements that it pays for maternity care, and the stipulations for how much they pay based upon who the provider is), then they pay her.

I asked her what would happen if they decide to not pay her. She shrugged and said then she wouldn't get paid. It's sticky, to be sure. I'd ask your midwife what her policy is if the insurance company won't pay.