Help me evaluate my options HB/Hospital Insurance coverage

[MisaGoat]

I am 12 weeks pregnant, I have 3.5 year old who was a hospital birth with and OB and an epidural. I can't say it was a bad experience but not really what I wanted.

I am currently being seen at a large ob practice (7 Drs, 1 NP and 1 CNM). I had three miscarriages between my son and this pregnancy so I had a work up done by a Reproductive Endocrinologist and they referred me to this practice.

My other options are all about an hour's drive from me:

1) 2 CNMs who deliver at a hospital an hour from me who I saw during the pregnancies that I miscarried. The CNM who was on call during my first miscarriage was very supportive and helpful and spent a lot of time talking to me on the phone while I was at home miscarrying. In-network for insurance.

2) 2 CNMs who do homebirths and also have hospital privileges at a different hospital. Out of network for insurance.

3) a group of 3 CNMs who deliver at a very natural birth friendly small hospital and who recently partnered with an established HB midwife. I know that the CNMs who deliver at the hospital are in network but I spoke with the HB midwife when I was pregnant 2 years ago and she was out of network then with a $7000 fee. I am hoping that now that she partnered with the other midwives she will be in network but I don't think she is right now.

Insurance coverage:

The OBs= in network and deliver at the hospital where I start working next month a mile from our house. I think it might even be covered 100% because I work there.

In-network midwives-80% coverage with an hour drive one way for appointments and then when I am in labor.

Out-of network HB midwives- After a $1000 deductible insurance will cover 65%.

Other thoughts:

We will be on 3 different insurance plans throughout the pregnancy due to my switching jobs.

My husband is fine with HB would rather save money but knows the OB practice isn't what I want. He is also a little concerned I won't be able to handle it.

I just imagine my home (we just bought a house in April) filled with food and friends during labor.

I work at a hospital, I don't want to be there in my off time. I think it will alter my mental attitude toward birth.

I have to go eat dinner. Thoughts and input greatly appreciated.

[etsdtm99]

so.. are the out of network homebirth midwives close? or would they come to your home for some prenatal appts?

it kind of depends on what you can afford and how much it is worth to you.. i like to save money as much as the next person, but when it comes down to it i will do what it takes to have the birth i want this time (though turns out we're actually saving money by using a not-covered by insurance midwife over an in-network OB) for me, i know that i can not have the birth i want in a hospital here, i have tried and failed twice and i know i could have done it at home..(my hospital 'choice' - i only have one choice- is not natural birth friendly at all) at this point, it is worth it to me to do what it takes.. and though my experience wasn't all that bad, i would not go back to my OB practice if they paid ME ..

[DinaAurichio]

I know money is tight for so many of us now. I think what it should come down to is what is most important to you for your birth. You know you can have a good birth in the hospital but having a home birth is so very different. I had 2 children in the hospital and the last at home ( almost 12 years ago). The difference for me was beyond words. My birth was mine, and I did it, not my midwife. I left my daughters experience so empowered; I could have done anything, you know? Please consider your options for your birth. There are Certified Professional Midwives in NJ, such as myself that offer home birth as well, but tend to be a bit more flexible with payment plans and such.
Good luck to you!
dina

[MisaGoat]

The HB midwives are also about an hour away, maybe less depending on traffic. My check-ups would be at their office.

Dina- I guess I wasn't really looking into CPMs because I was trying to get it covered by insurance. Do CPMs qualify for insurance payments in NJ? If you don't mind you can PM your fee or I can call you later this week. I've looked at your website before.

I think I am disappointed that the option I want isn't available. IE in-network HB midwives close to me. I have insurance, it seems silly that I would have to pay for the service I want out of pocket when I have insurance that covers maternity. arg. I think this is a common complaint.

This time around I feel like I could stand up for what I want better with an OB and in the hospital but I don't really want to do that. I want someone who is on the same page as me and supportive. For a while I was thinking of the OB as a "lifeguard" figure, just there to watch and intervene if necessary. Even if that would work out I want more than that. I want someone be there for me and help guide me in my choices throughout the pregnancy that I can trust.

I think basically I've decided that I am switching out of the OB practice. I'll make some calls this week and hopefully have the details of my husband's insurance plan that we'll start on in June so I can make a decision on where to go. I wish it didn't require driving so much but I'd rather drive than stay at the OB practice.

[Galatea]

I'd do the in-network, hour drive CNMs. That's basically what I've decided for me - though we had a great HB with DC3, I am too cheap to shell out for it this time, and the CNM birthing center that my insurance will pay for is great, just 45 minutes away. I'll just leave when labor starts.

[mbhf]

Personally, I would go for the homebirth. I have military insurance and a hospital birth would be paid for 100% but it is worth every penny I have spent out of pocket (over $10,000 for my 3 previous homebirths and this one coming up in September, two partially paid by insurance two totally out of pocket) to have my babies at home.

[lunarlady]

I'm paying most of my HB out of pocket because I don't have good insurance. I see birth as a once in a lifetime experience. And I would rather have the birth I want than a pricy vacation or other expensive item. So this year's tax return was carefully squirrled toward the birth, and I've made other cuts to our usual expenses to make it work.

I know that HB is expensive, but if insurance covers part after deducable, than that sounds like a good option for you. You might manage to get and out-of-network wavier if you can prove there are no in network HB midwifes within a reasonable distance. (This lowers your cost.)