I have FEP and planning a Home BirthETA: I have FEP Basic, hubby works for the USDA
First, I live in IL, though the Federal program should be the same for any state since it is a Federal program and has nothing to do with the state itself.
Ok, with that said.... I too was under the impression that a home birth was not going to be a possibility unless we paid OOP. I called tons of times and I always got a different answer/response.
Finally I got one representative who was very detailed and explained everything very thoroughly. As long as the MW was Certified as a MW whether she was a CNM, CPN or even a Lay Midwife and she was a preferred in network provider (only because I have the Basic Option, otherwise I am pretty sure you can choose an out of network provider without having to jump any extra hoops) my birth would be covered, at home or at a hospital.
So, I began calling every MW in my area, and turned out that only one MW attended Home Births and she was not under my preferred provider list. So, I called again and explained the situation. I was told that I needed to file an exception of coverage to have an out of network provider be covered at 100%. To do this I had to state that there were no providers within my network and within a 75 mile radius who offered the services I "needed".
I file the exception with the same rep over the phone, she required some extra information from the MW such as tax id number, provider name, etc... 2 weeks later I had my approval letter.
We are having to pay the MW upfront for her services ($2,600) and after the birth, she will file a claim for the charges (not to exceed the $2,600, unless there is an emergency Hospital transfer). BCBS will then pay out the claim and she will reimburse us her fee once she has received the full payment from the insurance.
The only OOP expense was a one-time copay of $25 for the first visit to establish pregnancy, every other visit/exam/US/lab work is covered at 100% with FEP.