Insurance questions

[wembles]

Hi all!  I am currently navigating the insurance mess trying to determine if we might be able to get our planned upcoming home birth covered.  I was reading through the benefits booklet and noted this clause:

"Home health care benefits are available for up to 120 visits per Plan Year, as long as:

-the care is provided by a home health care agency, and

-a home health care program is established.

Four hours of home health aide care count as one visit.  Each visit by other members of the home health care team counts as one visit.  No benefits are paid for custodial care or for care that is not considered medically necessary."

Should I assume that home birth would not be covered as it is not a service provided by a home health care agency?  

All home health care has to be pre-certified on our plan.  I am unsure if home birth is even categorized under the home health umbrella.  I want to have all my ducks in a row before I call them (Empire Blue Cross, if that helps anyone!), so I am checking here first.  Thanks for any help you might be able to give!  I'm happy to answer any other questions you might have about our plan...

[averlee]

The "home health care agency" is probably not the area of your insurance that will cover the homebirth. Home health care agencies tend to do the care that includes housekeeping, transportation to doctor appointments and pharmacies, food prep, help with bathing and dressing, etc., especially for elderly people who are recovering from surgery. 

Some BC/BS insurance systems are set up to pay any CNM who accepts your insurance, no matter what the location for the service. And then some blue cross policies have it tucked under "reimbursable if not direct billed" type items.

Good luck!