Hooray for VT moms! I live in a rural area of Washington state, with very limited access to quality healthcare of ANY kind, let alone maternity/birth care, and I am planning a home birth with a midwife and doula. The nearest birth center is about an hour and a half drive and the nearest hospital is over an hour away, so even if I wanted a hospital birth it would be kind of an ordeal just to get there (who wants to sit in a car for over an hour while in labor???). Our insurance policy states that they will cover 65% of the cost of a home birth. However, they will ONLY cover services by CNMs (not only will they not cover any services by a LM, they won't even cover CPMs), and in our state CNMs work almost exclusively in hospitals...therefore, if you need insurance to cover some of the cost, you are pretty much forced to go to either a hospital or birth center. I searched for months for midwives, birth centers, etc. and did not come across a single CNM who would do home births. So, in short, we are going to end up paying 100% of the cost our home birth out of pocket.
This policy doesn't make a lot of sense to me...the insurance company will cover 100% of a hospital birth, but only 65% of a home birth (and ONLY if your HB is attended by a CNM or OB/GYN)...home births in our state generally cost about 1/3 as much as a hospital birth, so why on earth would the insurance company not cover the less expensive option? I feel very lucky that my husband and I will be able to afford it (barely), but my heart just aches for all the mothers who out of economic necessity have their choices restricted by what the insurance company will (or will not) cover.