Question for Mamas who have had their homebirth covered by insurance

[martine03]

I'm currently 25 weeks pregnant and planning a homebirth with a Licensed Midwife in January. I have Anthem Blue Cross PPO and got the great advice to start calling them now for approval for an "out of network referral" to cover my midwife services/homebirth and to be very persistant with them! Well I did this and finally got my request put in, then got an approval letter in the mail stating my request to recieve services from this provider has been approved. I'm super excited about this, but I did notice that they included "dates of service" on the letter which is a 90 day period, 9/15/11-12/15/11. Now I'm confused. They know this is for maternity care which is obviouly much longer than 90 days and I'm not even due until January 13, not to mention post partum care. So my question is this, for those of you who have also gotten approval, did your approval also have a 90 day dates of service on it? I'm just hoping they wouldn't try to only cover a 90 day period of my maternity care with her! Thank you in advance for any wisdom you can give me!

[Lynann]

I have Anthem BCBS PPO and got approval for my CNM. You need to call them back and ask them to extend your coverage. They will probably initially give you until your due date, then just before then you call back to extend for the postpartum care.

I was initially approved for one visit, called back and eventually got to speak to one of the nurses in the department that deals with these requests (ask to speak to a nurse when you get through to the call center) and she extended my approval to 9 visits and up to my due date. She then said that I would need to call back after the 8th visit to extend cover and dates, and she gave me another phone number that isn't on my card to get directly through to her department. When I called back using the number the nurse gave me they didn't hesitate to extend my coverage to 8 weeks past my EDD and extended to 20 visits. I just had my baby 4 weeks ago so I haven't seen the final statement yet to see how much they actually cover (should be 100% minus co-pays and $250 deductible) so I'm really hoping to get a refund on some of the money we paid to the CNM upfront, as insurance should cover everything but about $500, and we paid her $1000. She did say she would refund any money that the insurance covers.

Be persistent, and make sure you get to speak to a nurse, not just a call center person who has no approval authority.

Good Luck with your home birth.

[ebegreen]

I had success with Anthem BCBS covering my homebirth 100%. We paid nothing out of pocket.  Like you I called to request approval for out of network provider. I spoke to a nurse who was very nice and I was given a direct phone number to contact them if I had any questions.

My midwife uses a billing service so the billing service handled submitting the paperwork to the insurance.

I think if you are able to speak to a nurse they should have no problem extending it to cover your due date as well as postpardum care.

Good luck!