Turns out my Insurance is not NYS mandated so that clause won't apply to me. They are trying to go to the employer to see if they will make an exception in this case but I won't hear anything until next week...
I am planning a home birth and due in September 2013. I just had my first prenatal appointment (12 weeks) with my midwife and she said that insurance coverage shouldn't be a problem and that her insurance person will contact me. A couple days later I heard from her insurance person and there seems to be a problem.
Apparently I have Blue Cross/Blue Shield OF MASSACHUSETTS even though I live in NYS. My insurance is through my husband's job and although he works in NYC, his company's HQ is in Boston. I never even knew that I had BC/BS of MA. Apparently Mass. doesn't cover home births. I was so excited after my first prenatal appt and now I am so upset :( The insurance person told me that I need to file a grievance and ask them to look at my case with individual consideration since I live in NYS and NYS has the mandate for home births to be covered.
Cjeanjot- this sounds similar to your problem. Did you file a grievance with your insurance company? Has anyone else been in the same boat as me? I am just hoping there is some way they will cover it!!
Why does it have to be so difficult to give birth the way we want to ?!?!?
Sorry to hear this.
It does sounds a lot like my case.
I hope your insurance company will be a bit more flexible. It all depend on very specific aspects of your plan but in the end the insurance could just decide to make an exception.
Mine would not and they are apparently well known for being unflexible for homebirth.
In your case like in mine the NYState Attorney General office will probably not be able to help but it does not mean you are figthing alone. These questions are very technical and I felt overwhelmed by the jargon. I found it helpful to put the insurance person of my midwife in touch with the insurance broker of my employer. The broker was very nice and really tried to help convince the insurance and I think it was helpful for her to discuss the case with the insurance person of the midwife who is dealing with these specific cases all the time. If your husband's employer is ready to help and put some pressure on the insurance it might help too.
It is really one of those "in between" cases in which a nice person ready to help out might make the difference.
It is definitly crazy that we can not have the birth we want, especially since it is so much cheaper than any hospital option.
As I said before I think we should find a way to join our efforts and share our stories to help other, not just throguh this forum.
In any case let us know how it worked for you!
The odds are you will get nowhere. Sorry to tell you this.
The NY mandate does not apply if companies are self insured. Aetna has a medical policy denying coverage of home birth UNLESS mandated by law. They won't pay if it's not. This is the official Aetna policy statement on home births:
Hi, Has anyone here had any recent experience with getting a home birth covered by Empire Blue Cross Blue Shield or Anthem Blue Cross Blue Shield recently, in the last year? We have been told we are covered out of network but only 50% of the mysterious allowable amount, which they will not tell you until after the birth. A gentleman at my insurance did provide a website where you can look up the common "allowable amounts" for your zip code. In case this helps anyone the website is fairhealth.org. Not encouraging. We want to fight this and get the birth fully covered with a "homebirth exception". I've heard this was easier in the past but they changed the rules and it is harder now.