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Experience with CareFirst BlueChoice HMO to cover HB?

post #1 of 4
Thread Starter 

Hi ladies!

In Maryland, have any of you had experience with getting a homebirth covered under CareFirst BlueChoice HMO OR the HMO Opt-Out Plus-Open Access plan? I'm trying to sort out my options.

 

I called CareFirst and under our current HMO there is NO coverage with an out-of-network provider. It seems (reading on other forums) that it's possible to appeal and get a HB covered if you state adequate reasons (such as no in-network HB MW available in the area) but this seems tricky. If anyone has found a loophole with the HMO and been able to get reimbursed for a HB in MD, I would love to know how you did it. Right now I'm thinking about going with a CPM, which throws a wrench into the mix because technically in MD, CPMs aren't even licensed and I'm not even sure Insurance would recognize them as an provider!

 

I'm just wondering if it's possible to get anything back from CareFirst with enough persistence and smarts to "work the system".

 

Any tips would be appreciated!

post #2 of 4

Welcome to MDC! I'm bumping up your post. Anyone have experiences to share?
 

post #3 of 4

I'd also love to hear from anyone with experience on this!

post #4 of 4

I don't know if it varies in MD, but our HMO covered absolutely nothing for a homebirth with a CPM in VA.

For my first, it did cover all but the copay for visits with a CNM and supposedly would have covered the birth with her (minus copay) as well. I transferred to a hospital and it covered the birth with the doctor, again, minus copay.

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