Does insurance pay for a hospital transfer?

[mamabtt]

I was discussing my homebirth plans with a friend today and she wondered since insurance doesn't pay for homebirth, what if I had to transfer to a hospital? Would insurance kick in and pay for the hospital birth or would I be responsible for that....Eek! I just said I didn't know but that my midwife almost never transfers. Also I am not considered at risk and have a "proven pelvis", etc. So does anyone know if insurance covers transfers?

[nikirj]

I would assume they would cover it, since as soon as you set foot in a hospital you are considered more 'normal' by their book, right?

[rubelin]

Your insurance should cover emergency room costs, which is where you most likely will go. To avoid having to deal with the emergency room (and the luck of the draw for who the OB on call is) we're registering at our local HMO-covered hospital and having one appt with our HMO-appointed OB. In that case, if we have to transfer, it doesn't matter that we started the birth process at home. Lots of mommas labor at home too long and barely make it to the hospital

[georgia]

I've never heard of it not covering, but then, I learn something new each day . The hospital is billing insurance, no matter where the mother *intended* to give birth. No one can prove where you were planning on birthing. Kinda like if I planned on healing my back pain with accupuncture and out-of-pocket, but I ended up needing surgery....it doesn't matter to insurance what path I'd originally intended. If the policy has maternity/birth coverage, then it seems like there's no reason to assume a birth could be excluded. OB prenatal care is not mandatory, as far as I know. But, hey, insurance companies are not my favorite topic these days.......

Whew, I'm rambling tonight!

[laurata]

Yes, they should, but

They may cover it at a reduced rate if you haven't jumped through all their hoops. (Pre-registering the birth with the insurance company, etc.) I had a UC and post-birth transport, and they paid for 90% of my hospital stay, and about 50% of the ambulance ride. Since I was in an ambulance, they took me and babe directly upstairs to the OB unit. (However, if I had checked out AMA, I don't think they would have paid.)

[pamamidwife]

I've never heard of insurance not paying. It would be like showing up at the hospital in labor to birth.

Now, if we're talking about after the birth, that could be more sticky. However, I haven't heard of insurance not covering any type of transport.

[Fluffy Peanut]

My insurance (special Medi-cal for pregnant women) paid for my birth (c-section), hospital stay (we planned a homebirth, but transferred when I couldn't push the baby all the way out), postpartum care and my baby for 1 month. We would have been screwed if our insurance didn't cover it because we were financially challenged at the time! I would call your insurance and find out, just in case. You never know what will happen in labor/birth. I do hope you have a wonderful homebirth though!!

[SaraC]

My insurance(TriCare) paid for my transport when I went with my first DD. They knew that I had planned a homebirth or hadn't seen any of their doctors and they still paid. I was in the hospital for 3 days and Maddie was in there for 6 days. TriCare is pretty picky so if they paid I am sure others would too.

[LizD]

Every insurance company is different, but as has been said you would go to the closest emergency room and ER costs are usually covered. Some providers do want maternity coverage preregistered and such, or only cover a certain percentage of a birth center birth but completely cover a hospital birth, depending on your state laws, etc. So best to check.

Something to keep in mind when dealing with these issues is that even if your insurance pays the hospital bill in the event, god forbid, of a transfer, sometimes that means the midwife you've had prenatal care from and who labored with you does not get paid at all. I have wondered what I could do about this but of course hope I don't go to the hospital for any reason!