Does insurance cover homebirth?

[hannahmom]

Does anyone's insurance cover homebirth? If so, who do you have?

Dh's open enrollment is coming soon and I want to have a homebirth with #2 (not even ttc yet, just trying to plan ahead).

Thanks!

[plantmommy]

Aetna would cover 80%, since there weren't any "in network providers".

What you might do is call some local hb midwives and ask what their experience has been with different providers.

[hannahmom]

Good thinking re: calling hb midwives...
I have Aetna 80/20 now and boy are we getting SCREWED with deductibles and 20% charges. It really added up when I was pg with my dd. I had PIH and had to have non-stress test almost every other day for 3 weeks... Soooo - I'm thinking we might step away from that particular plan but if Aetna has another alternative I would considering staying with them.

[3 little birds]

Cigna paid for my homebirth, however, when I first called them, they said no they don't pay midwives, even out of network. Then I found out that my state has a statute that says that insurance has to pay midwives the same % they pay obs. My midwife got an authorization #. When she billed them they refused to pay. She wrote a letter reminding them of the statute and they paid her the contracted rate. (About $3500). It really helps to have a knowledgeable midwife who knows the law and is willing to accept contracted rates.

[ebethmom]

We've talked to our insurance, and they say that they will pay for homebirth with a midwife as out-of-network. That means a higher deductible, then 65/35. But that still comes out to be less than an in-network hospital birth.

We'll see if they really will pay. Our midwife has told us that she has the code numbers that they need, and that she has had success with our insurance company (Anthem).

[pamamidwife]

It depends upon the state and the insurance provider. I've heard that Aetna will not cover homebirths, but I think it's how it's billed. If you call and ask your insurance co if they cover homebirth, you're gonna get all kinds of crazy responses. If midwifery is licensed in your state, ask specifically about a licensed midwife.

I'd ask around to some people that have had homebirths in your state or midwives in your area. I've been reimbursed so many times when insurance companies say no.

[rose angel]

Originally Posted by 3 little birds

Cigna paid for my homebirth, however, when I first called them, they said no they don't pay midwives, even out of network. Then I found out that my state has a statute that says that insurance has to pay midwives the same % they pay obs. My midwife got an authorization #. When she billed them they refused to pay. She wrote a letter reminding them of the statute and they paid her the contracted rate. (About $3500). It really helps to have a knowledgeable midwife who knows the law and is willing to accept contracted rates.

What state do you live in?

[pamamidwife]

I think Florida and Washington state are the only states to have that mandate.

[anothermama]

My insurance will pay for an out of network provider whoever it is, but they only cover CNMs.........I didn't use a CNM so my homebirth may not be covered........

[laurata]

They may, or they may not, but here's the thing you need to know:

Many midwives expect to be paid up front, in full, by 36 weeks. Even if they plan on billing the insurance for you. It's not like when you see an OB, and you pay a co-pay, and all the paperwork happens almost magically for you. If you want and homebirth, and a midwife is important to you, start saving now.

[guestmama9924]

Originally Posted by pamamidwife

I think Florida and Washington state are the only states to have that mandate.

Yep! mandatory coverage here in Florida, for any company providing maternity coverage on their plan

[3 little birds]

Yes, I'm in FL. I almost fainted when I found out 'cause most of the laws here are wacky.

[Faith]

I lived in IL, and ins. covered licenced MWs, but not the lay MWs that I used.

Now I live in WA, and my CNM is 100% covered by insurance.

[georgia]

I've gotten two births covered with two different cos. One was CBSA, the other BCBS. One covered at 85%, we'll see what happens this time. It is not an easy road to get reimbursed if homebirth is not explicitly covered. Either way, we paid in full upfront. Worth every penny even if it wasn't covered!

Something important to consider is more than the price of the care you receive---what is the cost (emotional, physical, spiritual, etc) of not getting the care you deserve?

Hope you find a insurer that is smart---hbs are SO much less expensive for them!!!!

[sarahloughmiller]

I had a primary insurance ( Blue Cross) and a secondary (AIM -also Blue Cross) and I did not pay anything for my sons birth! Whenever I talked to my ins co they told me something different. About 2 weeks before I had my son they told me they did not pay for midwives and would not cover the birth at all. Some of the employees just don't know what they are talking about. Call the midwife, they will know who pays for what. My ins did require it to be a CNM. Good luck, it is a great experiance to have you baby at home.

[melixxa]

Does anyone have any experience with Kaiser and HB?

[pamamidwife]

I've had lots of Kaiser patients come to me for homebirth, but I seriously doubt they would EVER cover homebirth. I have never heard of it happening...in fact, I've heard some problems when people go to a non-Kaiser hospital.