Financially Swinging Home Birth?

[CuckooMamma]

I'm hoping someone here will be able to help with some info. We live in CT, and apparently because CPMs are not recognized in this state, insurance won't cover a home birth. They WILL cover a CNM who does a home birth, but I haven't found one :-) The cost of the midwife whom I contacted is $3000 - more than we can swing. I'm panicked at the idea of having a hospital birth, sure I'll end up in another C-section.

Has anyone challenged their insurance with success? Help!

Chrys

[PapayaVagina]

In the practice that I'm apprenticing in the midwife always tries to bill the insurance companies afterwards just to see if they pay and a lot of times they do. I'm not sure how that works though in a state that doesn't recognize CPMs. It's always worth a try though.

Maybe the midwife that you're working with knows of loop holes or is comfortable doing workable payment plans?

[girlfromthefuture]

Hi Chrys,

My CT VBAC homebirth was reimbursed by Blue Cross Blue Shield. Our midwives prepared a bill after the birth and follow-up care, which I submitted. It took a few phone calls, mostly because the claims dept. was confused because the bill looked different than what they're used to. If your insurance covers maternity care and delivery, they SHOULD pay. Mine was covered under my PPO, as an out-of-network provider at 80%. I'll just say I was reimbursed the full amount and we can privately discuss how later!

I'm currently pregnant and with different midwives - Birth and Beyond. They have a unique situation - they are the only (I believe) independent CNM's in the state that have doctor back-up and hospital admitting privileges (at Yale, and also soon at Manchester), but primarily do homebirths. Where are you located?

They bill the insurance companies directly, like a mainstream OB/GYN/CNM office would. All you should have to pay for would be the birth kit and the assistant's fee (they can't bill the insurance co. for two midwives to attend) - which I think is something like $500 total.

The midwives are:
Saras Vedam and Vicki Nolan
943 Boston Post Road
Madison, CT 06443

203.318.8884

Please let me know if you need any other information. I know all the homebirth midwives in CT, and would be happy to share anything I can.

Best wishes!
Mary

[carlasher]

same deal

I am in the same situation you are in - in California. I have insurance, but HMOs in CA does not cover homebirths AND my pregnancy is not even covered at all because of a pre-exhisting condition clause.

For us, it is about $3,000 - $4,000 too. I probably dont qualify for state insurance because I do have insurance, but just not for maternity. I will look into some other programs and see what I can come up with.

Like you, I will just die if I have to go to a hospital for my first birth!

[flowers]

If you are having a hard time financially would you qualify for medi-caid (or medi-care I always forget which is which). All the midwives in NH get almost fully reimbursed.

We do not have any extra money at all but we split up the 2000 our midwife charges (swinging fee based on our income) into monthly payments and just made it happen.

If you really really want it is there anything you can cut out of your lifestyle in order to be able to afford it??

[CuckooMamma]

Thanks so much to all of you. Both the support and info has been incredibly valuable. Mary, I met with Saras and Vicki on Friday and am thrilled that I'll be delivering with them I still can't believe this is actually going to happen. They seemed very supportive, not distant like the CNMs that I've had experience with. I even got to borrow some great books to read!

Thanks again to all of you!

[Electra375]

Real help... We put a line of credit on our house with a reasonibly low interest rate. Somewhat like a second mortgage but we only pay interest on what we use.
Another idea, and I will admit not a very good one, but if you are desparate is credit cards, you can usually get a few on-line and get several hundred in cash from each one to pay.
If you have good standing with a bank and do not own a home, you might be able ask for a personal loan, the int rate would be better than a credit card more than likely.
My mw was $2200 and my ins co-pay for my 2nd c/s was $2000, so the only difference was the hospital financed our $2000 at $100 a month.
Don't assume you will get paid back, I'm fighting that one now b/c DEM are not licensed in VA. Our ins does not have to pay out for non-lic providers.

[mom2threenurslings]

Originally Posted by girlfromthefuture

I'm currently pregnant and with different midwives - Birth and Beyond. They have a unique situation - they are the only (I believe) independent CNM's in the state that have doctor back-up and hospital admitting privileges (at Yale, and also soon at Manchester), but primarily do homebirths. Where are you located?

They bill the insurance companies directly, like a mainstream OB/GYN/CNM office would. All you should have to pay for would be the birth kit and the assistant's fee (they can't bill the insurance co. for two midwives to attend) - which I think is something like $500 total.

The midwives are:
Saras Vedam and Vicki Nolan
943 Boston Post Road
Madison, CT 06443

203.318.8884

Please let me know if you need any other information. I know all the homebirth midwives in CT, and would be happy to share anything I can.

Best wishes!
Mary

I've heard WONDERFUL things about Saras and hopefully will get to meet her should I get pregnant sometime next year (we're hoping!!!). My kids have HUSKY insurance, and in looking at health care providers covered by HUSKY (BC/BS), Saras is listed, so I'm hoping they'll cover me as well!

[carlasher]

Originally Posted by Electra375

Real help... We put a line of credit on our house with a reasonibly low interest rate. Somewhat like a second mortgage but we only pay interest on what we use.
Another idea, and I will admit not a very good one, but if you are desparate is credit cards, you can usually get a few on-line and get several hundred in cash from each one to pay.
If you have good standing with a bank and do not own a home, you might be able ask for a personal loan, the int rate would be better than a credit card more than likely.
My mw was $2200 and my ins co-pay for my 2nd c/s was $2000, so the only difference was the hospital financed our $2000 at $100 a month.
Don't assume you will get paid back, I'm fighting that one now b/c DEM are not licensed in VA. Our ins does not have to pay out for non-lic providers.

Heck, that only works if you have a house.

And no matter what, my DP would never use credit like that if we can do it UC. : Its good in a way because he has totally perfect credit, but bad because he (me too, I admit) are such tightwads. If we feel we NEED a midwife, we might dip into savings, but I rather not do that and pay outright - but we'll see.

[KariM]

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[NatureMama3]

Have you asked the midwives what arrangements they have to offer? Ours ended up being covered by our insurance (they billed pregnancy care, not birth) but our midwives offer the option to pay $50-100/ visit during pregnancy and continue payments for 6 months afterword. MUCH easier to hack than a few large chunks.

[Proudmom]

We also used dh flex-spending account. It splits the fee over a full year.

Proudmom

[~MommyAmanda]

Our midwife broke ours down into monthly payments. It has been tight but somehow we have gotten through and only ow about $500 more. I'll make apayment this month and next and be done by 36 weeks.

It feels good to payher though. I can actually see her working for the money and the care she has given me has been so much better then my very good OB.

[KariM]

We didn't challenge our insurance, but were told when we called that homebirths were not covered.

We still decided that a homebirth was important enough that we'd pay for it ourselves if need be and planned to use our flex-pay account and our savings.

Well, our daughter was born on August 31st and we just heard from our midwife that they are paying it as if she was an out-of-network provider. That means our deductible applies and they cover 80%.

Our midwife says that she has had great success in submitting insurance claims and getting medical policies to pay. She includes a very convincing cover letter that explains just how much money a homebirth saved the insurance company versus a hospital delivery and is convinced that is one of the reasons for her success!

--Kari

[Past_VNE]

My insurance (HMO with a small company) covers nothing maternity-wise, if it's out of network. They definitely don't cover CPMs. I looked into CNMs, before we had healthcare and they were way too 'medically minded' to suit us.

So, with next to no income and living with my MIL, we have managed to swing the $3500 fee for the midwives that suited us. I'm not saying this will work for everyone, by a long shot. However, that three and a half grand loomed very large over our heads. I'm now at 31 weeks and only owe my midwives 400 dollars or so.

My current dread? FInding the dough to buy all the cloth diapers I'm going to need.

Someone wrote on MDC that she had a $5 copay for her first birth in a hospital. She said, "And all I got was a five dollar birth." She then went on to compare it to her next birth, at home. It really struck a cord with me.

Best of luck in your endeavor to have a homebirth!!!

[Mamabeakley]

Sounds like the original problem has been solved, but I thought I would add this for others in a similar boat:

My health insurance co told me three different things over the phone while I was pregnant & planning a homebirth with CNM's in Maryland: yes, no, and maybe (maybe was that once they said they'd cover a birthcenter but not a home birth : ). So I wrote them a letter, and they wrote me a letter which again totally failed to give a clear answer.

BUT - I also sent a copy of my letter to the state agency responsible for oversight of health insurance companies. When I got the insurance co's non-answer back in writing and found that there was no way to clarify it with them over the phone (you can't talk to the people who write letters or write letters to the peope who answer phones!) I called the state agency. The insurance company had written them a letter which did answer the question! They sent a copy to me, which I had the midwives put in my file so that had there been any problem, we would have had documentation of the insurance co's agreement to pay.

And they did pay. But why, oh why couldn't they have just told me that in the first place?