Bummer: Insurance won't pay

[GinaRae]

Insurance won't pay for a homebirth. I am not sure if they will pay for the prenatal appointments or not, but no homebirth. We'll bill for lab work and we'll try to bill for prenatal appointments.

But we're committed to a HB and will pay the $3500 out of pocket, getting started right away.

The hospital here is SO expensive, I just think they will end up billing us at least $2,000 after insurance for a birth by the time all the doctors and L&D are done with us, so we might as well pay that for a HB!

My gosh, last time I took my oldest to the ER it was $100 deductable and then they billed me almost $1,000 (!!!!!!) for a doctor to look in his ears and tell us he ruptured his ear drums. That was AFTER insurance paid their amount!!!

[scheelimama]

I'm sorry. They won't pay for a homebirth for me either, but I think it has more to do with the legality of homebirth here. And of course, it's tricare/government insurance. They believe that birthing at a military hospital is the most cost efficient for them and it's hard to get them to cover anything else. But the midwife I'm considering only charges $2000. That's doable for me.

[Living Slowly]

My insurance has said they won't cover my HB either, but my midwife is going to bill in installments and see if they will pay anyway. She said her billing service does a pretty good job. We do have a high out of network deductable though, so even if they do cover some of it I don't expect to get much back. Our cost is $3,000 and while that seems like alot, the HB is really important to me and we have paid more for much less important things. I think the cost is worth it.

[monocyte]

I know a few people who have managed to get them paid for (or partially) after the birth. Does your mw bill? Or have a form you can send in?

If I could have a homebirth, I'd be rolling pennies!!

[Kontessa]

Worth it!

I have Tricare and as long as I drop down to standard they will pay 70% of a homebirth and the mid-wife care. The one that I have charges $2400 and I am thinking about just paying it monthly and keeping Prime and not getting any of it back from insurence as dropping down to standard gives me the least priority here at the military Drs and hospital and good care soon is hard to get there as is.

Anyway, I agree, paying for this is well worth it!

Blessings,
Kimmy

[scheelimama]

Kontessa, in Georgia, homebirthing is allegal. Not really illegal, but a certified midwife can't legally do it. So, really only a lay midwife can do homebirth legally and Tricare won't cover lay midwives.

[maclolo]

It is so frustrating that insurance companies won't cover homebirths! Ours won't either. They will cover a birth center birth, though (which makes no sense...same provider[s], same equipment, just different facility). We battled it when I was pregnant with DS and they said it was not "medically appropriate." : It is no different (medically) than a birth center birth! We also considered paying out of pocket but in the end decided to go with the birth center birthing room (beautiful and relaxing! still not home, though...). It might be worth it to me to just pay this time, though... I suppose there's some time left to decide.

[StacieM]

Yikes! Maybe there's some other kind of ins you can get? DH's insurance will cover a midwife, but I don't think it'll cover a home birth either.

I hope you get the birth you want and yeah, if you're going to have to pay that much for hospital anyway - may as well do the home birth.

[*Lindsey*]

My DH is self-employed so our insurance doesn't even cover maternity/prenatal care.

Here in Ohio my homebirth (with a lay mw) is going to cost us $1800. Saving now!

[Mama2Setia]

We're in the "insurance won't pay" club too. We'll be paying out of pocket to have a midwife but the way we see it, it's a small price to pay for the care and outcome we're hoping for. There's not even a faint sense of hope with what insurance is offering.

I hope that by the time our children have their children, midwifery will be embraced by insurance carriers and the medical community.

[Kontessa]

scheelimama -- I remember that issue living at Ft. Stewart! I have heard though that some have gotten other kinds of mid-wives paid for so I would try and bill Tricare at the end anyway just to see if it works. I really think it is who end up getting the bill, who you talk to on the phone, ect... Best of luck with your birth!

[scheelimama]

Well, if I do go with the homebirth midwife, I'll probably try to bill Tricare, but I'm not sure it will go through. She's a lay midwife, but she did tell me she had one client who got tricare to reimburse about half of her expense. She had to file 3 times, but she did eventually get some money back. I'm considering switching to Tricare Standard and going with a local birth center though. The only problem is that I have a really strong gut feeling that I'm having twins, but I can't know that for sure until I see the dr. and hopefully get an ultrasound. And if I switch to Standard, I don't think I can switch back for a year, so I'd rather just stay with Prime if I'm having twins and a homebirth. Ahhh...so much to figure out. I wish I lived in a homebirth friendly state!

[Undercover Hippie]

Ours won't cover HB either. Actually we just got new insurance and not only does it specifically say it won't pay for HBs, it says it will not pay for *any* MWs. I think it means not even CNMs in hospital or birth centers! :

Anyway, we paid for our last HB out-of-pocket and will pay for this one too. Luckily this time we can do some bartering--many MWs and doulas will barter so don't be scared to ask! Last time we didn't think of that. We were flat broke (DH unemployed for part of my PG) but we scrimped and saved and paid in installments.... that $1800 was totally worth it, as was the $425 for a doula.

Interesting side story... you never know what can happen if you submit a HB claim. Last time someone at our insurance misspoke and said they would cover our MW and HB. When they got the claim after the birth they said, no way can we pay that, your midwife is not licensed (no licensing for lay MWs in our state). But, simply because of the error, we got a bit of money back. That was fabulous!