I could cry, looks like HB won't be covered

[Bughead]

I am so disappointed/frustrated. I called my insurance company and they said under my plan (which is very specific, since the insurance we have is only for State of AZ employees, so it's not a "big" name or anything), midwives are SPECIFICALLY excluded. Even the ones at the birth center, which are contracted through the insurance company, but excluded in my plan. So it looks like I won't be able to get ANY of the homebirth covered under insurance. :

DS2's birth in the hospital cost a whopping $10. Yeah, the insurance is great IF you're using one of their providers. There is absolutely NO way DH will go for a homebirth if it's going to cost a lot of money, since he knows it would be cheap to do it at a hospital again. I could cry. This is my last baby and I really, really, really want a hb.

[Hoping4sumBBdust]

I'm sorry..... move to another state Okay, maybe not? But if it is your last child, enjoy it as much as you can. Spend as much time as you can at home before going to the hospital, and make your intentions very clear. There are some hospitals that have a birthing room...... tub.... and so on. Sorry to hear you're not going to get the birth you planned, but focus on a healthy baby. Best of luck to you.

[DoulaLMT]

So sorry I certainly don't know your financial situation, but I know that sometimes my DH is willing to be more negotiable on some things when he knows it is really important to me.

Or is it possible that you could shop really thrifty over the next 8 months and come up with a couple thousand for a HB?

Will you insurance cover a CNM at a hospital? A lot of CNMs are really hands-off during labor and even though the setting would be different, it might help you to have the kind of birth you want......

Good luck! I feel so blessed that it is an option for me.

[tyisrrs]

Can you talk to midwives in your area about OB's that support home birth? I just thought of it because when checking my packet from my midwife, I found one of her back up OBs to be included in my insurance. I set an appt with him because I need a PAP, plus I want to meet him in case I need to see him this pregnancy. Anyway, I called my midwife to ask about him and she went on and on about how great he is and said he supports homebirth.

Perhaps you could use one of those type of OBs as your health care provider this pregnancy. Good luck and I hope you find a good one and get a good birth. I have heard of some really awesome hospital births, they may be few and far between, but it is possible.

Also, perhaps consider hiring a doula to fight for your rights if you can't find a hospital and OB you are confident in.

[salt_phoenix]

Wow, i'm soooo sorry... I was shopping for midwives today myself and I was actually PLEASANTLY SURPRISED with the fact that our insurance DOES PAY for HB's!!!!! I just assumed it would come out of our pockets like my last two!

DD#1 cost me $800 & DD #2 was $1200.- 18 & 9 yrs. ago, respectively
HBs out of pocket here in Utah run from $1200-$2000 (some with more bells and whistles than the next)

Many of the local midwives will trade work/service for their own... I don't know any midwives that will refuse service just because of $$$$ maybe you could ask around about some sort of barter?
Just a thought.

[matey]

I feel your pain. I have looked into HB, but I can not do it. My insurance and state are anti-MW. A HB can only legally be done by a CNM. There is 1 in the area. It costs 3500 up front, by like the 7th month or something. If by chance I would get tranferred to a hospital with the CNM, it is the hospital that my insurance does not cover, then that would another chunk of money. It just isnt possible. We scrimp as is, and all extra money goes to debt, which includes my husbands hefty school loan (40,000+). So, a HB is out for us.

During my last pregnancy, when I realized we couldnt have a HB, people were really mean in my old DDC. One woman said that she had never heard of a midwife being so expensive and basically said I was being untruthful. Another woman said I just didnt want it bad enough or I would figure something out. I dont think that is fair. Do I think a HB is ideal? Yes. Do I want to do it someday? Of course. But right now, I cant. I dont have that extra stretch in my pocket.

I am going to hire a doula, which worked out very well for a friend of mine.

By the way, I have heard that sometimes the insurance will allow you to file a claim after the birth and you can get a percentage of the money back.

[lilylove]

There are, on occasion, some doctors that practice HBs. I know there is one in my general area. I'm sure it's not very common, but it might be worth checking out. You could also discuss using a HB midwife that accepts payments. If all else fails, perhaps you could try seeing a hospital based midwife that works under an OB. They often bill under the OB's name. It wouldn't be a homebirth, but it might help you get closer to the birth you want.

I had a hospital birth with my last child because of insurance refusing (they also had an excluding clause) to pay, and we couldn't fund it ourselves.

[pampered_mom]

Don't forget that some midwives charge on a sliding scale, will barter, and will often allow you to set-up a payment plan.

[paniscus]

Call Back and ask again!!

Seriously - then call back and ask again.

This is my experience with this birth so far:

Called before becoming pregnant - hb is covered, cnm is covered
Called again when pregnant - hb is covered, cnm is covered, b/u ob is covered
Went in for preg. test and referral - hb is NOT covered, cnm won't get approved because (long story), b/u ob is ok
Called back - hb is NOT covered, cnm is approved, b/u ob is ok
Called again - hb IS covered, cnm is approved, b/u ob is not getting approved.

Do I need to mention that I am calling again?? I had a similar situation with ds's birth (hospital with cnm). Also, check out the homebirth forum - there are some sample insurance appeal letters there.

[Bughead]

Thanks everyone. I am going to keep trying, although I don't have a lot of hope in this case because the plan specifically excludes homebirths. I even talked to a local midwife and she said she hasn't had good experience with insurance companies that have those types of policies.

We're not poor, so we *could* come up with the $2500 if we had to, but I just don't think that's fair to DH. He's already sacrificing a lot just "letting" me have another child and extend the time I am a SAHM, so I just don't feel right asking him to make that kind of financial sacrifice, even with a payment plan. It's still the same amount of money. So I am either going to look into the birth center (which I think is covered by my insurance, at least partially), or start with covered care, then switch to a midwife later in the pregnancy. It all depends on what the final cost ends up being.

[lilylove]

Also some insurances will cover prenatal care with a HB midwife and then you pick up the cost of the actual birth. That might be a solution

[MamaVolpe]

Ask around the homebirth forum they know all the best ways to work with or around insurances to get homebirth covered. Despite what you insurances says there is always a bit of fudge space you can work around. Dont give up.