Thinking about a homebirth...steps with insurance?

[razz116]

Hi, everyone! New here. I was recommended by a friend over here to check out the homebirthing resources.

I'm sure this has been asked a million times, but I'll ask again

I want a homebirth for our next and last birth. I called our insurance (Blue Cross...I don't think it's Blue Shield, though. My DH is union and it's through the union.) They told me that they do cover midwives that are contracted through them in leiu of an OB.

So, what is my step? Do I just call midwives for interviews and ask if they're contacted with Blue Shield?

Thanks!

[ZoeyZoo]

Do you have a midwife on your policy that does home births? Usually, most insurance companies cover CNMs who work in hospitals; not home birth midwives. Several states require that insurance companies offer licensed midwives but not every insurance company is open to homebirth.

Most people on this board have asked for an out-of-network exception so that the hombirth midwife is treated like an in-network provider. Others have found that when they mention homebirth the insurance company denies coverage. Many have found that when they submit the bill that they are reimbursed even if homebirth wasn't covered. it all depends on the provider and the billing codes they use. Many of the homebirth midwives in my area aren't contracted but have had luck being reimbursed with certain insurance companies.

I have found sometimes naturpath doctors in my area offer homebirth and midwife services so this may be another idea to check out since naturpath doctors are covered by many plans.

Hope this helps.

[clancybaby]

check insurance website

First I'd think you need to figure out which blue cross you have. I'd call them and get the website that you're supposed to use to look up in-network providers. See if you find anyone local who does what you want. In my area we have CNMs who do homebirth or birth center birth that are in network for BCBS Mass but I still can't use them b/c I'm carrying twins. So I found a CPM with lots of twin experience and am in the middle of battling with our insurance to get in-network coverage for my out of network CPM since none of the in-network midwives will take me.

BCBS Massachusetts is very pro homebirth so I think I have a shot. Different plans and carriers are going to be different, I don't know how they all relate or what they share. If you don't find any listings on their website for midwives that work for you, by all means contact local midwives and talk with them. Different ways of billing with different insurance carriers have found success even when homebirth isn't covered at all, the midwives in your area may have experience with this even if they are out of network.

Good luck!

[XanaduMama]

Can I jump in here with an additional question (hope this isn't hijacking)? clancybaby--are CPMs legal HB attendants in MA? They aren't in NC, but there don't seem to be any CNMs who do homebirths in my area . If they're not legal, does this affect whether insurance will cover them?

: This is stressing me out.

[razz116]

Thanks, ladies. I'll try to find out.

[clancybaby]

Xanadu - I'm in VA (husband's company's hq is in Boston, hence the MA insurance coverage). I'm fairly certain that CPMs are legal in MA, its typically a pretty midwife friendly state, and they are definitely so in VA (one of the few progressive things VA has done lately). My midwife lives in MD where CPMs aren't recognized, but my birth here in VA will be totally above board and she'll actually be able to sign the paperwork that she was here. That's one fight I'm thankful I don't have to have this time. She practices in MD regularly but I don't know how the insurance works.

In MD many people do homebirth. I would think that it depends a lot on the type of coverage and insurance carrier you have what is covered. I know that some people submit larger bills for prenatal services, which a lot of carriers will cover...CPMs/CNMs local to you will be able to give you the best guidance about what they can do for you. Since NC is unfriendly it may be harder to find the CPMs but I'm sure they're there, they just can't advertise -- try seeking out a local homebirth network, I'm sure there are some lists or other resources available to you because its more than certain that people are homebirthing there. And have you searched all available midwives in your area according to your insurer to find CNMs? Here where I am there is a birth center, staffed by CNMs that does birth center and homebirth - that is in-network for me, as are some others, but like I said they won't take twins so I'm out of luck. Maybe there is something like that lurking somewhere near you? or are you near a border to VA or SC? What is CPM status in SC?

I found you some links that might get you started, I didn't investigate them fully so I can't vouch and some are regional which may only provide minimal help:
http://www.nchomebirth.com/index.html
http://www.ncfom.org/ncfomResources.html
http://northcarolinamidwives.net/index.aspx
http://www.ncmidwives.org/for_consum..._hospital.html
http://www.newdawnmidwifery.com/home.htm
http://nc.local.yahoo.biz/opwh/
http://www.maitrimidwifery.com/

I would contact everyone midwife related and ask if they know someone local to you who practices and provides homebirth services. You might also be able to dig up an internet list of homebirther mamas who would be invaluable for the information you seek.

Sorry to not be more help. Try to not stress out, just start contacting people and asking questions. You might find some really good information.

[XanaduMama]

Thanks so much for all the info! I have found a couple of MWs in the area who do HBs--one turns out to be a CNM after all, so at least there's that option, and the other is a CPM (who I'm actually leaning toward, since she's closer and apparently amazing). I'm going to talk to her about our options. We may decide to just try paying for a CPM out of pocket.

There's a bill before the state leg right now to legalize CPMs for HB, so we're all crossing our fingers. Not sure about the situation in SC, but I suspect it's even worse than NC. I'm pretty lucky to have several options in our area (there's a great birth center nearby, if "worst" comes to worst!).

Thanks again--I feel a bit better about things today. Good luck with your birth!