Anyone HBing in part because it's cheaper?

[Upside]

It crossed my mind today that I have read posts from people who want to have a homebirth but it's too expensive because their insurance doesn't cover it. In my situation, it's cheaper for us to have a homebirth. We buy our own health insurance and I did a lot of research and phone calling in the area before we TTC. Adding a maternity rider to our BCBS policy cost $300 more a month. Being optimistic, I figured 10 months of maternity coverage at $3000, add to that our deductible of $1000 and 30% (we have 70/30) of the total bill (for DD was around $6000 for totally uncomplicated unmedicated hospital birth with a midwife and one night hospital stay) which is another $1800, that totals nearly $6000 to have a baby with insurance! And only if we conceived immediately.

Well, I had looked into HB with DD but DH wasn't into it and if we had had the same insurance this time around I probably would have gone to the birthing center right off. Anyway, I don't know what my point is other than we hired a CNM this time (DH totally on board) for a homebirth for $3000 and could have gone with a number of other CPM or direct entry midwives for less than half of that. Fortunately my pregnancy has been uncomplicated and no specialists were required, but isn't it crazy that it could cost that much for a "regular" vaginal delivery when you HAVE health insurance???

[Ladybyrd]

Cost definitely was part of the decision for me - we don't have health insurance. Midwife's fee was $3000 - that is cheaper than the hospital, which I don't want to go to in the first place. My DH was very enthusiastic about birthing at home, because he doesn't feel that having a baby is a medical event, either.

[Belleweather]

Yep. We have health insurance which covers our homebirth (minus supplies) but wouldn't cover a midwife at the birth center. As much as I love the tubs at the birth center, I don't love them $1500 much, so we're birthing at home.

Hospital birth, of course, would be free. But when the choice in hospitals amounts to being between "dumb" and "dumber", sometimes free isn't worth it.

[Romana]

Not us. For us, homebirthing is about $500-1000 more expensive. But I'm happy for those who are getting a $$ break by doing a homebirth! Yay!

[bekkers]

Not us either, in fact, it really disgusts me that our insurance was no problem (clearly routine) to pay for upward of 30,000 in hospital bills for the transfer and surgical birth and nicu stay with my first birth, but they wouldn't cover the cost of a midwife, or even birth supplies for the home birth. What really pisses me off is that I could have run up an even higher bill electively by going in for an induction and many hours of various drugs, etc, and they wouldn't blink an eye, but to save thousands of dollars (and health risks) they wouldn't cover the better option. blech.

[Upside]

Originally Posted by bekkers

Not us either, in fact, it really disgusts me that our insurance was no problem (clearly routine) to pay for upward of 30,000 in hospital bills for the transfer and surgical birth and nicu stay with my first birth, but they wouldn't cover the cost of a midwife, or even birth supplies for the home birth. What really pisses me off is that I could have run up an even higher bill electively by going in for an induction and many hours of various drugs, etc, and they wouldn't blink an eye, but to save thousands of dollars (and health risks) they wouldn't cover the better option. blech.

That just makes no sense to me : . Our entire healthcare system makes no sense to me : : .

[barefootpoetry]

DH and I were discussing the cost of our future homebirth the other night, and we figured that it will actually be cheaper than a hospital birth this time around. With DS I was on Medicaid, so I didn't pay a dime - which I'm very grateful for, since my textbook intervention-smorgasboard complete with C-section would have racked up quite a bill! Even though $3000 for a homebirth isn't exactly pocket change, it's nothing compared to what it would cost for me to birth in a hospital, esp. since I'd probably get railroaded into a repeat C-section.

[DomerJen]

Does your insurance cover you if you need to go to the hospital in an emergency without the maternity rider? I'm totally pro home-birth, but it could be a lot more expensive than $6k if you needed a transfer... might be worth the rider either way.

[Upside]

Originally Posted by DomerJen

Does your insurance cover you if you need to go to the hospital in an emergency without the maternity rider? I'm totally pro home-birth, but it could be a lot more expensive than $6k if you needed a transfer... might be worth the rider either way.

Well, I'm due in 5 weeks, so it's too late for the rider...but coverage would depend on the nature of the transfer. If it's a complication of pregnancy, like a hemorage, I would be covered. If it's something like failure to progress I don't think so. I thought about it a lot before we started trying and I think I'm just an optimist when it comes to my body, or naive...we'll see .

[MamaEssie]

My birth with insurance at the hospital (assuming a normal vag birth w/o complications) would cost $3000. My homebirth will be around $2500 with no insurance. Of course that's assuming that DH's company can actually stay with an insurance company for more than one year!!

[dubfam]

Our birth would be free if we went to the hospital. (except for maybe a $15 copay or something...)

We are having to pay some of the Home Birth costs. The insurance will cover at least half, though.

So for us it is the opposite.

[Mamabeakley]

I think some of this might vary by state . . . I don't think it's legal in my state to write a health insurance policy that excludes maternity care. At any rate, I've never heard of anyone *here* having health insurance but no coverage for maternity. Also, I believe most states offer some form of medicaid/care to pregnant women who qualify re: income. Some of those states will thereby cover homebirth with a midwife and some won't (they won't, here, so far as I know.)

It's all totally crazy, though. Logically, the insurance companies should WANT to cover homebirth (cheap) and NOT cover or provide lower benefits for hospital birth (usually more expensive even in a best-case-scenario vaginal birth with no medications.)

Since our health insurance does cover the CNMs I used for our homebirths, homebirth was (probably) cheaper for us - though I don't know for sure since there was no way I was going to the hospital short of a life-threatening emergent emergency and I didn't look into the costs very hard.

[Upside]

Originally Posted by Mamabeakley

I think some of this might vary by state . . . I don't think it's legal in my state to write a health insurance policy that excludes maternity care.

In NC, employers who provide health insurance are required to include maternity care. Unfortunately, DH's employer doesn't offer insurance so we buy our own and in NC its a la carte. I'm still fighting with the insurance company over a thyroid test. Because I had the test done under a midwife, they haven't paid it, but if I had gone to my GP or a specialist they would've covered it. They told me to have the hospital recode the test and then they will cover it. Hospital has so far failed to recode even though someone from the practice is supposedly helping me...

The hospital charges $124 for a thyroid panel, fortunately they opened a great new clinic in Chapel Hill that has negotiated with a lab for reduced fees. So I can go to the Intergrative Health center and get the same test for $25. This is crazy! Inflated costs, holy cow!

[crsta33]

I have no coverage, and cannot get it...not eligible for state aid, cannot get individual insurance, and right now have no access to group insurance (though we are working on that), so HB was the less expensive option. But I chose HB last time when I had state aid and could have birthed at the hospital for "free" (monetarily speaking only).

A transfer would cost us dearly, but the odds are in our favor for a 2nd noneventful homebirth, so we are just banking on that.

Christa

[DoomaYula]

What really pisses me off is that I could have run up an even higher bill electively by going in for an induction and many hours of various drugs, etc, and they wouldn't blink an eye, but to save thousands of dollars (and health risks) they wouldn't cover the better option.

: We're paying for our hb oop.

[Thandiwe]

For us, after deductibles and copays, the cost would actually be the same. We did, unfortunately, end up paying almost $1,000 in deductible for dual care, though, in addition to the $3,500 it costs to have a HB. My greatest fear now is a transport, as it would cost double the cost of what we've paid. But when I struggled with doctor after doctor, we sat down in my fifth month and realized if the cost is equal, why not have a birth by choice??

A big motivating factor for me was convenience. I don't have available care for my toddler for prenatals or the delivery, plus I don't want to leave him for a couple of days just to have this baby. He's a very "high-needs" toddler, and I know that no one else would take the same time with him that he requires.

[pixiedust]

our insurance covers either BUT, after the birth of this baby we are switching to a family insurance w/ a super high deductable (for emergancies only) and it will be cheaper then to do a homebirth.. even cheaper than my old insurance was to be honest. We figured it up and we just came out even having insurance. Once you pay $285 a month for 2 years you might as well just pay out of pocket for the hospital bill.

[Belleweather]

Originally Posted by DomerJen

Does your insurance cover you if you need to go to the hospital in an emergency without the maternity rider? I'm totally pro home-birth, but it could be a lot more expensive than $6k if you needed a transfer... might be worth the rider either way.

If you are uninsured and are forced to transport, you can look into applying for Emergency State Medicaid, which may cover charges for your care or the baby's care and has different rules than traditional medicaid.

This is also why if you CAN get on Medicaid as a pregnant woman and use it as a secondary payer health care, it can sometimes be a good idea. Worst case scenario, Medicaid has higher lifetime limits, higher hospital limits, and will guarantee coverage for a baby born while his mother is on Medicaid -- which is HUGE if you have a baby with complex medical needs that might not be covered under traditional plans or might exceed yearly or lifetime maximums.

Just FYI.

[MamaVolpe]

It is cheaper for us too. I think it depends on if you insurance has a copay: flat dollar amt or coinsurance: a percentage that you have to pay. Ours is a 20% coinsurance. So 20% of a midwife is less than 20% of OB and Hospital combined. Plus the high deductable. However if I had a plan that just had a flat dollar amt copay then hospital might be cheaper option.