Why why WHY?! Insurance vent - Page 2

[smittenmom]

Claire-- I would love to do what you did and get our insurance to pay, but the policy specifically says they won't cover homebirth. How could that not come up in the billing? There must be something on some form somewhere that says where the birth took place. There are only two hospitals in my area, both covered by ins, and if the bills don't come from one of them I think the ins company may be suspicious. Maybe I can find a mw who knows her way around the rules. I hope so, because I just ran into my doula from my first birth, who's only working at homebirths now, and she said she knows of two mws in the area.. one charges $2000 for everything and the other charges $2900. Yikes!

[Spark]

Heather, remember, if you go to a Dr. for prenatals (not including the birth) it would be a lot more than if your midwife just billed her total costs as prenatals. That's how you'd get around the NO HOMEBIRTH detail. She would just bill the insurance company for prenatals totalling $2000-$2900. The thing to keep in mind is that you act as the go-between your midwife and your insurance company. Most times your midwife will just write it up however you want her to. You just have to have a game plan. Bill everything as prenatals totalling her charges. "Standard" care would suggest that you see your care provider once a month until the 3rd trimester. Then, once every other week, then once a week until the birth. Although, if complications arrise, you see your care provider more often. Just figure out approx how many prenatals you need at what price to reach your total ammount.

I went to an OB/GYN for one appointment so I could get an u/s this pregnancy. That one appointment was $550. I'll assume that might be the going rate. At that pace, they might not bat an eyelash if you bill them for $2000-$2900 worth of prenatals and maybe even some postnatals over a 9 month time period.

For the record they never need to know you had a homebirth. Even if they cared enough to look at the birth certificate in the dept that adds children to your policy they probably wouldn't do anything. If something came up, you could just say you never made it to the hospital in time to deliver, but you did see your care provider well baby care directly after the birth.

If you want to test out the waters, pick a midwife and go for a fertility consultation. Have her write up a bill for you & submit it to the insurance company. Just make sure it's something that they cover. See what happens. I typically call and talk to a live person, then fax the bill directly to that person. Seems to work better if they see you as a human being and not just a number.

My current PPO is a branch of Blue Cross Blue Shield. They cover 80% out of network providers. That's what your midwife would be considered. Again, I know some midwives that will overbill insurance companies (because of delay of $ and increase in paperwork) to end up getting their total amount reimbersed and so their clients pay nothing. Mine doesn't do this, but I know others that do.

[smittenmom]

Thanks, Claire. I'm definitely going to keep all of this in mind and see what I can work out when the time comes. I appreciate the explanation. Do you wanna give my insurance company a call for me?

[Spark]

Yeah, that's the pain in the butt part -- the calling. But, honestly, I probably made $200 per phone call. I just thought of it as my job.

Best wishes in your baby planning stages!

[NaturalFamiLEA]

I think it's a money thing. Insurance companies are "in it" together with the hospital...neither of them care as much for the baby and your own health as they do about money. It's not about care, it's about business!

I am having a home birth. I will be paying my midwife $2500.00 for the whole thing, including birth. We have insurance, but even if they did cover it, we haven't made our deductable yet.

But it's worth every penny!