insurance without a certified midwife?

[PancakeGoddess]

Do I have any chance or way of getting my homebirth covered if my midwife is not a nurse midwife or certified in any way?

[KarenEMT]

My insurance (a blue cross PPO) told me that they would refuse to pay a midwife that wasn't a CNM. I am in PA. I thought about writing an appeal letter, but am determined to go ahead with the homebirth, paid or not.

DH just gripes because I could have a hospital birth with CNM for $10 and instead we will be paying $2000 out of pocket to have a homebirth.

[PancakeGoddess]

THankfully my dp doesn't complain at all about the expense, but I'd sure like to make an effort to save the money!

[Snowdrift]

My insurance won't pay for any out-of-hospital birth, and they well-used to fighting this fight too, since all I got a sigh and a bunch of rote lines when I asked. I'm seeing a CPM practice.

Someone in one of the forums here siad something very wise a while back: sinc we believe that pregnancy and birth are natural and normal and not health crises or illnesses, it is a bit coutner-intuitive for us to expect insurance to pay. Insurance is for medical expenses--which this ain't.

Of course, it's about the only natural and normal life activity that I don't want to do without professional assistance, so the analogy breaks down at some point, but it is an empowerng thought.

[PancakeGoddess]

Someone in one of the forums here siad something very wise a while back: sinc we believe that pregnancy and birth are natural and normal and not health crises or illnesses, it is a bit coutner-intuitive for us to expect insurance to pay. Insurance is for medical expenses--which this ain't.


I think insurance is for healthcare, which this is. I guess I'm just crabby right now, but that doesn't make sense to me, personally.

Thanks for the thoughts though :)

[alegna]

Not exactly what you're asking but we got our insurance to cover a midwife who is just "documented" in TX (TX terminology)

-Angela

[Eman'smom]

Mine will only cover CNM's not LPM, not CM, not Lay, nothing but CNM's.

[~lioneyes~]

My insurance, which is also Blue Cross, said they would cover my CPM and a homebirth. I didn't think they would, but my midwife's money person called and they said yes.

[PancakeGoddess]

I am seeing a CNM one time early on to get basic bloodwork done. This CNM group is very friendly and cooperative with my hb midwife. I wonder if they would be willing to work together on billing, kwim? Like, if I agreed to come to a few prenatals there?

[busybusymomma]

My midwife's associate is a CPM and her ad in the health food store classifieds says some insurance coverage so I guess it depends on the company/policy. My midwife is a DEM so I doubt I could have her covered in any case even if I did have health insurance but dh and I won't go any other way now so we'll just pay out of pocket. :)

When I think about it, my homebirth is cheaper than an insurance premium (with $700 deductible and copays) would be so it works out fine for us since I won't go to a doctor unless I'm losing body parts or need trauma care. ;)

[hotwings640]

Our last birth with a midwife was covered by insurance. She wasn't certified or licensed in anyway. She told me the key was to not give them more information than what they asked for. She submitted everything to them and they paid for it. So, rather than asking the insurance if they will cover a homebirth I would ask if they would cover this care provider. If you have a policy that allows for out of network care providers, you have a fighting chance that they will pay for at least part of it, esspecially if the midwife is good about submitting the claims.

[beaches1098]

I had a direct entry midwife and my insurance paid for it.

[Ell-Bell]

My insurance (United Healthcare) covers our homebirth midwife (not a CNM) 70% because it's out-of-network. All the in-network midwives are CNM and only do hospital births.

Both the midwives in California and Oregon said that they have had good experiences with our insurance paying. :thumb The midwife we are using has a billing person that deals with all the insurance and even records conversations with insurance people so they can't deny that they aproved coverage!

So I say talk with the midwife, ask what their experience is. I know our midwife bills for everything separately, all the check-ups, etc. and doubt that they even say WHERE the birth will be happening.