insurance won't cover midwife - Mothering Forums

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Old 03-05-2003, 02:50 PM - Thread Starter
 
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venting here:

our insurance company is saying that they won't cover midwifery services...i gave birth to my ds in a hospital and it cost $25,000 for a non-medicated, no complications delivery. that included two u/s and an amnio, as well. the midwife will cost less than $5,000 total, and i've had only one u/s (which they are also balking at paying for). excuse my ignorance, but what can possibly be the justification for this?
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Old 03-05-2003, 03:26 PM
 
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is your midwife a CNM?? are you planning a homebirth??? Does she work under an OB?? What are the laws in NY?? I am in Va. and planning a hoembirth with a laymidwife (Va is not a legal state-yet) so we are paying 2,000 out of pocket BUT I am also seeing a CNM at a local OB practice where I have had all my labs done etc...I noticed when the insurance is filed they file it under the main OB not the midwifes name. If your midwife is in a group practice talk to them about your insurance...they know the ropes!! I think my insruance says they don't cover midwfery care...but I am not going to a midwifery practice I am going to an OB who has a midwife on staff. (if that makes sense)
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Old 03-05-2003, 04:35 PM - Thread Starter
 
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i'm going to a CNM at a birthing center here. i went first to Elizabeth Seton, but i was told that they had had problems with this insurance company paying them. apparently, the coverage is 80% when you go out of the network, but the company wouldn't even send the payments to the birthing center until months and months later, so ESBC won't even deal with them anymore. we *thought* we were in the clear with the other birthing center. now we find out, in my 30th week, that this is not the case.
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Old 03-05-2003, 05:22 PM
 
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Every insurance company is different, but my suggestion to you is that you should file the paperwork after the baby is born. When the ins. co. sees how inexpensive this is, as compared to a hospital birth, they may be more willing to pay it then. Also, if you could get the birthing center to help you with the paperwork, that will probably help. With baby #1, I had insurance that covered out of network services and they did pay for 80% after my deductible. I was thrilled. We paid for everything upfront, filed the paperwork after birth, and then were reimbursed. i am now preg w/ baby #2 and have ins. that will not pay for any out of network services. You better believe that I am still going to file the paperwork. they can turn me down if they want but I am going to try!
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