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!