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Homeschooling mama to 6 year old DD.
Homeschooling mama to 6 year old DD.
Who is your insurance? I'm dealing with the insurance co. right now. Long story short on my side, they want my mw to be put in their provider list so they can check her credentials, then we need to put in Gap EX.
I'll be following your story since I might be on your road soon enough. Pls, keep me updated and hopely they can reverse after reviewing your appeal!
Preggo or post partum moms don't need this stress. (I read in my benefit book that Grievance form must be filed within 1 months of service lendered...)
The rep told me that they had a Nurse Midwife in network but she doesn't do homebirths. But they consider Homebirths a "personal preference" so therefore they were denying my request.
I WILL be appealing this! How can you say that Homebirth is a covered benefit but then not cover any providers in network???
I have United Healthcare also. My homebirth was covered out of network. While on paper it was supposedly 60% coverage. In actuality our out of pocket was only about $300. Our midwives billed for some newborn exams and home visits and got them to pay for the majority of their fee. Our midwives are CPMs.
Code of Federal Regulations Title 45, Volume 1:
(iii) Attending provider defined. For purposes of this section, attending provider means an individual who is licensed under applicable State law to provide maternity or pediatric care and who is directly responsible for providing maternity or pediatric care to a mother or newborn child.
c) Construction. With respect to this section, the following rules of construction apply:
(1) Hospital stays not mandatory. This section does not require a mother to--
(i) Give birth in a hospital; or
(ii) Stay in the hospital for a fixed period of time following the birth of her child.
(2) Hospital stay benefits not mandated. This section does not apply to any group health plan, or any group health insurance coverage, that does not provide benefits for hospital lengths of stay in connection with childbirth for a mother or her newborn child.
|Here are some links leading to the parts of Title 45 I quoted:
Googled "Code of Federal Regulations", clicked on it, picked Title 45 from the drop down menu, picked Volume 1 - subtitle A - 1to199, clicked 146 Requirements for the Group Health Insurance Market, clicked 146.130
Standards relating to benefits for mothers and newborns., Clicked on Subpart C,
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