got my homebirth covered - happy dance!!! - Mothering Forums

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#1 of 9 Old 10-29-2010, 10:21 PM - Thread Starter
 
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Just had to share this! I live in NY, which has insurance regulations that mandate coverage for homebirths. Well, when we submitted our paperwork, we were denied because our plan is self-insured, and therefore NYS insurance regs don't apply. After several weeks of phone calls to DH's employer benefits, and several appeals, we not only have been approved, but there was a meeting in the insurance legal department. They have actually CHANGED THEIR POLICY because of our case, so the next family wanting homebirth coverage won't have to go through what we just did!!! I am so happy I could cry, and I had to share this somewhere! I am so excited to be able to birth at home, with my family, and have it covered as recognized valid maternity care, and I am so happy to have been instrumental in the progression of birthing rights for this company and this area. YAY YAY YAY! Please happy dance with me

happy coffee-addict ballerina wife to my DH:, SAHM to my awesome ds#1blahblah.gif5/05), dddust.gif(7/07), and ds#2babyboy.gif(1/11)

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#2 of 9 Old 10-29-2010, 10:29 PM
 
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VERY good news! great work mama!



may I ask a question? Do you know if state insurance will pay for a homebirth? I'm in NY too


ETA my happy dance:

with love, bailey...
macey 5.18.08
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#3 of 9 Old 10-29-2010, 10:45 PM - Thread Starter
 
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Here is a link to the regulation. State insurance should cover an out-of-network midwife (with the minimum state requirements) as in-network, if your insurance does not already have one in-network (most don't). Otherwise, this page should get them to cover you. Expect them to turn you down the first time though - they have to make you jump through at least a few hoops, right?

Good luck!

http://www.ins.state.ny.us/ogco2005/rg050409.htm

happy coffee-addict ballerina wife to my DH:, SAHM to my awesome ds#1blahblah.gif5/05), dddust.gif(7/07), and ds#2babyboy.gif(1/11)

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#4 of 9 Old 11-01-2010, 11:04 PM
 
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oh my gosh, I can't believe that someone else in buffalo has just gone through the same thing I am right now!!!! Did you deliver with Eileen Stewart? I have Independent Health, but not really, its just administered by them through my school, a self funded plan like yours! My baby is due in 5 weeks. i'm trying to get a pre-certification. I was denied as well, and have sent my appeal with the same regulation that you posted above, as well as another regulation that is actually from the self funded regulations from ERISA (fed law) that basically says that a woman who is a a policy holder can not be forced to delivery in a hospital. i am still inside my 15 working days waiting for 'THEIR' decision. Its ridiculous having to beg for this coverage, but I feel like you do - i want to make a difference for other moms who could use my same research. I would love to be able to email you to discuss this more. Especially if I AM denied again, I'd love to use your case to help my own. Thanks for anything/everything.
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#5 of 9 Old 11-03-2010, 09:09 PM
 
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That is so awesome!!! I'm so happy for you and everyone else who will benefit from this!!

Crunchy Christian mama to my home birthed, unvaxed, uncirc boys Shane and Cody!!joy.gif
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#6 of 9 Old 11-03-2010, 09:34 PM
 
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:j oy

- Emy . Single mom to DS nut.gif Ezra (15.12.05), angel2.gif Thames (reincarnated 18.04.08) and DD rainbow1284.gif babyf.gif Allora (11.02.11) and dog2.gif Hoppylactivist.gif  novaxnocirc.gif  waterbirth.jpg fambedsingle2.gif bfinfant.giffemalesling.GIFcd.gif

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#7 of 9 Old 11-04-2010, 02:40 PM
 
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congrats & good work!!

I'm going through this right now, as we've just received our second rejection of a claim. They were covering everything just fine for awhile, but suddenly stopped without so much of an explanation. So we're at the very beginning of the appeal process.

~ diane & DH & Trent Julian 1/29/11 & Harmony Marija 11/29/12 x 2
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#8 of 9 Old 11-05-2010, 09:59 PM
 
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Congrats mama! I am happy dancing for you!! Our insurance refused to cover our hb because our midwife was "out of network" (there are no hb mw "in network")... I appealed just on principle (was denied) and will do the same with our new babe. I think insurance reform to accept homebirths is a great thing and that is awesome that you are making a difference!

Kristen, Loving my family heartbeat.gif Sweet DH, C 11, A 9, B 7, G 4, H 1, C newbie!
2ndtri.gif Free Healthy Pregnancy & Natural Birth Series, click here!

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#9 of 9 Old 11-15-2010, 05:17 AM - Thread Starter
 
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So thanks everybody!  To share an update, our employer is fighting with us, but Independent Health is still giving us quite a hard time.  Mom2disnykids, we plan to deliver with Jen Bozza, but I know Eileen and she is wonderful too.  We are very blessed to have to employer we have, that is trying to tell IH to leave us alone and just cover us, but I think they are upset that we went over their heads, so they are now telling us that our midwife doesn't have enough malpractice insurance - when they covered her for someone else 2 months ago!!  They also told us she had to refile all her documentation, that they had nothing for her on file inthe last 2 years, also a blatant lie.  However, thanks to our plan being redefined as to follow NYS standards, this can only take so long before they have to give us approval.  I really thought we were done, but like I said, it just seems like IH is mad that we overstepped them.  Best of luck to the rest of you!!


happy coffee-addict ballerina wife to my DH:, SAHM to my awesome ds#1blahblah.gif5/05), dddust.gif(7/07), and ds#2babyboy.gif(1/11)

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