Homebirth in Massachusetts, Aflac and other questions - Mothering Forums

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#1 of 7 Old 01-23-2012, 08:59 AM - Thread Starter
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So I've been researching a lot for the past few weeks. My hub and I are trying to conceive and we are very excited about the option of having a home birth.

Clearly we want to explore all coverage options before we decide that paying out of pocket is all we got. Unfortunately, we have Tufts, and as I've read, they DO NOT cover homebirth. Then I heard Aflac disability coverage will pay the costs.

But I just spent 20 minutes on the phone with them, was transferred 4 times, and still didn't get an answer, what coverage do I  sign up for to receive that coverage for my homebirth?? I think they used to cover, back in 2009 (the last post I read about this disability coverage)...and now your employer has to offer aflac's disability coverage, (is what it says on their website)...


Does anyone have any updates to this? Do I have any other options?


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#2 of 7 Old 01-23-2012, 09:49 AM
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I'm not a lawyer, I don't work for an insurance company, etc so mine might not be the last word.


But Massachusetts does not permit CNMs to perform homebirth services.


Therefore, only DEMs (direct entry midwives), a.k.a. "lay midwives," can do homebirths. (They are "alegal" - not protected by state law, but also not forbidden).


Insurance companies only cover licensed medical practitioners.


I assume Tufts actually would cover a home birth no problem - as long as a doctor was doing it. A doctor is the only licensed medical practitioner who can do a home birth in this state. Obviously, good luck getting a doctor. So I think that while their policy doesn't exclude home birth per se, it's a de facto  exclusion:  people who have home births almost always use midwives, and you can't have a licensed midwife legally attend your birth here. Therefore: no homebirth is the short way of answering you. And it's not a matter of not having the right policy or even the right insurance carrier.

Homeschooling mama to 6 year old DD.

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#3 of 7 Old 01-23-2012, 11:01 AM
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I think really AFLAC only uses a hospital and sickness policies to cover for a birth- and those must be in a hospital and must be offered through your employer.  At least that was how it was in 2009.  It wasn't their disability policy that you used.  And in 2009 when I used it I paid in about $200/mo for both policies with a return of $6000 (because I was grandfathered in) at the end and of course you had to not be pregnant when you took it out.  Now the payout is less than $4000 for the same kind of deal- which is not nearly as good since it may take awhile to get pg while you are still paying the premiums.


The cost of a home birth varies a lot across the country.  Ours was about $3200 when it was all said and done.  More than half of that was in milage for our midwife to come to us and supplements.  Her actual birth fee was only $1500.  It was worth every penny.  The level of care is just nowhere near the same with a dr.  Our midwife has since raised her rates and it is still a great value.  


I will pm you with another idea....

Iowaorganic- mama to DD (1/5/06), DS1 (4/9/07), DS2 (1/22/09), DS3 (12/10/10), DD2 (7/6/12) and a new kid due in early 2014

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#4 of 7 Old 01-23-2012, 02:11 PM
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If you had a disability policy with Aflac, it would certainly cover the time you were off work after the birth. You would probably need to have a licensed health care provider sign that you actually had a baby and what the date was, but the disability portion has nothing to do with where you give birth. It's to cover loss of income after a medical event (in this case a birth). I had Aflac cover a portion of my prenatal care and birth with an unlicensed DEM in 2007 under a policy that paid out for medical visits and certain medical events (can't remember the name of the policy type anymore, sorry!). I believe you do have to subscribe to Aflac through an employer offered plan, but you can continue it if you leave the employer and pay the premiums directly.

Fledgling midwife on hiatus, Wife to B, mama to C (c/s ribboncesarean.gif 12/04) and S hbac.gif (12/07), angel3.gif m/c (3/12) and expecting another bean 6/13 stork-suprise.gif.

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#5 of 7 Old 01-23-2012, 03:04 PM - Thread Starter
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Yes but i am not currently working, so aflac is kind of out of the question for now.

Also, the other coverages clearly state "Hospital Confinement, Hospital Care, etc"....so they don't apply to "home birth"  :(


Any suggestions? Thanks!

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#6 of 7 Old 01-24-2012, 06:49 PM
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Hello.  I'm an independent AFLAC agent in MA.  Short-term disability will pay about 60% of your monthly salary when you are out on maternity leave---IF you've had the policy in effect for 10 months prior to the birth.  The premium paid is based on your salary and the waiting periods you select for coverage. If you are NOT working outside the home, it becomes a mute point. Most of the young women I have as clients opt for the 0/7 (waiting periods for accident 0 and illness 7) ), which has a higher premium.  if you'd like more info on how it works, please email me at jacquiemurphy@comcast.net.  AFLAC's claim form for initial disability requires a doctor/doctor's staff person to sign the paperwork verifying the birth and time out of work.  AFLAC pays 6 weeks vaginal birth; 8 weeks Cesarean---minus the elimination period, often 7 days.  AFLAC coverage is best offered through payroll deduction at work since you get the "group" rate.  AFLAC offers different policies/coverage in different states.  The most important thing to remember is AFLAC is a supplement to your major medical, but it is NOT medical insurance coverage as required by law in MA.  AFLAC pays YOU, not doctors or hospitals.  If you plan to do a complete home birth with no licensed medical practitioner present, it will get very complicated.  My daughter and I worked with a fabulous doula on the South Shore.  She came to the house and since my daughter wanted a 'water birth,' we headed to Jordan Hospital in Plymouth once the doula felt it was time to go.  We paid the doula directly for her incredible support, but BC/BS paid the "maternity bill" at Jordan, which was much less since the doula and the licensed midwife we worked with are not compensated the way a regular OB is.  Hope this helps.  Good luck!

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#7 of 7 Old 01-29-2012, 07:18 AM
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Best thing to do is contact some midwives you're considering directly and ask them how they've had the most luck being reimbursed.  Unfortunately, the possibility of reimbursement is more of an unlikely bonus than a certainty.


Is there a chance you can change insurance?  I think the only way you'll be able to get any reimbursement is with a PPO policy that allows you to see out of network providers, and then you'll have to make sure your policy does not specifically exclude homebirth.  Some older ones might not, but ones you would be issued now more likely would. 


Could you travel to NH to give birth at the Birth Cottage?  


I'm afraid the options are not very promising in MA  :(


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