does anyone have any experience getting bcbstx to cover the cost of midwife care? i am in west texas and we only have 1 midwife within an hour and a half radius. i called a representative and she said that to be covered, the care provider would have to be listed as Advanced Practicing Nurse (APN). Does anyone know if this is true or if there is a way around this?
Welcome to mothering Stina! Just thought I'd bump your post up for input.
Have you joined a Mothering Due Date Club? You'll find them here: http://www.mothering.com/community/groups
I used this website: http://www.gentlebirth.org/archives/preApproval.html it has links at the bottom to example letters, processes, and understanding what you're doing. I have blue cross this time, so I don't know yet the process, but I was able to get a homebirth covered under United previously by a provider that was not in their list.
You can't get discouraged. It's a process...
Even though I live in Oregon we have BCBSTX. Weird, I know. We were able to get a portion of our CMP birth center birth paid for. We had to switch to a PPO, I think we paid, 40%, they paid 60%. Our midwives were the ones that submitted the paperwork. I'm pretty sure they would have paid for a homebirth because it was the same midwives/practice.
SAHM to DS BuggaBoo 12/07, and DD Doozer 03/10. Sharing life with The Hubby since 01/05.
It all depends on your specific plan, I believe. I currently have BCBSTX (in NJ/PA) and my plan doesn't cover midwives whatsoever so I had to pay for mine out of pocket. I plan to try to get reimbursed but I'm not optimistic after speaking to different representatives and supervisors at least 20 times and two submissions from my previous midwife being decline.