I just got a check from the insurance company! - Mothering Forums

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#1 of 19 Old 02-06-2007, 07:37 PM - Thread Starter
 
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We paid $3,000 out of pocked to our homebirth midwives (worth every penny) and our baby was born Jan 1st of 2006 (so is over a year now). Finally in Dec I got the forms ready for both insurance companies (we got a new company the first of the year, so some was billed to each).

Blue Cross/Blue Shield we had in 2005, and they said they would pay 70%. Some got billed to them, and we haven't heard back yet so very well may get a check from them.

Aetna, who we had starting 2006, said absolutely not, they wouldn't pay a cent. Well they just coughed $1,400!!!

The rest of the good news is, now I'm pg again, going with the same wonderful midwife, and have Aetna this year as well. If they paid before, they will probably pay for this upcoming birth as well!

I hope the rest of you are as lucky! Just goes to show you, even if the company claims they won't pay, submit anyways, you just never know!

~Tracy

Rockin' mama to Allison (9), Asher (5) and Alethea (3), head over heels in love with my sexy husband, Tony.

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#2 of 19 Old 02-06-2007, 07:49 PM
 
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That's great news! I have Aetna too. Since I was planning on getting nothing back, anything is icing!
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#3 of 19 Old 02-06-2007, 08:18 PM
 
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Woo hoo!

I am hoping I'll be able to squeeze s.t. out of my company too... not holding my breath though...

Mama to my spirited J, and L, my homebirth: baby especially DTaP, MMR (family vax injuries)
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#4 of 19 Old 02-06-2007, 08:42 PM
 
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Hooray! That is fantastic news! We live in MN too and have BC/BS--fingers are crossed to see how much they will pay because they have a strict "we don't pay for homebirths" policy. (The customer service rep was absolutely incredulous and said "So you mean you're NOT going to have your baby in a hospital?" Yeah, that's the general idea with a HOMEbirth, genius!)

Congratulations!!!

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#5 of 19 Old 02-06-2007, 11:13 PM
 
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I have Aetna and I am planning a HBAC in June. What all did you do to get reimbursed? Thanks!
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#6 of 19 Old 02-07-2007, 10:09 AM
 
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wow, that's great!

mama  to 3 farmboys (, & ) and 1 farmgirl ()
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#7 of 19 Old 02-07-2007, 07:56 PM - Thread Starter
 
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jennyfah, when we first inquired to blue cross/blue shield they said no way. When I called another time, I was told yes.

My impression is it is sort of a gamble. Like it depends on whose desk your claim ends up on. You need to try, you never know!

My midwife uses a service that bills for these types of things. We had the option of having them bill just an initial bill for one appt for free, and seeing what happens, or having them do all the work of billing everything and we pay the services $100. Well, obviously it was well worth it, we are still up $1,300, plus whatever the other insurance company pays.

My midwife said she has had plenty of clients get paid by Aetna, so she doesn't understand why they get all up tight on the phone.

The service my midwife uses (maybe anyone can use them?) is:

http://www.larsenbilling.com/

Larsen Billing Service, LLC ~ 223 S. Ridge Hollow Circle ~ Smithfield, UT 84335 ~ Fax (435) 563-5028
Any questions about the verification process, please call Mary at (435) 723-4455

~Tracy

Rockin' mama to Allison (9), Asher (5) and Alethea (3), head over heels in love with my sexy husband, Tony.

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#8 of 19 Old 02-08-2007, 02:44 AM
 
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We got 100% reimbursement from Aetna, after they told us by phone that they would not pay a dime.

I just sent in the invoice from the mid-wives with a very brief cover letter.

I jumped for joy when we got our check in the mail. I was shocked! Congrats! I know how good it feels.
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#9 of 19 Old 02-09-2007, 12:54 PM
 
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I guess this wasn't something I had thought about. I always thought I would have to pay out of pocket for a homebirth. I now know I have options.
Thanks to the person that started this thread!

Kristen, married to Dh since 1995, Mom of 4 hatchlings chicken3.gif
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#10 of 19 Old 02-09-2007, 01:05 PM
 
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My last homebirth was covered by my insuranse. THey just treated it like an out of network healthcare treatment.
My current insurance actually states in our policy book that it will not cover homebirths or birth centers. I think its totally dumb since that saves them so much money over hospital births.
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#11 of 19 Old 02-10-2007, 01:42 AM
 
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Quote:
We got 100% reimbursement from Aetna, after they told us by phone that they would not pay a dime.

I just sent in the invoice from the mid-wives with a very brief cover letter.

I jumped for joy when we got our check in the mail. I was shocked! Congrats! I know how good it feels.


Would it be possible to find out what your midwife wrote in the cover letter? And who did you send it into/what addy? We have Aetna too but didn't even think of sending an invoice since hb is not technically legal in Georgia.

Ellie
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#12 of 19 Old 02-10-2007, 02:05 AM
 
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Ellie,

I pm'ed you the address and the letter that I wrote to accompany the invoice. Also, I forgot that I filled out the medical claim form that is on the Aetna website:


http://www.aetna.com/data/forms_library/gc-7.pdf

Let me know if you have more questions.
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#13 of 19 Old 02-10-2007, 08:11 PM
 
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Tracy,

That is great news about calling BC/BS---I did get the feeling that the person I talked to didn't really know what she was talking about.

And my midwife uses the same billing service! (Maybe we have the same midwife??) She said she's had pretty good luck with BC/BS paying for at least something because they are a "fee for service provider" (not sure what that means). She has had really good luck getting Medica to pay for homebirth, so if anyone in MN has Medica, that's good news for you. . .

Again, congrats, and here's hoping you get more checks in the mail!!
Jen

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#14 of 19 Old 02-11-2007, 01:13 PM
 
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Well this gives me hope. We also hae BC/BS. My midwife only charges $1,200 but it's still a lot for us. I will definitely be billing them and hoping.
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#15 of 19 Old 02-11-2007, 01:26 PM
 
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Something else to consider is setting aside money in a flexible spending account through your employer. We have BCBS HMO -- zero out-of-network coverage and my mw isn't an in-network provider. I called the company who administers my flexible spending account to ask if her fees would meet their qualifications. The guy I spoke to told me he & his wife had a hb for their baby (SHOCK!!!) and whatever wasn't covered by insurance would certainly qualify. So, while it's not nearly as awesome as having insurance cover it, it is really helping us to be able to spread the (tax-free) "payments" out over the whole year.

hippie.gif+reading.gif= Peanut (2004), Pumpkin (2007) and Butter Bean!! (2011)

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#16 of 19 Old 02-11-2007, 01:34 PM
 
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Quote:
Originally Posted by risen_joy View Post

Would it be possible to find out what your midwife wrote in the cover letter? And who did you send it into/what addy? We have Aetna too but didn't even think of sending an invoice since hb is not technically legal in Georgia.

Ellie
No cover letter, just call Aetna and ask where the out of network claim form is. Follow instructions. No guarentees.
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#17 of 19 Old 02-11-2007, 11:42 PM
 
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Hooray!! I'm so excited at just the POSSIBILITY of getting ANYTHING back for the hb!!!
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#18 of 19 Old 02-12-2007, 03:41 AM
 
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I know ca is sometimes different than other states but I was able to not only get blue cross of ca to pay but also to pay as if midwife was in network. I simply stated that they didn't have a midwife in 30 mile radius that would do homebirth and that I "had to have a homebirth". they eventually said that they would give me an in network excemption for the midwife of my choice. Bad part is that it was only for three months so a week before my due date I have to call and get an extension. they said wouldn't make for longer because "at that time we may have someone in-network" I guffawed and said and you would expect me to change mid wifes a week before birth?!! they said yes, but you could appeal decision. thankfully I feel sure that noone will suddenly appear in network.
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#19 of 19 Old 02-12-2007, 06:27 PM
 
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Quote:
Originally Posted by nakagain View Post
My last homebirth was covered by my insuranse. THey just treated it like an out of network healthcare treatment.
My current insurance actually states in our policy book that it will not cover homebirths or birth centers. I think its totally dumb since that saves them so much money over hospital births.
Ah, yes, but think about how much money they save if they don't have to pay for the birth at all by saying they don't cover it and then denying your claim on those grounds.

Maternity care is a sizeable chunk of what the insurance pays out each year for an otherwise healthy population that doesn't visit the doctor much.

Wife, mother, midwife, triathlete
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