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#1 of 19 Old 02-13-2007, 09:53 AM - Thread Starter
 
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I was wondering if anyone has had united healthcare and if they reimbursed your homebirth at all?

thanks
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#2 of 19 Old 02-13-2007, 10:00 AM - Thread Starter
 
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#3 of 19 Old 02-13-2007, 01:17 PM
 
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Yes. They covered mine 100%

-Angela
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#4 of 19 Old 02-13-2007, 01:19 PM
 
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Yes. They covered mine 100%

-Angela
mine too... eventually

mama to DS born 9/7/05, DD born 8/20/07, DS born 9/4/10 and DS born 11/26/13


Loving our chaotic, crunchy, homeschooling life!
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#5 of 19 Old 02-13-2007, 03:23 PM
 
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: No, I have Horizon BCBS and they are not, I have a $5,000 deductible.
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#6 of 19 Old 02-13-2007, 03:31 PM
 
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We have united healthcare and are hoping that they will cover ours. I have heard generally that they are good about covering homebirths, but it depends on which policy your employer has chosen.

Unfortunately, the one that my husband's employer has chosen does not cover homebirth per se. We are going with a CNM (homebirth) but hoping that they will at least cover the prenatal fees. She works under a doctor, so at least any labs/tests will be covered. Although, we probably wont' really have many tests anyway. Regardless, we're going to submit and cross our fingers. We don't plan to ask them anything specific now. We'd rather wait until after the birth, so that they can see that there is no risk -- that everything went fine and that it was cheaper than a hospital birth. Of course, that means that we can't *count* on anything being covered.

I hope they'll cover your birth! Good luck!
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#7 of 19 Old 02-13-2007, 06:30 PM
 
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Most Unitedhealth Care policys cover for home birth. If it is not listed as a specific exclusion in your policy then you should be ok. Also if you claim gets denied, find out why, often it is just the wrong billing codes, something that is generally easy for fix. And you can always appeal anything if you feel it was denied incorectly. I know a lot about health insurance so if you have any specific questions PM me. I also made a list of questions everyone should ask their healthcare about maternity services that may be useful if you dont know what to ask. PM me if you want all that info.

Livin' surf.gif Laughin' lol.gif Lovin' joy.gif - Just Me and Sammers, my homebirthin' little girl. 

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#8 of 19 Old 02-13-2007, 06:43 PM
 
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MamaVolpe, I'm not the OP, but I would love any information you have that you'd be willing to share!
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#9 of 19 Old 02-13-2007, 06:50 PM
 
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MamaVolpe, I'm not the OP, but I would love any information you have that you'd be willing to share!
I would love your info as well- I bet there will be a lot of interest, if you're willing to post it that would be wonderful! Otherwise, I'd love it via pm : Thanks so much!
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#10 of 19 Old 02-14-2007, 05:08 PM
 
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Yep, 80%. My MW billed it as a series of office visits.
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#11 of 19 Old 02-15-2007, 12:21 AM
 
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We have UnitedHealthCare and they say they wont pay for my homebirth. At first they said they would but it would be out of network, and then they said the wouldn't because my midwife is a CPM, not a CNM. I expect it to be a huge pain in the rear, but I'm going to send them the bill anyway and then make a fuss once it's all over.
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#12 of 19 Old 02-15-2007, 11:16 AM - Thread Starter
 
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Marvelleaux the two midwives that will atten my birth are cmn and cpm so i suppose there is a way around that as far as title yes?
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#13 of 19 Old 02-15-2007, 11:19 AM
 
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I never called to ask anything. I just sent the statement my MW filled out after the birth, which had the fee on it. They sent me a check for 70% after deductible and I was happy with that that I didn't have to fight! I may try to code it differently next time to get them to cover more, but I was thrilled that it was to easy.

WAHMama to Allen (2-10-05) and Alexa (6-27-08)
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#14 of 19 Old 02-15-2007, 11:48 AM
 
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Marvelleaux the two midwives that will atten my birth are cmn and cpm so i suppose there is a way around that as far as title yes?
If you're having Certified Nurse-Midwife then I think your chances of getting covered are much better, but don't take my word for it. My midwife has had a lot of trouble getting payment from insurance companies (she is a CPM not CNM) so she makes it clear up front that clients should be prepared to pay the full cost themselves and anything that the insurance does pay for is reimbursed to the client.

If you want to know for *certain* (I still wouldn't trust what they say) whether your insurance will pay then you're going to need to get down and dirty and speak to a 'higher-up' in the chain of command. I don't believe most of the 800-number operators have experience with homebirth claims and are likely to give you mis-information, as I was. Your eligability depends on a lot of factors--your policy type, your state, your deductable, etc.

LianneM~ Was your midwife a CNM or a CPM?
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#15 of 19 Old 02-15-2007, 07:26 PM
 
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Below is my list of questions to ask your health insurance. This is for everybody not just homebirthers. If you have more specific questions about insurance feel free to ask me. I will give all the tips advice I have. I am thinking of making a Homebirth specific tips for insurance list. Would anyone be interested in something like that? PM me if you want.

Livin' surf.gif Laughin' lol.gif Lovin' joy.gif - Just Me and Sammers, my homebirthin' little girl. 

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#16 of 19 Old 02-15-2007, 07:46 PM
 
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?Questions to Ask?

Physician Visits
* What is my copay/coinsurance for maternity visits?
* Do I have a deductible to meet and how much is it?
* Do you cover for midwives and/or doulas? Copay/coinsurance?
* Is my provider in-network with my insurance plan?

Delivery
* What is my copay/coinsurance for my delivery?
* Do I have a deductible to meet and how much is it?
* What is my out of pocket maximum per year? How much have I met?
* Does my plan cover for a Birth Center and/or Homebirth?
* Is my chosen facility in-network with my plan?
* Does my delivery require a prior authorization or pre-notification?
* What is the length of stay cover for delivery? Vaginal and C-section?
* Can I have a nurse do a home visit if I leave the hospital early?

Additional Inquiries
* Does my plan cover for childbirth classes?
* Is their a maternity support program offered thru my plan?
* Is my child automatically covered for the first 30 days?
* Who do I need to contact to add my newborn on to my policy?
* How long do I have to enroll my newborn?

Livin' surf.gif Laughin' lol.gif Lovin' joy.gif - Just Me and Sammers, my homebirthin' little girl. 

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#17 of 19 Old 02-15-2007, 08:55 PM
 
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Home Birth Insurance Tips

Policy Tips
+ The first thing I would recommend doing when considering homebirth is to get a copy of your insurance policies EOC- Evidence Of Coverage booklet. This is the booklet that tells you everything about your policy. The first section to check it the exclusions, as long as home birth is not listed as a specific exclusion then you have a chance to get it covered. Also look to see if there are any restrictions under the maternity section as to who or where you can have services. Many times when you call to ask if homebirth is covered the call center agent does not know because it is not something most people as about. Since most women do not ask about it most insurances co. don’t write anything about homebirth into the policy. A lot of agents will not see any thing in the policy about it being covered so they will assume that it is not. But it has to be listed as an exclusion for them to deny. The lack of information on homebirth written in your policy will work to your advantage.

HMO, Network Tip
+ With and HMO policy you must use an In Network provider to be covered for any services. There is only one way that the policy will cover for an Out of Network and that is if an authorization is set up before the services are used. This is usually only done if there is no provider in your area that can do the same services. My tip would be to find out if there are any In Network midwives with in a 45-mile radius of your home. If not then request an exception to use your Out of Network midwife; if there are In Network providers then you are going to have to use one of them to get covered.

Facility Birth Work Around
+ Some policies only cover for services at a hospital or birth center and not homebirth. My tip would be to request an authorization to have the services at home. To do this you are going to need a reason for doing this that the insurance will accept. Some possible reasons would be if you had an immunity disorder or allergy that would make a hospital an unsafe environment to deliver in. You could also reason mental health reasons for delivering at home, such as panic, anxiety disorders or agoraphobia (fear of public places). You could also request the exception due to general safety of home vs. hospital birthing. For any of these reasons you are going to need documentation of your condition that requires the homebirth as well as documentation of the safety of home birth. It is best to gather all of this before you request the authorization. The more information you have the better. Insurance like per reviewed studies best as they hold the most weight in this type of request. Also if you have medical documentation of your condition, ex: medical records from allergist, immunologist, and mental health counselor are also things you would want to gather before submitting your request. Also if you do request the authorization and it gets denied don’t worry you can always appeal usually twice in house then you can appeal to the insurance commissioner for your state. The key is to get all the research and medical records to support your request.

Livin' surf.gif Laughin' lol.gif Lovin' joy.gif - Just Me and Sammers, my homebirthin' little girl. 

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#18 of 19 Old 02-15-2007, 09:01 PM
 
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+ The first thing I would recommend doing when considering homebirth is to get a copy of your insurance policies EOC- Evidence Of Coverage booklet.
Where does one get this? Company HR? Direct from the insurance co?

thanks!

-Angela
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#19 of 19 Old 02-15-2007, 09:29 PM
 
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You can usually get it either from your Benefits Administrator at your work place (Human Resorces) or some insurances will mail it directly it depends on the company. I would call the insurance first to see if they will send it directly to you if not than ask them to send it to your HR just in case they don't have it to hand at least they will get them in the mail soon. If they won't send it to you then ask your HR for a copy.

Livin' surf.gif Laughin' lol.gif Lovin' joy.gif - Just Me and Sammers, my homebirthin' little girl. 

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