Hi ladies. I just found out that my husband's company is switching from Premera to Aetna Jan 1st. Im due Jan 6th with my first baby. Of course Aetna does not cover my direct entry midwife that I've been with my whole pregnancy or my home birth. I'm kinda freaking out here.
There is NO WAY in HE77 Im changing care providers to a CNM (they dont cover DEMs but even if they didnt Im not changing anyway).
I'm not terribly worried about the Midwife's fee. If I have to pay the whole thing out of pocket it wouldnt be the worst thing that happened. Im pretty sure Premera is going to cover the predominance of the prenatal care since all but a week of my 40 weeks was on their plan.
What I am worried about is that if we HB and God forbid something happens and I have to transfer that Aetna will refuse to pay those fees because we had tried to HB.
I talked to my midwife and she said not to worry about it, but did confirm that Aetna was horrible and that I should do everything I can to not change to one of their plans.
Unfortunately that isnt an option.
Also, Im in WA state. Its so hard to get valid information but Ive heard that here in WA they have to provide access to every provider category. They have CNMs but no DEMs on their plans. Ive heard they have to cover my DEM at in network because they have no other options on their plan. The plan is not self insured. I've also heard that WA is one of the few states where Aetna will pay homebirth fees regardless of what they tell me on the phone. I've been careful not to give them my name and ask general questions.. we have also asked the broker who is no help whatsoever.
Can anyone share their experience with Aetna in WA? Or their experience with what would happen if I transfered while trying to do something they prohibit? Also, can anyone give any insite on how all this works when your pregnancy straddles a year like this? Optimally the baby will decide to make his or her arrival before the first of the year. I really feel like that is what is going to happen, but this whole thing has me rattled.
Thanks for any input you have and for letting me vent!