Home birth and insurance in Florida - Mothering Forums

Forum Jump: 
 
Thread Tools
#1 of 20 Old 03-22-2009, 05:46 PM - Thread Starter
 
jenfl's Avatar
 
Join Date: Oct 2007
Location: Central Florida
Posts: 2,000
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
After a fabulous (non-reimbursed) home birth in California, my husband and I would like to do another home birth if we have another child here in Florida. I know that Florida law requires insurance companies to pay for midwives and home birth... unless the company providing the insurance is self-insured. And we're under a self-insurance plan (Healthchoice from Orlando Health).

Anyone want to share stories of how your fight to get your home birth covered went?

Thanks!

Jen, former sys admin and current geek , wife to DH , SAHM and Montessori homeschool teacher to DD "Nugget" (05/07) and new arrival DS "Sprout" (03/31/10)
jenfl is offline  
Sponsored Links
Advertisement
 
#2 of 20 Old 03-24-2009, 04:51 PM
 
purplevega's Avatar
 
Join Date: Apr 2005
Location: South Florida
Posts: 269
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I have private health insurance with blue cross. They did not pay a dime. I did have the option to add maternity coverage for about $150 a month. It was not worth it for me. My midwife took cash and gave me a discount for it. It worked out cheaper to self pay then to pay insurance.

Kim

Mama to 2 Boys...Nurse and IBCLC to the rest of the world!

www.BosomBabiesLactationServices.com

purplevega is offline  
#3 of 20 Old 03-30-2009, 12:30 AM
 
1hautemama's Avatar
 
Join Date: Mar 2006
Location: here
Posts: 383
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Where in S. FL are you? I know a midwife who can work either way for you since she is a CNM but also does homebirths. Best of luck t you momma:
1hautemama is offline  
#4 of 20 Old 03-30-2009, 12:39 AM
 
1hautemama's Avatar
 
Join Date: Mar 2006
Location: here
Posts: 383
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Sorry to go off topic BUT: I should also add that I chose to go unassisted VBAC bc the Docs in our area do not attend or support VBAC, and the local midwives have their hands tied behind their backs legally to attend out of hosp vbac. However in this neck of the woods we are fortunate to have an MD who is supportive of natural pregnancy/childbirth/and all around pro-mom-pro-baby care. If you wish to know more just PM me and I'll point you in the right direction.
1hautemama is offline  
#5 of 20 Old 04-02-2009, 01:14 AM
 
Hallielynn01's Avatar
 
Join Date: Sep 2007
Location: Clearwater, FL
Posts: 589
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
not a fight story, but I'll toss the insurers who were helpful out- I had cigna then switched to united and I didn't pay a dime for our homebirth

mom to Reaghan born underwater into midwife's hands 1/17/07 & Myra born surrounded by doulas and midwife at home 1/12/09. Birth Educator, and Photographer, Baby #3 Coming May 2013!

Hallielynn01 is offline  
#6 of 20 Old 04-02-2009, 12:08 PM
 
ErikaG's Avatar
 
Join Date: Nov 2005
Location: Apopka, Florida
Posts: 662
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Hallielynn01 View Post
not a fight story, but I'll toss the insurers who were helpful out- I had cigna then switched to united and I didn't pay a dime for our homebirth
United covered your whole homebirth? That's really great to hear. I'm hoping that if/when there's a next time I don't risk out of homebirth and I have United. The midwife we interviewed mentioned that she's had trouble with United before, and we've been putting some money aside in case it does happen that we have a significant portion of the birth to pay for.

Were there any hoops to jump through, or anything? Or did you/your midwife just submit the claim and they paid it?
ErikaG is offline  
#7 of 20 Old 04-04-2009, 12:43 AM
 
CanidFL's Avatar
 
Join Date: Jul 2007
Posts: 3,027
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
I had BCBS through my work and they said my midwife was out of network, which she was but they did not have a homebirth midwife in network. Soooo I sued them and got the fee covered 100% plus all the court costs.
CanidFL is offline  
#8 of 20 Old 04-04-2009, 12:59 AM
 
ErikaG's Avatar
 
Join Date: Nov 2005
Location: Apopka, Florida
Posts: 662
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by CanidFL View Post
I had BCBS through my work and they said my midwife was out of network, which she was but they did not have a homebirth midwife in network. Soooo I sued them and got the fee covered 100% plus all the court costs.
Can I ask who your midwife was?
ErikaG is offline  
#9 of 20 Old 04-27-2009, 08:10 PM
 
FLPanther's Avatar
 
Join Date: Jun 2008
Posts: 38
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yes, Florida law requires all healthcare insurers licensed in the state to pay for home births. If a licensed midwife attends the birth, she is a legal maternity provider. Here's a link to the Florida Statutes:
http://www.leg.state.fl.us/statutes/...27/Sec6574.HTM
See especially Section 7.
Please note that the law does not apply to Tricare dependents (Tricare is not a state licensed provider, but a federal one).
FLPanther is offline  
#10 of 20 Old 04-28-2009, 12:53 AM
 
Hallielynn01's Avatar
 
Join Date: Sep 2007
Location: Clearwater, FL
Posts: 589
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ErikaG View Post
United covered your whole homebirth? That's really great to hear. I'm hoping that if/when there's a next time I don't risk out of homebirth and I have United. The midwife we interviewed mentioned that she's had trouble with United before, and we've been putting some money aside in case it does happen that we have a significant portion of the birth to pay for.

Were there any hoops to jump through, or anything? Or did you/your midwife just submit the claim and they paid it?

As far as I know that's all they did. I'm not sure if United has different types of plans or not, I know this plan (we had to switch because DHs employer was dropping cigna and it was the most like the cigna plan we had). But we just got a statement showing recent actitivy,and it showed the charges from the birth center and showed us not owing anything. So....looks like its all said and done now. Some insurance we looked at it was gonna be an 80/20 (since it was being concidered out of network, or outpatient, or something that seemed rediculous), but still.... thats better than complete out of pocket

mom to Reaghan born underwater into midwife's hands 1/17/07 & Myra born surrounded by doulas and midwife at home 1/12/09. Birth Educator, and Photographer, Baby #3 Coming May 2013!

Hallielynn01 is offline  
#11 of 20 Old 05-11-2011, 02:11 PM
 
ralphyl44's Avatar
 
Join Date: May 2011
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I know this is a few years after the last post was posted, but when y'all are talking about FL insurance having to cover home births, is that only IF you have maternity coverage?

ralphyl44 is offline  
#12 of 20 Old 07-12-2011, 12:40 PM
 
gnvdude's Avatar
 
Join Date: Jul 2011
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I hope this email finds you.

 

You mention you sued and won against BCBS. Can I ask who your lawyer was ?

 

We are expereriencing the same thing as you, and hiring your lawyer might be the easy button.

 

Thank you.

gnvdude is offline  
#13 of 20 Old 07-16-2011, 07:41 PM
 
mtrand2's Avatar
 
Join Date: Sep 2008
Posts: 16
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

lurk.gif

(very interested in this thread! I'm a 2 time HBAC newly looking for someone in SWFL and I can't afford to pay homebirth out of pocket!)

mtrand2 is offline  
#14 of 20 Old 08-18-2011, 07:13 PM
 
jamebaby's Avatar
 
Join Date: Apr 2011
Posts: 5
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Don't know how relevant this is for any of the previous posters, but I thought I'd add my experience here. I have AvMed, called before I was preggo to ask if they cover homebirths, they said they did, so I decided not to switch insurance companies. Of course, it was more complicated than that. After getting pregnant, I met a midwife that I liked, but her billing service said that she would be considered out of network and that because our plan was a PPO it was unlikely that we would be able to get her covered as in-network. It would end up being about $3200 out of pocket instead of about $1100. I prepared for a fight since there are no in-network homebirth midwives on our plan, but after a little more digging found that there is a nearby birth center that is in network, and the midwives there will also attend homebirths and are able to bill through the birth center and get it covered in-network!

 

Just an idea for anyone who's unsure of what to try next...

 

Also, keep in mind that our hospital birth (completely uncomplicated, no meds) that was "covered" still ended up costing us about $2500 out of pocket, so the expense might not be as different as you think.

jamebaby is offline  
#15 of 20 Old 08-23-2011, 10:44 AM
 
AtomHeartMother's Avatar
 
Join Date: Jul 2011
Location: jacksonville, florida
Posts: 16
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

depending on your household income, i would strongly suggest applying for pregnancy medicaid if you're insurance isn't covering your desire to have a home birth or if you don't have maternity coverage. florida medicaid will pay for a midwife (lm or cnm), whether in a birthing center or at home. as long as the midwife you've chosen will accept the medicaid, you'll be good to go. if you're approved for the program, your medicaid counselor/"momcare adviser" will be able to refer you to local midwives that'll accept the medicaid and are certified by the state to do so. i work as a "momcare adviser" and refer women to our local midwifery all the time (i'm also a client and pregnancy medicaid recipient). if anyone has questions about this, i'm happy to answer anything off list. :)


first time mama-to-be, due sometime in the last half of october. avid smart ass, trivia player, roller derby official, aspiring political hack, and android addict.

AtomHeartMother is offline  
#16 of 20 Old 08-30-2012, 11:15 AM
 
Dmoore's Avatar
 
Join Date: Aug 2012
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I would love more information! I actually have health insurance, but they say they won't cover a homebirth. (even though they are far cheaper) While I don't make much money since I work part time, my boyfriend and father to our 2 year old makes around $40,000 a year. I don't think I would qualify. Help!

Oh! And we live in Orlando, FL

Dmoore is offline  
#17 of 20 Old 10-28-2012, 09:53 AM
 
GenKCM's Avatar
 
Join Date: Oct 2012
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Hi!

 

This is an older thread, but any information you can share about your experience with BCBS in Florida would be greatly appreciated! They paid for our claim at the Medicaid level, which amounts to 1/3 of the cost. I think they have pulled a number out of a hat and I pan to challenge them on this (appeals have been submitted, I am speaking with a lawyer)!

GenKCM is offline  
#18 of 20 Old 04-15-2013, 11:00 AM
 
aurorabudora's Avatar
 
Join Date: Apr 2013
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Hi, I know you posted this awhile back. I wanted to know who your lawyer was? We are just trying to get an in-network exception for our midwife and are having a hard time just with that. But we are fighters and we will do what ever it takes. Any help would be greatly appreciated. Thanks Aurora

aurorabudora is offline  
#19 of 20 Old 07-16-2014, 03:53 PM
 
Join Date: Jul 2014
Posts: 2
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Homebirth insurance info requested...

Hello,

I am in Pensacola area and just got off the phone with our ins carrier BCBS of Florida. They do not have any Homebirth Midwives in their in-network plan, so everyone is out of network, which is subject to out of network deductible and only covered at 50%. I saw that someone sued BCBS and won! Any idea if there are any loopholes in this, or chances of me fighting it for full coverage?

Thanks,
Mama of 9
Mama of 9 is offline  
#20 of 20 Old 07-16-2014, 03:59 PM
 
Join Date: Jul 2014
Posts: 2
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by CanidFL View Post
I had BCBS through my work and they said my midwife was out of network, which she was but they did not have a homebirth midwife in network. Soooo I sued them and got the fee covered 100% plus all the court costs.
Hello,

I am in the Pensacola area and just got off the phone with our ins carrier BCBS of Florida. They do not have any Homebirth Midwives in their in-network plan, so everyone is out of network, which is subject to out of network deductible and only covered at 50%.You said you sued BCBS and won! (Congrats!) Any idea if there are any loopholes in this, or chances of me fighting it for full coverage? Who was your lawyer?

Thanks,
Lora
Mama of 9 is offline  
Reply

User Tag List



Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off