Blue Cross Blue Shield MI midwife/birth ctr coverage - Mothering Forums

Forum Jump: 
 
Thread Tools
#1 of 13 Old 12-19-2010, 05:45 PM - Thread Starter
 
carrie79's Avatar
 
Join Date: Dec 2010
Posts: 4
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Just want to see if anyone with this insurance was able to get their midwife and/ or birth center covered.  I only have access to CPMs in my area, no CNMs, and only one birth center I'm willing to go to.

 

Thanks!

carrie79 is offline  
#2 of 13 Old 12-19-2010, 05:57 PM
 
shelleyd's Avatar
 
Join Date: Jul 2005
Posts: 892
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I wasn't able to get BCBS to pay for my midwife in Nov 2008.  Dh's employer switched our insurance when I was 8m pregnant with no warning from HAP to BCBS.  HAP did pay my midwife when I had my first dd in Dec 2005.  I wasn't real happy with BCBS or my husband's employer.

 

Good luck.

shelleyd is offline  
#3 of 13 Old 12-19-2010, 10:15 PM
 
Thandiwe's Avatar
 
Join Date: May 2007
Location: Where the wild things are...
Posts: 2,017
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I have never been able to get them to cover my births, but the thing is, the coverage in hospital (for us) would have cost more than what I paid out of pocket for waaaaay better care by m/w and a homebirth.  It was worth paying (and I would have paid that much and then some with deductibles and copays) cash and having a phenomenal birth (two homebirths).  I personally don't know anyone who's had their homebirth covered by bc/bs.  Good luck if you try though!!


 

joy.gif Wife to  geek.gif,  mama to  reading.gif,   guitar.gif, fly-by-nursing1.gif, and thumbsuck.gif - bonus mommy to  loveeyes.gif!  homebirth.jpghomeschool.gifnovaxnocirc.gif

Thandiwe is offline  
#4 of 13 Old 12-20-2010, 05:52 AM - Thread Starter
 
carrie79's Avatar
 
Join Date: Dec 2010
Posts: 4
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

BCBS will cover my care and delivery with my OB 100%.  So I can't say it's going to be cheaper with a m/w out of pocket, it'll be a whole lot more money.

carrie79 is offline  
#5 of 13 Old 12-20-2010, 09:27 AM
 
zenmumajen's Avatar
 
Join Date: Dec 2010
Location: SE Michigan
Posts: 149
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Hi! I was able to get coverage for my CNM with BCBS...I live near Flint though. This was also a hospital birth...


 Doula mom to Leo [7.11.10] and fiance to Jakefamilybed1.gif

zenmumajen is offline  
#6 of 13 Old 12-20-2010, 12:36 PM
 
Thandiwe's Avatar
 
Join Date: May 2007
Location: Where the wild things are...
Posts: 2,017
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Good luck!  Our bc/bs plan does cover CNM's in hospital, also, but it's in hospital only.


 

joy.gif Wife to  geek.gif,  mama to  reading.gif,   guitar.gif, fly-by-nursing1.gif, and thumbsuck.gif - bonus mommy to  loveeyes.gif!  homebirth.jpghomeschool.gifnovaxnocirc.gif

Thandiwe is offline  
#7 of 13 Old 12-20-2010, 12:52 PM
 
lynsage's Avatar
 
Join Date: Jul 2004
Posts: 1,244
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

We live in the Ann Arbor area and have BCBS PPO and had to pay our HB CPM out of pocket. I don't know of anyone who has had an out-of-hospital birth covered by BCBS and our CPM said she has never had any success with clients trying to bill them after the fact.

 

Our paperwork says BCBS MI HMO covers in-hospital birth 100 percent, PPO in-network is 90 percent after co-pay and out-of-network is 70 percent after co-pay. So you might have some out-of-network CNM options, maaaybe. Definitely call around and ask providers if they take your plan, though- we were just looking for a chiro and the one we chose was not on their website, but we called and checked and it turned out they do take our plan.

lynsage is offline  
#8 of 13 Old 01-11-2011, 10:46 AM
 
mothercat's Avatar
 
Join Date: Mar 2006
Location: SE MI
Posts: 1,170
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I think my situation is unique among home birth midwives. I participate with BCBSM and they are currently paying about $3K toward the total cost for a home birth.

Catch is, as far as I know, that the provider has to be a CNM or physician and be participating with BCBSM.

Payment has been better since I went from "registered, but not participating" to "participating". I know that there are other CNMs that are trying to get at least registered and are not having any luck. I'm pretty sure that the midwives at Greenhouse in Okemos have their clients with BCBSM pay them up front, then give them a superbill, and the client gets at least partial reimbursement from BCBSM after submutting the superbill. For a while they clients had a support group that was working with BCBSM to make this simpler.

 

BCBSM won't register or allow participation by unlicensed providers so I don't think that any of the CPMs can receive payment, nor can their clients, as the midwife needs a BCBSM provider # to put on the claim for it to be processed.

 

Not sure if it's still true but BCBSM was one of the few insurance companies that has an inclusion clause. That meant that if the employer wanted midwifery services, CNM, CPM, DEM, whatever, included in the plan, they had to specifically request it. All the other insurance companies had exclusion clauses. Midwives were included by default and could only be excluded by employer request.


Wife, mother, midwife, triathlete
mothercat is offline  
#9 of 13 Old 01-14-2011, 11:25 AM
 
whippet99's Avatar
 
Join Date: Aug 2007
Location: Suburbs of Detroit
Posts: 31
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I was able to get reimbursement for about half the out-of-pocket costs from my prenatal, home birth and postpartum care. We have BCBS Community Blue PPO. My midwife submitted the forms with the appropriate codes for me after the birth (2/09), and about 2 months later I got a check in the mail. I was not expecting to get anything, but decided to try... Glad I did!! BCBS had to pay out several thousand dollars more for my maternal care the first time I birthed, so it was a great deal for them the second time too!

Good luck to everyone submitting to insurance...

whippet99 is offline  
#10 of 13 Old 01-15-2011, 05:37 PM
 
Thparkly's Avatar
 
Join Date: Jan 2011
Posts: 64
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I also have BCBS and called them to ask what their rules are for birth centers. They said I have to get an "authorization request " from the birth center, which to me sounded like they will cover it if somebody fights hard enough for it. But in the end I decided on a hospital that has midwoves and has a super good rep with all the doulas I talked to about this, so I can be sure it is insured.  I don't think midwives are an issue if they are catching at an approved 'location', but to be sure get it documented and have the midwife assist since they will be the experts on that topic.

Thparkly is offline  
#11 of 13 Old 11-15-2012, 07:40 AM
 
handfulofblessi's Avatar
 
Join Date: Nov 2012
Posts: 1
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

@Mothercat

 

Are you still practicing in Michigan and participating with BCBSM?  If so, where are you located?

handfulofblessi is offline  
#12 of 13 Old 11-15-2012, 12:04 PM
 
Rodeo Mama's Avatar
 
Join Date: Sep 2006
Location: Michigan
Posts: 264
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Here's the website:  http://mothersownbirth.com/home/

The birth center is in Temperance.


Amanda, wife to A , mama to D ('05), O ('07), and W ('10)
Rodeo Mama is offline  
#13 of 13 Old 11-16-2012, 05:23 AM
 
mothercat's Avatar
 
Join Date: Mar 2006
Location: SE MI
Posts: 1,170
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Thanks Amanda.

Yes, still in practice.
 


Wife, mother, midwife, triathlete
mothercat is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may 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