Blue Cross Blue Shield covering Homebirth - Mothering Forums

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#1 of 5 Old 07-06-2013, 08:23 AM - Thread Starter
 
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We have Blue Cross Blue  Shield of Michigan (even though we live in Texas) and are trying to get a homebirth covered. Does anyone have experience or success having their homebirth covered - even partially?

 

Thanks!

Kim                                                                                                                                                                            


Kim, Mama to 4 and 1 more on the way!
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#2 of 5 Old 07-07-2013, 07:17 PM
 
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Yes. They only cover CNM's though. And pinning them down was tough...I got a lot of different answers and for one birth we owed almost $1000 and the other they paid 100%. They are frustrating for sure.

Amanda, wife to A , mama to D ('05), O ('07), and W ('10)
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#3 of 5 Old 07-07-2013, 07:57 PM - Thread Starter
 
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This is good to know. My CPM works with a CNM so we can bill through her. The billing lady tried to tell me they would only cover it if I were in the hospital with a CNM. We're you at home when yours was covered?

Kim, Mama to 4 and 1 more on the way!
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#4 of 5 Old 07-08-2013, 05:42 AM
 
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You need to know what the policy is between the local units of BCBS. My practice (CNM) is in Michigan. When I have a client with BCBS from any other state, the bill goes first to the local unit (MI). If they have an agreement with the unit where you reside, then they pay the bill based on that agreement. If they don't have an agreement, the bill is then forwarded by  BCBS Michigan to Texas BCBS and they pay it.

 

Yes, it's all very complicated and a PITA.

 

Specific rules for MI: the provider can be participating (in network) or non-participating, but must be licensed. They usually don't pay for the birth kit supplies or for tub rental/hydrotherapy. Michigan BCBS does seem to pay about 2/3 or a bit better for what we bill, but it's helpful to have access to their fee schedule of "usual and customary". That will tell you how much they will pay.

 

Your CNM should have a billing person who can give you more specific about the insurance.
 


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#5 of 5 Old 07-08-2013, 05:53 AM
 
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Quote:
Originally Posted by ksjhwkr View Post

This is good to know. My CPM works with a CNM so we can bill through her. The billing lady tried to tell me they would only cover it if I were in the hospital with a CNM. We're you at home when yours was covered?


Yes, I was.  That's my midwife who answered above this.  :)  Much better info than I could've given.  Insurance is such a pain to deal with.


Amanda, wife to A , mama to D ('05), O ('07), and W ('10)
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