Mothering Forum banner

Does anyone have info about homebirth and HMO's??

785 Views 2 Replies 2 Participants Last post by  rubelin
We chose last year to discontinue our POS insurance because the cost was doubling. We have a wonderful family DR who is/was our primary cary physician, but we only have the option of one OB group (which happens to be out of one of the most C-sec happy hospitals in the country) We knew that the we wanted a homebirth for our next baby and that we'd have to pay out-of-pocket, but now I'm just wondering if there's anything we can do, any hope of maybe getting some reimbursement from our HMO? We're in CA and I'm not sure of the laws here, I jsut assume that there's nothing one can do if you have HMO insurance.

We used an OB for our first birth because we could not afford to pay out of pocket. It was one of the most horrific experiences of my life and I vowed never to set a pregnant foot in a hospital again. This baby will be born at home, I jsut wish we didn't have to go into major debt to do it.
1 - 3 of 3 Posts
Hi, Robin!

This has been my experience in getting my homebirths paid for. (I'm in MI and actually CA is much kinder insurance wise for homebirths. Your insurance laws kindly include homebirths.)

With my first I had Health Alliance Plan. They said that my midwife was out of network and would not pay for her. But, I had submitted a few $100 charges here and there and got them reimbersed 100%. I ended up having to pay all but $200 out of pocket. I then, proceeded to write letters, make phone calls, etc for a whole year and managed to get them to pay for 100% of the birth around my son's 1 year Birthday. The way they paid, is I kept repeating, "If you didn't pay for the $200, I would have discontinued services with my care provider, but I was under the impression, you were going to cover my care 100%." Also, they were never billed for the birth, but rather prenatal care. They liked that better, since they don't believe birth takes place outside of hospitals.

With this pregnancy I have Blue Cross/ Blue Shield Empire Blue PPO. They will cover 80% of out of network care after I have paid the first $250 out of pocket. That's a drastic savings. Yeah! I'm happy. They seem to jerk me around less than my old insurance.

Now, since you babe is due next year, your other option is to switch insurances if your current one is unfriendly. Your midwife might even be willing to not bill you until 2004, so all the care would appear on your new insurance, not your old one. I think you have options besides paying for it all. You may have to wait to be reimbersed and be diligent, but in my experience, you will get paid (at least some) back.

Best wishes! And, I'm so glad that you're expecting a little one! I love to see our Nursing Mama's graduates! Yeah!
See less See more
Thanx for the info, Claire (and it is so good to be over here!!) Changing insurance is not an option, the increased costs would be more over time than paying for the midwife. I suppose I should probably wait until I meet with her anyway, she might actually know something
See less See more
1 - 3 of 3 Posts