Homebirth, Flexible Spending Account and insurance

1140 Views 7 Replies 7 Participants Last post by meltf, Mar 9, 2007

meltf

Discussion Starter · Mar 9, 2007

Can I do this? I will be having a homebirth in GA, where technically homebirths are illegal. My midwives are certified in TN, so their bills may (or may not, still checking) have a TN address.

Can I submit my bills for to the FSA account for reimbursement? What about the cost of supplies (we're having a waterbirth) I need to find out ASAP b/c it will affect how much we put into the account significantly. DH just started a new job, so we are signing up now.

Also, I have Aetna insurance, has anyone been successful in getting them to reimburse for a homebirth? How do I go about doing that, my midwives don't deal with insurance, so it's all on me.

Thanks so much for any help!

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heathenmom

· #2 · Mar 9, 2007

I'm in GA too, and am currently going through this. I can't answer you RE the insurance question, because I have an HMO which has NO out-of-network coverage and specifically excludes coverage for midwives. However, I did include a chunk of money in my flexible spending account to help with the midwife's fees. It may vary according to the company that administers the plan, though. Best thing to do is call the customer service line for the plan administrator and ask them. That's what I did, and almost fell out of my chair when the guy said, "My wife & I had a homebirth and those costs absolutely qualify."

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pamamidwife

· #3 · Mar 9, 2007

I've had numerous payments that have gone through flexible spending accounts. Just have your mws give you an itemized statement. One thing, though:: Most FSAs only pay for services already rendered, so if you're paying in advance for your birth, you will have to wait until the services are completed to apply for reimbursement.

re: insurance, I've had Aetna pay twice, even though they say they don't pay for homebirth. Go figure!

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Yo Becca

· #4 · Mar 9, 2007

Considering FSA's pay for OTC meds (like tylenol) and contact solution, i would imagine they would definitely cover your HB supplies. But I would call and verify (you don't even have to say it's for a homebirth - they are all pretty unequivicobly medical supplies, but I would also hit them up for some herbs also

). Be sure to save all your receipts/invoices!

I think you'd have better luck getting your insurance to pay if the bills come from a state where they are legally recognized. My understanding is that if they state recognizes the midwives, you can push for payment from your insurance company (and it seems like if the MW is a legally recognized provider they are required to pay even if it's out-of-network). But here in GA and states like ours, HB midwives aren't legally recognized, so insurance companies won't pay - even if the same company would pay in another state. Don't take my word for anything though - ask your insurance folks.

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time4another

· #5 · Mar 9, 2007

Not in GA but wanted to mention something...

FSAs are a federally administrated program and its Uncle Sam that makes the rules on them.

So to answer your question. YES!!! you are eligible for FSA reimbursement with a HB for both the mw fees and the supplies. (do a google search)

With us, our HB cost as much as the FSA program allowed, so we diddn't claim any supplies with our FSA. We submitted everything at once and were reimbursed within 2 weeks! Unfortunatly our insurance won't pay for HB.

Heather

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pigpokey

· #6 · Mar 9, 2007

I submitted my GA hb mw bill to Aetna following their out of network claims protocol. They paid about 33% saying that I did not precertify. I submitted the rest to the flex account for reimbursement. This was in 2003.

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mwherbs

· #7 · Mar 9, 2007

DH had a flex spending account- and I have had clients with flex--- I don't like an itemized bill- just like the pharmacy bill we get it just says what would be covered by flex work does not get to know what you are buying just that it is covered-- as long as the services are paid for ahead of time- you can turn in your receipt that shows you paid an amount. my chiropractor payment has his business name on the top of the receipt and we just turn in a copy--
letter head or a receipt with business name will do--
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as for supplies--- err probably not flex excluded vitamins unless rx -last year-- ask your HR person how to turn in "home nursing supplies"as an expense-- and a for instance say chux , these seem very mainstream medical kwim--

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meltf

Discussion Starter · #8 · Mar 9, 2007

Thanks so much, so it sounds like I should max out my FSA account if possible. My "supplies" are for the waterbirth, so I doubt I can submit a receipt from Toys R Us and Petsmart for a pool and such, but that's ok it's minimal anyway.

Hopefully I can get some covered under my insurance, but knowing that it qualifies for FSA helps.

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