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Discussion Starter · #1 ·
Dh just got a new job and we need to pick which type of insurance we want. Would they have the same coverage or could it be different? Are midwives ever in network? One is an HRA and one is a PPO (United Health Care) It's in Salt Lake City, if it helps. Thanks!
 

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you can call and ask if they cover licensed midwives or CPMs (certified professional midwives). this should cover some options in California. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
FWIW, I've been paid by United HealthCare three times. But, if it is United HealthCare as a Preferred Provider Option it could mean you only have a choice of a certain list of providers and this likely will NOT cover a homebirth midwife. The HRA may be a better option. I'd call them and ask about it.
 

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Discussion Starter · #3 ·
Thanks! I saw a long list of CNM's that are in the network, is it likely they do homebirths? I guess I could just call a few and ask. If we had a PPO would a midwife not even be out-of-network (that would atleast be 70%)?
 

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yeah, if it covers CNMs that do homebirth, that's a route. I've been paid by United Health as a non-preferred provider. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> So that's always the other option! I would just make sure what type of credentials are covered (CNM, CPM, LM) to offer you a variety of choices.
 

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Here in AZ, UHC PPO covers homebirth (definitely for CNM, maybe for others) as an out-of-network provider. My current coverage, UHC EPO (kind of like an HMO) does not cover it. However, two things to ponder. First, it would cost us more to carry the PPO coverage than it would to pay out of pocket (and be reimbursed or not by a tax-free savings account). Second, we're going to submit the paperwork to the UHC EPO anyways...you never know.
 

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With a PPO if their are no in network providers you can use you out of network benefits. Generally PPO's are easier to get coverage with because their are less restrictions. EX: dont need to use par providers, dont need to use par facilities, dont need to follow par guidelines.<br><br>
Many HMO's, that cover in network only, have rules such as Midwives are only covered if they deliver at a in network facility. That would leave you with the only homebirth option to be with an OB/GYN and I don't know of any that do homebirths. With PPO's you aren't required to follow that rule as the out of network providers aren't contracted with the insurance so the HMO can't dictate the location like they can with the in network ones.
 

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i see you are in the bay area, i'd give Peggy Vincent a call! have you read Baby Catcher by her? she's in Berkeley. it should be fairly easily to find a home birth midwife in the bay.<br><br>
the birth center i went to was in the network. it was ran by midwifes.<br><br>
i have blue cross blue shield PPO plan. i called them and asked them if they would cover <span style="text-decoration:underline;">insert midwife's name here</span> (i did not tell them it was for a home birth). they said she was out of network and we would have to pay a $300 out of network fee and that BCBS would pay 80% of her fee and we would pay the rest.
 

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Discussion Starter · #8 ·
I am currently in the bay area, but dh's job is in Salt Lake City, Utah, so we will be moving there soon. Thanks though! That's hopefully what we will be able to do, pay the deductible and then they cover most of it.
 

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In Utah, CNM's cannot attend homebirths. There is, however, a very active and thriving hb community here, and lots of wonderful midwives. I'm currently pregnant, and it will be interesting to see what if any of the homebirth we're planning will be covered. DH's insurance policy says it will cover liscensed midwives, but since the only mw's in network are CNM's, we are hoping to be covered at the out of network rate- 70%. Check the plans carefully- I never would have seen that distinction had I not been reading every line carefully.<br><br>
For the past two years, Utah has had a very friendly hb climate. However, there is a push on Capitol Hill this term to gut the midwife bill that passed two years ago, and pass a law that would essentially risk out 96% of homebirth clients. We are fighting it, and hopefully the bill will go down in flames in the next two weeks.
 
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